A Primary Care Telehealth Experience in a US Army Correctional Facility in Germany

To assess the feasibility of using telehealth (TH) equipment and infrastructure within the US Army's European Theater to evaluate and treat inmates with general medical complaints, and perform physicals and medical safety checks in a US Army Correctional Facility (CORFAC).

Synchronous TH encounters were performed using Polycom RealPresence software on providers' computers with high definition cameras on monitors at distant sites and PolyCom HDX9000 Practitioner Cart along with AMD Global Telemedicine devices at the originating site within the CORFAC. These devices included an AMD-2500 General Exam Camera, AMD Fiber optic Otoscope, and AMD Telephonic Stethoscope. Patient consent for TH was obtained, and they were seen in the Medical Dispensary with Army Medics presenting the patients to the providers via TH.

From May 22, 2014, to January 12, 2015, a physician assistant, nurse practitioner, and 4 physicians completed 177 synchronous TH encounters primarily at a CORFAC in Mannheim, Germany. Of these 177 encounters, 114 were Special Housing Unit (SHU) safety checks and 63 encounters were for physicals, medication management, and a variety of medical complaints including acute infections, abdominal pain, and musculoskeletal and dermatological complaints.

Synchronous TH was an effective option for the delivery of high quality routine medical care for minor illnesses, injuries, and other nonurgent conditions, as well as for general physicals and SHU checks in a correctional facility. Acceptance by providers and clinic staff was found to be high. Inmates were generally satisfied with their TH encounters. However, some inmates reported a preference to see providers in-person, highlighting one of the challenges with acceptance of telehealth programs.