2002

M@RITIM - Medical assistance and consultation to seafarers via telemedicine - A survey

M@RITIM - Medical assistance and consultation to seafarers via telemedicine - a survey

Stein G. Moksness, Eli Larsen, Jan Norum. Norwegian Centre for Telemedicine, University Hospital of North Norway

Purpose: Maritime telemedicine dates to the days of "wireless telegraphy". Whereas the use of information and communication technology (ICT) has been adopted by many health providers on land during the last decade, the implementation of ICT in health care service among seafarers has been limited. In this study, we wanted to clarify seafarers' and medical aid providers' suggestions for the implementation of ICT in medical assistance at sea.

Methods: Between December 2000 and July 2001, 24 persons representing 14 different shipping companies ("those in need of help") and public/private medical service providers ("those who provide assistance") were interviewed about their experiences and views concerning the medical services provided to seafarers. The interviewees were also asked to give their opinions and proposals concerning the use of new and more technology-based functions. A structured interview employing an interview guide was employed.

Results: In this survey, we identified few maritime telemedicine services (except for the use of radio and telephone systems) in routine use. The panorama of diseases and injuries varied between the different maritime settings. Whereas interviewees representing cruise liners and ferries reported frequently coronary heart disease, accidents were the main problem among the others. Seamen on merchant ships usually contacted Radio Medico for medical support, while the fishermen most frequently contacted the coast guard or the emergency medical dispatch centres.

The analysis shows good correlation between "help seekers" as well as "help providers" on how to improve the health services for those at sea. The users want telemedical tools/solutions, and the personnel on board the ships especially, will feel more secure and safe if more medical data can be transferred between sea and land. The results indicate a potential for improvement in all elements in the chain of health provision from equipment, software, procedures/administration and to the organisation of the services.

Several areas for improvements were suggested. A wireless communication system operational everywhere on board the boat and integrated with the ship's communication systems was strongly recommended by most interviewees. Similarly, transmission of photos and medical parameters like blood pressure, ECG, pulse and oxygen saturation was prioritised, and even the use of video at times. Other areas focused were improved training (courses, repetitions), better support systems (PC-based systems, CD-ROMs, journals, procedures, reference material) and an improved organisation (one number to call, cooperation and coordination between the health providers).

Conclusion: The health service among seafarers may be improved by the implementation of ICT and better organisation of the health service providers on land. Seafarers and their help providers have several suggestions for improvements that deserve further attention.

---