SOP 208.02 (IIA12-0001): Telemedicine

|GEORGIA DEPARTMENT OF CORRECTIONS
Standard Operating Procedures|Col2|Col3|
|---|---|---|
|`Functional Area: `
`Facilities Division`|`Reference Number: `
`IIA12-0001`
`(208.02)`|`Revises`
`Previous`
`Effective Date:`
`8/15/01`|
|`Subject:`
`Telemedicine`|||
|`Authority:`
`Bryson/Jacobs`|`Effective Date:`
`04/22/15`|`Page 1 of`
7|

I. POLICY:

   The Facilities Division supports and will establish, in
   concert with the GDC Office of Health Services, multiple
   statewide remote telemedicine sites strategically located at
   selected prisons which will serve as an adjunct to the
   existing health care delivery system and support the provision
   of quality medical clinic services while also realizing a
   reduction in transportation costs. A transportation routing
   system, which incorporates the primary concern of security
   while addressing telemedicine site delivery efficiency, will
   utilize a coordinated system of inmate/probationer drop-off,
   pick-up, and delivery to remote telemedicine sites within each
   of the Division's regions. Each Region will have, at a
   minimum, one remote telemedicine site which will provide
   medical consultation capabilities for selected inmates and
   thus will reduce the former level of dependency to physically
   transport all inmates to the Augusta State Medical Prison for
   consultation services.

II. APPLICABILITY:

   All State Prisons, Transition Centers, and Probation Detention
   Centers, County Correctional Institutions, Diversion Centers;
   privatized facilities and women's facilities are excluded.

III. RELATED DIRECTIVES:

   A. GDC Rules and Regulations: 125-2-4.

   B. Standard Operating Procedures: IIB01-0006, IIB01-0013,
      IIB01-0028, IIA07-0007, (Transfer Officer Post Order),
      GDC Health Services - VH17-0003, VH30-0002, VH36-0001,
      VH36-   0002, VH82-0002.

   C. ACA Standards: 3-4182

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Facilities Division|Prev. Eff. Date:
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|`Functional Area:`
`Facilities Division`|`Effective Date:`
`04/22/15`|`Reference Number:`
`IIA12-0001`
`(208.02)`|

    DEFINITIONS:

   D. Telemedicine - An interactive voice and color video
      communication system integrated with biomedical science.

   E. Remote Telemedicine Site - A prison selected within a
      catchment area responsible for sending medical
      information to the clinical provider located at the hub
      site utilizing interactive video equipment. Selected
      inmates/probationers are transported to this site for
      consultation.

   F. Hub Telemedicine Site - Augusta State Medical Prison
      (ASMP) will serve as the hub site where the primary
      medical providers via electronic video equipment will
      interact with medical staff and the inmate/probationer at
      the remote telemedicine site. Responsible for sending and
      receiving medical information required by the medical
      providers in regards to providing health care services to
      the inmates/probationers located at the remote
      telemedicine site.

   G. Catchment Area - A grouping of facilities within general
      proximity to each other identified for transportation
      purposes. It will include originating facilities which
      provide the vehicles and transportation staff, drop- off
      facility sites, facility pick-up sites, and the remote
      telemedicine site. (Attachment 1)

   H. Home Facility - inmate's/probationer's permanent
      prison/center assignment.

   I. Remote Telemedicine Site Coordinator- Serves as the
      individual responsible for facilitating and coordinating
      systems operation with the hub site and designated
      facility catchment areas. This individual will serve as
      the site contact for security staff (Transportation
      Officer).

IV. ATTACHMENTS:

   Attachment 1- Remote Telemedicine Sites and Catchment List

|Functional Area:
Facilities Division|Prev. Eff. Date:
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|`Functional Area:`
`Facilities Division`|`Effective Date:`
`04/22/15`|`Reference Number:`
`IIA12-0001`
`(208.02)`|

V. PROCEDURE:

   A. Overview:

   1. Selective telemedicine clinics will be conducted at
      multiple sites within the state, which include but
      are not limited to, Georgia Diagnostic &
      Classification Prison, Men's State Prison, and
      Georgia State Prison. These remote telemedicine
      service sites will serve as an adjunct to the
      existing health care delivery system. Medical staff
      located at ASMP will conduct the consult in concert
      with medical providers at the remote telemedicine
      site.

B. Regionalized transportation plan of facility vehicle
   starting points, inmate/resident drop-off locations,
   pick-up location, and destination points (remote
   telemedicine sites) will be developed and distributed by
   the Facilities Division Director.

   1. Transport vehicles will meet all requirements
      mandated in the applicable SOP.

   2. Staffing levels for transport purposes will comply
      with the applicable SOP.

   3. All inmates/residents being transported will be
      restrained in accord with the applicable SOP.

   4. In-route radio contacts will be initiated as
      mandated by the applicable SOP.

   5. The highest level of inmate security being
      transported will dictate the level of security
      applied to all transportees.

   6. Considerations will be applied to inmate/
      probationer mix in transport to assure the safety of
      all concerned (youthful offenders, protective
      custody, etc.).

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`Facilities Division`|`Effective Date:`
`04/22/15`|`Reference Number:`
`IIA12-0001`
`(208.02)`|

C. Notification of inmate/probationer appointments:

   1. Augusta State Medical Prison (ASMP) Appointment
      Clerk will fax to all facility and center
      Wardens/Superintendents and Health Services
      Administrators within the catchment areas, a list of
      inmates/probationers scheduled for telemedicine
      clinics at least 48 hours in advance of the
      appointment date. This will include the
      inmate's/probationer's name, State ID number, the
      home facility name, the date and time of the
      consultation, and the name of the telemedicine
      clinic. *See number 5 below*

   2. The Wardens/Superintendents of the home facilities
      will designate an individual responsible for
      transportation routing system coordination.

