Telehealth in Correctional Facilities (2025) | National Commission on Correctional Health Care

Telehealth in Correctional Facilities (2025)

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Position Statement

The National Commission on Correctional Health Care recommends the use of competent and effective telehealth services to enhance access to and quality of care for people who are incarcerated. Telehealth refers to the use of electronic information and telecommunication technologies to provide medical, dental, mental health, and nutritional care services remotely. NCCHC supports the use of telehealth when it is clinically appropriate, using protocols that protect patient autonomy, confidentiality, and continuity of care.
Telehealth services are to be delivered by qualified health care professionals who have undergone relevant training and are legally eligible to perform their clinical duties (see also 2026 NCCHC Standards for Health Services for jails and prisons, Standard C-01 Credentialing). Telehealth must be used ethically, ensuring voluntary informed consent, privacy protections equivalent to in-person care, and equitable access.

Recommendations for Implementation of Telehealth in Correctional Facilities

  1. Policy Development: Establish clear, written guidelines and standards for the use of telehealth, addressing clinical, ethical, and logistical considerations.
  2. Stakeholder Engagement: Collaborate with correctional administrators, health care providers, and policymakers to align telehealth practices with the unique needs of correctional populations.
  3. Quality Assurance: Implement monitoring and evaluation mechanisms to ensure telehealth services meet NCCHC standards and improve health outcomes. Quality assurance includes the following:
  4. Adherence to NCCHC standards and applicable state and federal regulations
  5. Appropriate use assessments to ensure telehealth services are being used in clinically appropriate circumstances, with clear protocols identifying when in-person care is necessary
  6. Technology performance monitoring to ensure the functionality of telehealth platforms
  7. Incident reporting and feedback for reporting adverse events
  8. Continuous quality improvement to include identifying areas for improvement, implementing corrective actions, policy updates, and training
  9. Equity in Access: Implement telehealth in a manner that ensures equitable access to health care for all patients, regardless of their location in the facility or the nature of their incarceration. Special attention should be given to vulnerable populations, such as those with mental health issues or chronic conditions.
  10. Provider Training: Providers performing telehealth clinical duties should adhere to the credentialing standards outlined in NCCHC Standards for Health Services for jails and prisons, Standard C-01 Credentialing. In addition, facilities should provide training for qualified health care professionals on the nuances of delivering care via telehealth in correctional environments, including cultural competency and security awareness.
  11. Advocacy and Research: Advocate for federal and state policies that support telehealth expansion, including reimbursement parity and streamlined licensure processes. Encourage research to assess telehealth’s impact on correctional health care quality and outcomes.

Discussion

The term telehealth refers to the use of electronic communication and information technologies (telecommunications) to provide or support clinical care services, including medical, dental, mental, and nutritional care, remotely. Telehealth technologies are successfully being applied to a wide variety of disciplines including radiology, pathology, neurology, psychiatry, cardiology, obstetrics-gynecology, pediatrics, dermatology, emergency medicine, mental health, and nutritional care services. Telehealth offers opportunities to provide quality patient care in correctional settings.1

Telehealth has the power to facilitate the provision of health care, including specialty care, to populations that may have lower health care professional-to-population ratios.2 It can also shorten the diagnosis and treatment process by reducing the time required for patients to be seen by providers. Additionally, telehealth can reduce the duplication of services and overhead costs of providing care and can potentially reduce the isolation of health care professionals by facilitating peer contact for patient consultations and continuing education.

The most widely recognized cost-saving benefit of the use of telehealth comes from reducing the need for transportation for specialty care, which, in correctional settings, has broad implications.3 The need to transport individuals outside the confines of a correctional facility can be a significant barrier to providing health care for fiscal, logistical, and safety reasons. Telehealth can expedite access to quality health care for people who are incarcerated while providing significant cost savings to the correctional system.

