Medical Sciences Forum (Nov 2022)
Advanced Telemedicine Solutions for High-Quality Medical Assistance at Sea
Abstract
The medical assistance to seafarers was not always improved in parallel with advances in medicine and telecommunications. Today technology offers systems including digital devices helping in collecting symptoms to be referred correctly to remote physicians. CIRM SERVIZI, the spin-off of Centro Internazionale Radio Medico (C.I.R.M.), and the Italian TMAS center, have developed an advanced system called CIRM PREMIUM. This aimed at offering extensive telemedicine solutions for the treatment of illnesses or injuries on-board ships. The objective of this paper is to present the results of offered service with CIRM PREMIUM and the standard basic TMAS service given by C.I.R.M. to ships not equipped with advanced technologies. We have considered 400 seafarers assisted on-board ships from 1 January 2020 to 31 December 2021 including 200 on-board ships equipped with CIRM PREMIUM (Test Group, TG) and 200 were on-board ships requiring the C.I.R.M. standard free telemedical assistance (Control Group, CG). The five most frequent different disorders assisted by C.I.R.M in the given period were considered. Diseases of the circulatory and respiratory systems were also considered to be the most frequent cause of medical emergencies on board. Data were analyzed comparatively by analysis of variance (ANOVA) and by the Chi-squared test. The average time for a patient’s complete recovery was 115.1 ± 12.8 h (4 to 5 days) in the TG group and 132.8 ± 14.4 h (5 to 6 days) in the CG group. From a temporal point of view, PREMIUM patients showed an improvement in 12–24 h from the first request for medical advice, versus 36–48 h for those using the standard medical service. The patients who fully recovered on board were 48.8% for the TG group and 27.46% for the CG. Telemedical assistance resulted in avoiding diversions in 73.7% of cases in the PREMIUM service and in 43.7% in the standard service. The results of our analysis revealed that the CIRM PREMIUM services provide a better and quicker outcome for patient conditions and cause significantly less ship diversions for medical reasons. This indicates that technological progress can offer relevant advantages for treating diseases or accidents on-board ships. The presence of telemedical devices on board, their larger and constant use and a closer collaboration from the ship will offer seafarers adequate health protection and will reduce the present disadvantage of being ill while at sea.
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