   3. It is the responsibility of the facility to have
      the inmate/probationer prepared for transport to the
      telemedicine site on the date specified. This will
      include verifying if any medications (with
      instructions) need to accompany the
      inmate/probationer, medical records to be
      transported to the site, if the inmate/probationer
      requires any special security considerations, or
      other information relevant for the Transportation
      Officer's safety or the safety of the
      inmates/probationers making the trip.

   4. All telemedicine consultation appointments will be
      scheduled on Mondays, Wednesdays, or Fridays,
      between the hours of 8:00 a.m. and 3:30 p.m.

   5. At the originating transport vehicle starting
      points, the designated Transportation Officers will
      review the telemedicine faxes and identify the
      necessary route stops required in accordance with
      the GDC routing system (Routing Maps available
      through Facilities Division Regional Offices).
         *Identifying a more effective process*

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`IIA12-0001`
`(208.02)`|

   6. In cases where medical personnel must cancel a
      scheduled consultation at a telemedicine remote
      site, ASMP will be notified at least 24 hours
      preceding the consultation and will in turn notify
      those affected facilities. Likewise, if an
      inmate/probationer is precluded from attending the
      consultation, the home facility will contact ASMP,
      the Remote Telemedicine Site, and their Originating
      Vehicle Facility at least 24 hours prior to the
      scheduled clinic so that this information can be
      processed.

D. Responsibility of the home facility prior to pick up of
   their scheduled inmate/probationer (this includes
   inmates/probationers being transported from their
   assigned facility as a drop-off to a pick- up site
   awaiting subsequent transport to the telemedicine site,
   or inmates/probationers located already at a designated
   pick-up location awaiting transport to the telemedicine
   site):

   1. All scheduled inmates/probationers will be
      thoroughly searched to preclude any unauthorized
      items from entering the transport vehicle and
      subsequently the remote telemedicine site.

   2. No personal property will be allowed to accompany
      the inmate/probationer on the vehicle transporting
      them to the medical appointment. This does not
      exclude prescription eyeglasses, dentures,
      medications, or other medically approved prosthetic
      devices.

   3. Staff will verify the identity of the
      inmate/probationer just prior to departure and
      assure that picture photo identification is
      available and accurate.

   4. If prescribed medication is required to be taken
      during the inmate's/probationer's absence from their
      home facility, and its' need is supported by medical
      staff it, along with appropriate instructions, will
      be provided to the Transportation Officer.

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`IIA12-0001`
`(208.02)`|

      Inmates/probationers will be allowed to bring
      authorized self-administered medications.

   5. The home facility will ensure that the individual
      inmate's/probationer's medical records or necessary
      documents are placed in a sealed envelope with their
      name, State ID number, and the home facility name
      printed on the front. This envelope will be
      surrendered to the Transportation Officer for
      delivery to the Remote Telemedicine Site
      Coordinator.

   6. The home facility will provide a pack-out
      lunch/beverage for inmate/probationer with their
      name printed on the bag, which will be secured on
      the vehicle and later distributed at the appropriate
      meal time.

   7. Any special security instructions or intelligence
      information regarding an inmate/probationer will be
      prepared and provided to the Transportation Officer.

   8. For those facilities who earlier delivered
      inmates/probationers to a drop-off point, they will,
      upon return of the inmate/probationer from the
      telemedicine appointment, pick them up and return to
      their home facility. To expedite the return process,
      the Transportation Officer will via radio, or other
      approved method, contact the inmate's/probationer's
      home facility with an ETA to the drop-off point so
      that when they arrive at that location the home
      facility will be there to accept the returning
      inmate/probationer.

E. Responsibilities of Transportation Officer(s) upon
   arrival at the remote telemedicine site:

   1. Escort inmates/probationers to the telemedicine exam
      room and insure that security is maintained among
      those awaiting their appointment as well as the
      individual being seen in the clinic. Restraints may
      be removed only when the individual is being seen in
      the clinic exam room by medical personnel and when

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`(208.02)`|

   medical staff concurs with the removal of the
   restraints. All medical records/documentation
   transported will be surrendered to the clinic
   personnel.

2. Should the inmate/probationer being seen begin to
   act out or act inappropriately and this behavior is
   perceived as a posed or probable security risk or
   risk to the safety of staff, the Transportation
   Officer(s) shall enter the exam room and secure the
   situation immediately. An incident report will be
   completed.

3. At any point from arrival at the telemedicine site
   through the conduct of the actual appointment,
   should the inmate/probationer refuse medical
   services, the issue will be reported to the Remote
   Telemedicine Site Coordinator for appropriate action
   and documentation in accordance with policy.

4. Should the inmate/probationer become physically
   aggressive towards medical staff or others in the
   exam room, or become destructive towards the
   physical plant/equipment, they will immediately be
   controlled and restrained. The appointment will be
   terminated and an incident report will be completed.
   Inappropriate behavior will not be tolerated and
   restitution for damages will be pursued.

5. Some situations may require the presence of the
   Transportation Officer(s) to be present during the
   telemedicine exam with the request generated from
   the medical staff in charge of the consultation.
   Other situations may necessitate the Officer's self   initiated presence because of unique knowledge
   he/she has regarding the inmate/probationer being
   examined. Whatever the basis for their presence,
   every attempt should be made to ensure the
   inmate's/probationer's privacy (refer to SOP VH30   0002) while balancing the concerns of security.