Telehealth can also alleviate the difficulties of attracting and retaining health care professionals given the challenges of providing health services within carceral facilities. Telehealth may also mitigate providers’ avoidance of practicing in correctional facilities due to concerns regarding adverse conditions.4, 5

Benefits of Telehealth in Correctional Facilities

  1. Improved Access to Health Care: Telehealth can bridge the gap between health care providers and patients, particularly in medically underserved areas where access to specialists and comprehensive medical care is limited. Research indicates that telehealth significantly enhances access to care, allowing patients to receive timely consultations and follow-ups without the logistical challenges of transporting them to outside facilities.3
  2. Cost-Effectiveness: Telehealth can lead to substantial cost savings for correctional facilities. By decreasing use of patient transportation and minimizing security challenges, telehealth can reduce operational costs. Telehealth can also reduce costs by decreasing emergency department visits and hospitalizations.6
  3. Enhanced Security: Telehealth reduces the security challenges associated with transporting patients to external health care facilities. This eliminates the need for additional security staff and reduces contact outside the correctional facility. Telehealth consultations can be conducted within the secure environment, mitigating potential public safety risks, including escape attempts and other security concerns.7
  4. Reduced Harms: Telehealth reduces exposure to the risks of restraints during transport while also reducing the psychological distress of restraints, particularly for patients with mental health needs.8
  5. Continuity of Care: Telehealth supports continuous monitoring and management of chronic conditions prevalent among the incarcerated population, such as diabetes, hypertension, and mental health disorders. Regular telehealth consultations can help maintain consistent treatment plans and improve health outcomes.9

Challenges of Telehealth in Correctional Facilities
Despite the benefits of telehealth, there remain considerations prior to instituting or expanding its use. Regulatory considerations (including interstate licensure, patient confidentiality, and regulations of the Food and Drug Administration), start-up budgetary needs, and sufficient administrative support are a few challenges encountered by correctional health care facilities that have implemented telehealth technologies.

  1. Licensure: Licensure barriers include the requirement for health care providers to obtain and maintain licenses in each state where they practice, following state-specific licensure rules, interstate licensure compacts, and telehealth-specific regulations. In licensure and telehealth cases, the applicable standards of care are those of both the jurisdiction where the patient receives treatment and the jurisdiction where the provider practices. Providers licensed in that state are responsible for framing consultations in the context of the applicable state laws and clinical guidelines.10
  2. Technological Limitations: The successful implementation of telehealth requires reliable internet connectivity and appropriate technological infrastructure, which may be lacking in some correctional facilities. Ensuring that all facilities are equipped with the necessary secure technology that is compliant with the Health Insurance Portability and Accountability Act (HIPAA) is critical.1
  3. Privacy and Confidentiality: Maintaining the privacy and confidentiality of medical consultations can be difficult in the correctional environment. Measures must be taken to ensure that telehealth encounters are conducted in secure, private settings to protect patient confidentiality.
  4. Appropriate Use: One of the most serious risks associated with telehealth in correctional settings is its potential for inappropriate or overextended use. The pressures to contain costs, limit the use of personnel, and reduce patient transportation can lead facilities to rely on telehealth in situations where in-person care is more appropriate or necessary.
  5. Resistance to Change: Correctional staff and patients may exhibit resistance to the adoption of telehealth due to unfamiliarity with the technology or concerns about the quality of care. Comprehensive training and education programs are essential to facilitate the acceptance and effective use of telehealth.11 Working with universities and companies with expertise in telehealth implementation and delivery may provide opportunities for correctional facilities to enhance their use of telehealth services.

Ethical Considerations for the Use of Telehealth in Correctional Facilities

  1. Consent for Treatment: It is essential that patients receiving telehealth services consent to treatment just as they would for any face-to-face encounter. Patients must be fully informed about the nature of telehealth, the potential benefits, and any risks associated with remote consultations.12
  2. Quality of Care: The quality of care provided through telehealth must be equivalent to that of in-person consultations. Health care providers must ensure that telehealth services adhere to established standards and protocols, including those that mandate timely, in-person evaluation for urgent and emergent conditions.12
  3. Documentation: Corresponding documentation of the encounter must be entered into the electronic health record by the person providing the service to the patient (either through direct access to the EHR or as a scanned document). 
  4. Patient Preferences for In-Person Care: Surveys of nonincarcerated patients regarding postpandemic use of telehealth show that although many are satisfied with telehealth visits, most prefer in-person care. When feasible, the patient’s preference should be considered.

