Elizabeth a krupinski phd arizona telemedicine program
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Elizabeth A. Krupinski, PhD Arizona Telemedicine Program. Reception center staff evaluates each inmate on substance abuse , education, mental health , and medical . Initial classification for placement in state institution conducted and finalized prior to movement.

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Elizabeth a krupinski phd arizona telemedicine program

Elizabeth A. Krupinski, PhD

Arizona Telemedicine Program


  • Reception center staff evaluates each inmate on substance abuse, education, mental health, and medical. Initial classification for placement in state institution conducted and finalized prior to movement.

  • Inmate may be held at reception center for > 10 days if inmate has special medical needs or other special circumstances such as pending extradition.


  • 1 to 5 scoring system. Most important factors that determine final score & placement are public risk, institutional risk & medical needs.

  • Scores establish custody level & need for specific services such as medical, mental health, substance abuse or sex offense treatment, and program needs including education, vocation training & work skills.

  • Relocation based on bed availability in appropriate custody level & medical rating of inmate and facility.


  • Comprehensive final score & placement are public risk, institutional risk & medical, dental, & mental health services considered medically necessary.

  • Ongoing treatment by licensed professional (physicians, PAs, NPs) plus nurses, lab technicians, pharmacists, radiology techs. All phases dentistry including oral surg & restorative. Mental health assessment, crisis management, & therapy.

  • Emergencies facilitated through area hospitals. Specialty services provided through contracts with Board eligible or Board certified specialists in community by direct contact or video conferencing & telemedicine.


  • If inmate requests medical attention may submit written Health Needs Request (HNR) to Medical Unit. Request reviewed & inmate scheduled if necessary. If request urgent or life threatening, inmate seen immediately.

  • All medical information is considered privileged and highly confidential.


  • Health care recommended & provided at local facility level Health Needs Request (HNR) to Medical Unit. Request reviewed & inmate scheduled if necessary. If request urgent or life threatening, inmate seen immediately. by local providers. If specialty services/consultation recommended, request forwarded to Health Services Central Office.

  • Only procedures/treatments considered absolutely medically necessary considered for approval. Cosmetic or elective in nature will not be approved. Final determination for any treatment plan decision of AZ DoC medical staff.


  • Charge up to $5.00 when scheduled after submitting HNR, or on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.

  • Prescription medications supplied as necessary. Certain OTC medications (ibuprofen or multi-vitamins) available at inmate store.


St mary s hospital
St. Mary’s Hospital on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.

  • Carondelet Health Network Southern AZ’s oldest & largest non-profit HC provider.

    • Heart and Vascular

    • Neurology and Neurosurgery

    • Women’s Care Services

    • Orthopedics and Rehabilitation

    • Burn and Wound

    • American Diabetes Association Recognized Diabetes Care Centers

    • Hospice and Palliative Care

    • Diagnostic and Surgical Services

    • Outpatient Services

    • Lifeline Emergency Response Helicopter Program

    • Contracted Services for Correctional Care

    • Long-term Care Facility in Nogales, Arizona


St mary s hospital1
St. Mary’s Hospital on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.

  • March 1998 ATP provided TM services

    • Continues to present (~ 120 consultations)

  • St. Mary’s started March 2000

    • Main referring site both IP & TM

  • SF = 649

  • RT = 12,847

  • Total = 13,496

  • Mental Health services not included (> 7000)

  • Tandberg Healthcare System 3 codec 5000

  • Transitioning to Second Opinion


Scenario #1 - Medical Center Visit on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge. Average cost per case $849.90

Scenario #2 - Telemedicine VisitAverage cost per case $467.25

Savings per case$382.65


  • US Department of Justice 2002 on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.

  • Implementing Telemedicine in Correctional Facilities

  • www.ncjrs.gov/pdffiles1/nij/190310.pdf

    • Executive Summary

    • Introduction

    • Implementation Decision & Planning

    • Technology Evaluation

    • Cost Estimation Model

    • 8 Appendices with worksheets


What s being done
What’s Being Done? on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.


What s being done1
What’s Being Done? on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.


Ob gyn @ univ arkansas
Ob/ on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.Gyn @ Univ Arkansas

  • 6% incarcerated women are pregnant

  • Often at high risk (drugs, alcohol, smoking)

  • 1.4 Mbit T1 with 512 Kb video capability

  • Multi-disciplinary

    • Generalist Ob/Gyn

    • Maternal-Fetal Medicine Specialist

    • Genetic Counselor

    • Sub-Specialists (radiology)

    • Labor & delivery

Gordon Low “Pregnant & Incarcerated” ATA 2008


Ob gyn @ univ arkansas1
Ob/ on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.Gyn @ Univ Arkansas

  • High patient & clinician satisfaction

  • 41 pregnant patients served

  • 224 patient visits

  • 20 deliveries

  • 56 triage calls

  • 14 transport calls

Gordon Low “Pregnant & Incarcerated” ATA 2008


Derm @ fletcher allen vt
Derm on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge. @ Fletcher Allen (VT)

  • Video based consulting

  • 2002 – 2005

  • 668 DoC consultations

    • 78% new

  • 244 Community based consultations

    • 59% new


Derm @ fletcher allen vt1
Derm on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge. @ Fletcher Allen (VT)

  • Most common diagnoses both groups

    • Acne

    • Psoriasis

    • Dermatitis

  • Next most common non-TM services

    • Basal Cell Carcinoma

    • Actinic Keratoses

  • Only 0.4% for TM groups


Derm @ fletcher allen vt2
Derm on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge. @ Fletcher Allen (VT)


  • TM has clear & significant role in corrections on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.

  • Likely are programs without documented descriptions or outcomes

  • Numerous clinical specialties can be covered

    • Clearly some more common than others

  • Cost-benefit analyses generally show savings

    • Mainly due to reduced transportation costs

    • Secondarily to reduced physician travel costs

  • Outcomes data are scarce but likely positive


THANK YOU! on emergency basis. Appointments requested by a health care provider there is no charge. Chronic serious medical conditions (diabetes or hypertension) followed on routine schedule without HNR & no charge.


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