Correctional Health eConsults

A number of RubiconMD clients are correctional organizations, meaning that the patients
these PCPs serve reside in prisons or jails. Due to their location, there are nuances to be
aware of when answering eConsults from these providers, which are highlighted below.

Correctional Healthcare versus Mainstream Healthcare eConsult Tips

Watch in the eConsult for providers to state “corrections/incarcerated patient”
PCPs in corrections settings are advised to flag in their eConsult that their patient is
incarcerated — be on the lookout for that detail.

There may be local guidelines or restrictions on pain medications
Many specific pain medications are not available in the correctional setting. Please try to
provide various options and steer clear of advising on one specific pain medication as it may
not be permissible in their setting.

Correctional systems, like many companies, use formularies
When recommending medications, please try to recommend a class of medications or the
generic version of a specific medication.

“Comfort” features may not be possible in this setting
When possible, please refrain from making “comfort” recommendations that may not be
permissible in the jail or prison setting. For example, recommendations on bottom bunks,
specific mattresses, changes to restraints, etc. may not be an option due to patient safety and
security.

Dietary suggestions
Most correctional settings have options for medically indicated diets (diabetic, gluten-free, low
salt, renal). If commenting on food, please refer to general dietary recommendations versus
specific food items. Additionally, please be aware that the timing of meals and medications can
be regulated so be cautious recommending specific times for these.

Device/medical equipment recommendations
Braces, splints, or durable medical equipment with metal can be a security risk. Please consider
if the device will improve function, avoid invasive procedures or decrease risk of complication.
Please do not recommend these items if only for comfort.

Best clinical practices should always be followed & recommended.

The above is for educational purposes to assist in best responses for patients in this setting.