Telehealth represents a transformative opportunity to enhance correctional health care delivery, improving access, safety, and efficiency. By addressing ethical considerations and investing in robust implementation strategies, correctional facilities can ensure that telehealth supports equitable, high-quality care for incarcerated individuals, consistent with NCCHC’s Standards.

Adopted by the National Commission on Correctional Health Care Governance Board December 10, 2025

References

1 Williams, K. S., Singh, M. J., Elumn, J. E., Threats, M., Sha, Y., McCall, T., Wang, K., Massey, B., Peng, M. L., & Wiley, K. (2024). Enhancing healthcare accessibility through telehealth for justice impacted individuals. Frontiers in Public Health, 12, 1401950. https://doi.org/10.3389/fpubh.2024.1401950

2 Edge, C., Black, G., King, E., George, J., Patel, S., & Hayward, A. (2019). Improving care quality with prison telemedicine: The effects of context and multiplicity on successful implementation and use. Journal of Telemedicine and Telecare, 27(6), 325–342. https://doi.org/10.1177/1357633X19869131

3 Kaftarian, E. (2019). Lessons learned in prison and jail-based telepsychiatry. Current Psychiatry Reports, 21, 15. https://doi.org/10.1007/s11920-019-1004-5

4 Jeker, B., Shaw, D., Lagnaux, N., Wangmo, T., & Elger, B. S. (2023). Motivation and training needs of prison healthcare professionals: Findings from a qualitative study. BMC Psychology, 11, 167. https://doi.org/10.1186/s40359-023-01076-8

5 Senanayake, B., Wickramasinghe, S. I., Eriksson, L., Smith, A. C., & Edirippulige, S. (2018). Telemedicine in the correctional setting: A scoping review. Journal of Telemedicine and Telecare, 24(10), 669–675. https://doi.org/10.1177/1357633X18800858

6 Dahl, D., & Kumar, V. (2014). The impact of telemedicine in correctional facilities. Journal of Telemedicine and Telecare, 20(3), 123–129.

7 Pew Charitable Trusts. (2018). State prisons and the delivery of hospital care. https://www.pewtrusts.org/en/research-and-analysis/reports/2018/07/19/state-prisons-and-the-delivery-of-hospital-care

8 Moskovitz, J., Sapadin, J., & Guttenberg, M. (2020). Interfacility ambulance transport of mental health patients. Journal of the American College of Emergency Physicians Open, 1(3), 173–182. https://doi.org/10.1002/emp2.12012

9 Kassar, K., Roe, C., & Desimone, M. (2017). Use of telemedicine for management of diabetes in correctional facilities. Telemedicine and e-Health, 23(1), 55–59. https://doi.org/10.1089/tmj.2016.0036

10 George, G., & Heitmann, B. E. (2021). Legal and regulatory implications in telemedicine. In Latifi, R., Doarn, C. R., & Merrell, R. C. (Eds.), Telemedicine, Telehealth and Telepresence: Principles, Strategies, Applications, and New Directions. Springer International. https://doi.org/10.1007/978-3-030-56917-4

11 Kruse, C. S., Karem, P., Shifflett, K., Vegi, L., Ravi, K., & Brooks, M. (2018). Evaluating barriers to adopting telemedicine worldwide: A systematic review. Journal of Telemedicine and Telecare, 24(1), 4–12. https://doi.org/10.1177/1357633X16674087

12 Patch, L. E., Povio, J., Souza, K., & Wilson, B. (2024). Filling care gaps for underserved patients with telehealth: Best practices for telehealth in schools, prisons & rural hospitals [Webinar]. American Telemedicine Association. https://www.americantelemed.org/resources/filling-care-gaps-for-underserved-patients-with-telehealth/