AUSTIN, TX – The Texas prison system combined a statewide electronic medical record system with the world’s largest telemedicine system outside of the Pentagon to create a program that has saved Texas taxpayers nearly $1 billion over the past 10 years, according to the Gartner Group.

Texas has one of the highest incarceration rates in the country and healthcare costs to inmates are rapidly increasing nationally, state officials say. To rein in expenses and streamline care, the Texas Department of Criminal Justice, through the University of Texas Medical Branch (UTMB), contracted with Atlanta's Business Computer Applications, Inc. for an EMR system.

A 2004 Texas Medical Foundation audit found that the Texas EMR contributed to improved health outcomes while significantly lowering patient cost per day.

“BCA’s EMR coupled with UTMB’s and Texas Tech’s telemedicine services have helped UTMB and Texas Tech provide improved access to specialists, continuity of care, and follow-up care while decreasing costs,” says Michael J. Bourdeau, director of correctional managed care information systems, UTMB.

Texas’ system is recognized as being the second highest provider in quality healthcare in a correctional setting, second only to U.S. government hospitals. The Texas system has also been called a national model for the way it taps into university resources with oversight from a state committee controlled by doctors.

The EMR system is used across the board by UTMB and Texas Tech, which provide the medical care in the Texas Department of Criminal Justice prison system. The EMR is used for medical, dental, mental health and pharmacy services not only in the state prisons, but also in county jails and the Texas Youth Commission.

The statewide system serves 120 state prisons, 15 youth prisons and three federal prisons. It has been recognized for helping the state of Texas realize a 45 percent reduction in medical tests deemed to be unnecessary. A past study indicated the program has resulted in a 70 percent reduction in the number of transfers from prison facilities to physician offices and a 38 percent reduction in transfers from inmate housing to emergency rooms, says Bourdeau.

The Texas adult inmate population currently stands at approximately 150,000 inmates and costs the state of Texas more than $3 billion a year to operate. The EMR system covers 145 locations and handles 19 million interactions a month.

As a result of the EMR program, Bourdeau says, the inmate medical cost per day compared to other states has been reduced to $9.67. This compares to $41.25 for California, the only state with a higher incarceration rate than Texas.

A Department of Justice and Department of Defense Joint Program Steering Group report concluded in a cost-benefit analysis that a telemedicine consultation would cost an average of $71 compared to $175 for a conventional face-to-face consultation – a 60 percent savings.