Electronic consultation in correctional facilities worldwide: a scoping review

Area of Science:

• Public Health
• Health Informatics
• Correctional Healthcare

Background:

• Correctional facilities face challenges in providing timely and adequate healthcare to incarcerated populations.
• Traditional methods of specialist consultation often involve costly and complex transportation of inmates.
• Electronic consultation (eConsult) platforms offer a potential solution to bridge healthcare gaps in correctional settings.

Purpose of the Study:

• To conduct a comprehensive scoping review of the existing literature on the use and evidence of eConsult services within correctional facilities globally.
• To identify and synthesize the reported benefits, challenges, and outcomes associated with implementing eConsult in carceral environments.

Main Methods:

• A systematic scoping review was performed using three major academic databases (MEDLINE, Embase, CINAHL) and grey literature.
• Searches covered publications from 1990 to 2020, focusing on eConsult use in correctional settings.
• Inclusion criteria excluded synchronous, patient-to-provider, or insecure communication methods; reference lists were also hand-searched.

Main Results:

• Twenty-two resources were included, identifying 13 unique eConsult services across six countries, primarily serving adult male offenders.
• Evidence was organized into themes: feasibility, cost-effectiveness, access to care, provider satisfaction, and clinical impact.
• The review found eConsult services to be feasible, cost-effective, improve access to care, positively impact clinical care, and achieve high provider satisfaction.

Conclusions:

• eConsult is a valuable tool for delivering timely, high-quality healthcare to incarcerated individuals, avoiding unnecessary external transportation.
• While evidence supports its benefits, further research is needed on patient satisfaction and implementation factors, particularly for diverse populations (women, youth, transgender).
• Continued development and research into eConsult in correctional settings are crucial for optimizing offender healthcare delivery.