​Telemedicine: how digital technology is saving lives

By Adelina Campos de Carvalho 6/2/2017

In crisis situations, immediate access to advanced medical care can mean the difference between life and death. Telemedicine allows rescuers to contact doctors thousands of kilometres away, inform them of a patient's condition,and seek their advice.

Over 50 miners are trapped underground after a sulphur mine collapsed in western Ukraine. At least five of the miners have suffered severe burns as a result of the accident which took place this morning at 5am, close to Yavoriv, a town near the Polish border. Dozens of people were also injured as a gas explosion in the mine, 300 metres below ground, triggered earth tremors which destroyed nearby buildings and roads.  Emergency services fear further casualties as it is believed the quake may have caused a chemical leak when it hit nearby factories. Ukrainian authorities have now called for assistance with disaster relief efforts.

Life and death

The events mentioned above did not take place. They were part of a simulated exercise testing NATO's new Multinational Telemedicine System, a project partly developed by the NCI Agency which was completed in early 2017. While this scenario was fictional, the challenges it posed were very real.

In crisis situations, immediate access to advanced medical care can mean the difference between life and death. Unfortunately, medical specialists are not always available to treat casualties on site. Victims must thus rely on rescue workers or paramedics and the one of the only tools at their disposal – telemedicine.  Telemedicine allows rescuers to contact doctors thousands of kilometres away, inform them of a patient's condition, and seek their advice on how best to treat them.

The information can be transmitted securely within a matter of seconds.

"In the event of a disaster, telemedicine can enable physicians, located in different parts of the world, the ability to provide healthcare services remotely, to those individuals in disaster zone," explained Ambassador Sorin Ducaru, NATO Assistant Secretary General for Emerging Security Challenges.

"Telemedicine can make a huge difference for a wounded person, allowing fast connectivity with high level medical expertise in the 'golden hour' between life and potential death.

 I understood the meaning of this 'golden hour' during my missions with the North Atlantic Council to Afghanistan and other operational theatres, and consider telemedicine as a huge enabler for emergency response for victims of natural disasters or military conflicts."

Vital information sharing

In 2012, the NATO – Russia Council initiated a telemedicine project which was funded by NATO's Science for Peace and Security (SPS) Programme. Although Russia was involved initially, it was decided in 2014 that the Multinational Telemedicine System (MnTS) would be led by scientists and experts from NATO Allies Romania and the United States and Partner countries Finland, Moldova and Ukraine. Participating Nations and the Science for Peace and Security Programme contributed a total of 2 million EUR to the project, including 180,000 EUR which covered the cost of the support provided by the NATO Communications and Information Agency. The Agency was responsible for multiple aspects of the system. It created content, provided subject matter expertise, worked on the system's communications technologies and assumed the role of project coordinator.

As part of the project, the team had to decide which crucial information – or bio-signals - would need to be shared with 'long-distance doctors', the physicians providing medical expertise remotely. The team chose to include what is called the minimum viable dataset, namely: body temperature; heart rate; respiratory rate; blood pressure; additional signs such as any pain; a patient's level of consciousness; blood oxygen and glucose levels; gait speed; shortness of breath and functional capacity.

This led them to develop a software platform allowing all these details to be transmitted from a portable medical kit to a remote hub via satellite link or mobile network. "One of the most serious problems experienced during disaster events is the lack of appropriate means to communicate efficiently, to collect, process, and transmit important information in the midst of the disaster," commented Filip Hostiuc, NCI Agency Senior Engineer, Command and Control Services.

Increasing survival rates

"Mortality rates can be reduced if information exchange is reliable, fast and accurate, so establishing rapid and reliable telecommunications systems specifically directed toward the disaster medical field is one of the most important challenges," Mr Hostiuc added.

"During a disaster, communication may be congested or overloaded and the local administration may be damaged or not properly equipped to make contact with neighbouring areas to request help. Therefore, emergency communications systems, including contingency systems, should be quickly prepared and installed in areas where terrestrial communications lines or systems are unreliable, damaged, or non-existent."

The team also had to take into account any potential legal or language issues that may arise during emergency situations to ensure that telemedicine could be deployed.

After two years of development, NATO's Multinational Telemedicine System was tested live successfully in two of the Alliance's exercises, in 2015 in Ukraine and in 2016 in Montenegro. The Science for Peace and Security Programme Conference marked the completion of the project on 24 February 2017.

It has been suggested that this system could be used in the future by NATO in partnership with other organizations such as the European Union, the United Nations or the World Health Organization to provide humanitarian relief. Ambassador Ducaru remarked: "[This] system can improve access to health services and increase survival rates in emergency situations that spans both geography and time zones."


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