Beaming Down Satcom Surgeons
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The range of diagnostic equipment available to sailors is still slim, and the cost of this equipment is very high, but that is changing.
Any boat that wants to fully avail itself of a remote medical service will need enough power to run a laptop computer and Satcom system. According to Dan Richards, founder and chief executive officer of the Boston-based crisis management firm Global Rescue, onboard systems can range from a laptop computer costing a few thousand dollars, to one hooked to “smart” laryngoscopes and stethoscopes, which add thousands to the total cost.
“It all depends on what you want to spend and what you want to lug with you,” Richards said. Video, he explained, is not essential. “We handle a number of telemedicine cases using fixed images [sent by the patient].”
More expensive systems can quickly send fixed images back and forth, allowing doctors to view the patient almost instantaneously in high resolution. This gives doctors or paramedics key information they might not have without an image. Video images can provide information as well, but quality depends on bandwidth—the transmission speed measured in bits per second. Resolution on these sea-borne videos tends to be soft or grainy, and the images sent via streaming video lag behind real time.
Government researchers, including those working with the International Space Station and its undersea counterpart, Aquarius, are working to resolve latency issues, because any form of tele-surgery (surgery conducted remotely) would require live, high-speed video.
When Global Rescue needs a medical diagnosis in a hurry, it relies on a partnership with John Hopkins Hospital in Baltimore, Md., where doctors are on standby via Satcom. The hospital has a Division of Special Operations that gives Global Rescue access to the same type of services used by the U.S. Marshal Service or the U.S. Secret Service.
The satellite phones we have tested have global reach (PS, January 2012), but they still can’t transmit large amounts of data, an obstacle for live (streaming) video. New software technology is helping to overcome those limitations, but until the bandwidth issue is solved, telemedical services will rely mostly on text and voice communication coupled with still images.
Patrick Deroose, general manager of International SOS’s Corporate Assistance Division, said existing satellite connections typically transmit a series of sequential still photos, as opposed to video. While the images help, he said, voice communication with a doctor is invaluable. “Talk first, then discuss the photos,” he said.
Although ships can be diverted to help, Deroose said many sailors have unrealistic expectations regarding at-sea evacuations. “You can’t expect the Hollywood version of a helicopter coming out of the blue sky to rescue you,” he said.
International SOS gets calls from ships and sailors every day. While some companies route calls to nurses or paramedics, SOS works exclusively with medical doctors. Several of its clients are commercial shipping companies who recognize that a remote diagnosis and treatment saves money, because the ship doesn’t have to make a costly diversion to a port for medical treatment.
The success of any remote medical service hinges greatly on the preparations made before a boat leaves port. One or more crew should have basic first-aid training, and the boat’s medical kit should be stocked with medicines and supplies that might be needed.
Tom Milne, relationship manager for corporate logistics and executive services at Seattle-based Remote Medical International (RMI), described how the company’s database allows them to quickly identify who is calling for help and what medical supplies are on board. These records help the remote doctors to quickly select treatments available to the crew.
If the call indicates a severe medical problem, the RMI communications center confers with emergency room doctors and specialists at George Washington University.