Until recently, telemedicine systems were prohibitively expensive, but the two desktop video units used in the Colorado experiment cost less than $9,000 each.

"This is still a pilot program," says Katherine Hinsdale, director of Denver's telemedicine efforts, "but we've shown you can deliver effective health care for next to nothing." Since spring 1995, the program has saved approximately $100,000 in treating minor medical problems; telepsychiatry was added a few months later. Eventually, the Denver Department of Health and Hospitals hopes to extend the technology to 11,000 inmates statewide.

The program does more than reduce public expense for legitimate treatment, Katherine notes; it also discourages malingering. "Among inmates, getting a field day out of jail to visit a clinic can be a game," she says. Fewer inmates request treatment if they can't leave the facility.

Some inmates complain about the loss of human contact or condemn the techno-treatment as science fiction. Advocates of the program highlight the possibility of making this cost-saving approach available to the world's best clinicians -- and even offering them remote access.

Telemedicine is in its infancy, however. According to Katherine, "In North America, there were 2,110 telemedicine consultations in 1994. That figure nearly quadrupled in 1995. We accounted for 600 of those at Arapahoe, so telemedicine still isn't as widespread as some people think."