While most health services and some specialty health services are provided within federal institutions, the majority of specialist consultations take place outside institutional walls within Regional Health Authority (RHA) facilities. In 2010 the federal offender population in the Atlantic Canada region had increased. Two thirds of this population were in institutions within the geographic area served by Horizon Health Network (HHN), the larger of the two Regional Health Authorities in New Brunswick. This population increase resulted in a rise in the number of offenders visiting HHN facilities, where many of the specialists worked. To put this into perspective, during an 11 month period there were 880 medical escorts of federal offenders from the two minimum security Correctional Service of Canada (CSC) facilities alone. This was an average of 80 escorts per month. An analysis of these escorts determined that 294 of these or one third of these could have been completed using Telehealth technology. A medical escort consists of two guards, at times armed, accompanying an inmate in a modified vehicle to and from the appointment. During this time the offender, depending on security level, may have their hands cuffed and legs shackled at all times. While this can be disruptive to patients in the waiting room area and clinical staff, it is also embarrassing to the offender to the point that some refuse to go to outside medical appointments. It also can pose a falls risk for the offender.
In an effort to improve patient centered care and appointment attendance, HHN and CSC entered into a Memorandum of Understanding (MOU) and launched a strategic Telecorrections Partnership initiative. The clinical focus has been medical services provided by specialists from within Horizon to inmates from both Westmorland Institution and Dorchester Penitentiary. The original clinical areas of focus were plastic surgery, general surgery, and ENT. Expansion to other specialties has since occurred as the opportunities arose to include the establishment of a recurring infectious disease management clinic and a respirology clinic.
Through detailed process and change management Telecorrections has increased staff and patient safety by reducing and/or eliminating the need for inmates to be transferred to a hospital in order to receive specialty care. Security costs associated with medical escorts have been reduced and potential opportunity for elopement associated with these appointments eliminated. One tremendous advantage to embracing Telehealth technology and processes has been the ongoing knowledge transfer which occurs during these assessments for those CSC clinicians involved. Also, vice versa; having the clinicians present during each session has been pivotal in regards to maintaining an open dialogue and general facilitation.
This presentation will describe the process of establishing the partnership as well as clinical outcomes. Challenges experienced both clinically and technically will also be explored as traversal between two separate, private networks remains a necessity. Attention will be given how Telecorrections continues to assist CSC Health Services in providing essential health services to offenders while contributing to public safety.
Manager Clinical Services
Correctional Service of Canada
David Lewis is a Nurse Manager with more than 28 years of nursing experience. He began his nursing career working with Indigenous people in a small hospital and in remote communities in northwestern Ontario . He joined the Correctional Service of Canada (CSC) in 1993. For over 12 years he worked at Dorchester Penitentiary, initially as a frontline nurse and then as a nurse manager in both the Mental Health and Physical Health units. In 2005 he became the Regional Infectious Diseases Coordinator. He is currently the Manager Clinical Services for CSC in the Atlantic Region. David has a diploma in Nursing, a post RN/BN from University New Brunswick and a BSc from Mount Allison University.
He has been involved in many different projects and initiatives during his time at CSC including National Offender Infectious Diseases and Risk Behaviours Survey, Pandemic Influenza Planning, Discharge Planning, Hepatitis C prevention and treatment and Telehealth. He is currently working on developing a new collaborative care delivery model for CSC Health services in the Atlantic Region.
David is married with three grown children. In his spare time he enjoys travelling, reading running, good food and bad puns.
Monday, April 24
12:10 PM – 12:30 PM
Regional Telehealth Manager
Horizon Health Network RHA
Krisan has worked for Horizon Health Network 35 years in a variety of Nursing and Administrative capacities. Her current role is that of Regional Telehealth Manager. In this capacity she has been instrumental in facilitating many patient focused telehealth successes within New Brunswick and beyond. Through these team successes, and subsequent awards, New Brunswick is recognized as a leader in the International Telehealth arena.
Krisan has been personally recognized by CANARIE, the Canadian Association for the Advancement of Research, Industry and Education, for her contribution to Canadian Innovation. She was named Wired Woman of the Year by the International Wired Women’s Society and Women in Film and Video for her pioneering in technology. She has been recognized with a National Who’s Who in Healthcare award as well as New Brunswick’s own Information Technology Industry Person of the Year award.
Time magazine has referred to her as “one of the country’s foremost experts on long distance applications for healthcare, helping to build one of the Canada’s most sophisticated telehealth networks.”
Monday, April 24
12:10 PM – 12:30 PM