Oct. 23, 2007

 It looks like an ordinary teleconferencing screen, but when you look a little closer you can see that it is much more than that. “Can you move a little closer?’’ asks Dr. David Goldwag, Director of Emergency Medicine at Westchester Medical Center.  He is talking to Dr. Gail Bailey, who is Medical Director at the Westchester County Jail, as he examines the inside of a patient’s ear.

 Although they are several miles apart, both doctors are examining the same patient and conferring on a diagnosis. It’s all made possible by new technology being used at the jail in Valhalla. Telemedicine provides a way for emergency room doctors to examine inmates long distance. It’s part of an effort by Westchester County to use technology to provide better care, save money and improve efficiency.

  “Using this technology doctors at the medical center can examine patients at the jail without them having to make a trip to the emergency room,’’ said County Executive Andy Spano. “It’s better for the patient because he or she gets treated sooner. It’s better for us because we cut back on the cost of unnecessary trips to the hospital and its safer for the correction officers who don’t have to risk possible injury if an inmate should try to escape in transit.’’

 Spano announced the new technology at his State of the County address last March.  Since the program began on March 15 more than 50 patients have been examined using Tele-medicine and visits to the emergency room have been cut by half.

 “Patients can be evaluated quickly,’’ said Dr. Bailey. “Many of them prefer this to a trip to the emergency room. We can consult with an emergency room doctors almost immediately.’’
                                                                          
The infirmary at the jail is set up with three private exam rooms, each equipped with a Tandberg Intern MXP. The three units cost about $80,000. The tele-medicine stations consist of a live-time teleconferencing screen – one at the jail and another at the medical center. Special attachments such as a tele-med stethoscope, derma scope, otoscope and an ENT camera allow doctors in the ER to look into patients’ ears and throat or examine skin up close. They can also get vital information such as EKG, blood pressure and x-rays.  Earlier this year, the jail switched over to a digital x-ray system which eliminates film from the process. That means doctors at the medical center can share x-rays via computer and call up a patients’ file the instant the technician has completed the x-ray. The doctor can also manipulate the view of the x-ray without having to take multiple x-rays from different angles.

Westchester County Correction Commissioner Rocco Pozzi said that the jail is in the process of computerizing all of its medical files to make medical treatment at the jail more efficient.

It’s all part of a larger effort to make the jail more efficient and cost effective. In 2003, the jail began offering a credit card bail system so that bail could be posted sooner. At a cost of $250 per day to house each inmate, the savings to the county can amount to thousands in a year. Next innovation: tele-arraignments. The county will soon work with several local communities to arraign prisoners by tele-conference.
             
“It’s all about technology,’’ said Spano. “Doing things better and faster.’’