A n odd piece of cargo is trundled over the cobblestones of the Greek port of Piraeus before being wheeled up the gangway to a docked merchant ship. In size and shape it resembles a modern version of a steamer trunk, the type of luggage favored by world travelers in the 19
th century, although what it contains is actually a small piece of the future of medicine.
Modern technology has shrunk the world so that it is possible to be in nearly continual communication from ship to shore, but seafaring remains a high-risk occupation in a remote, isolated environment. When medical issues arise, they can quickly exceed the training of ship officers whose competencies extend to applying bandages, placing intravenous access, suturing wounds and administering strong painkillers.
In this instance, immediate assessment and diagnosis are critical in case emergency deviation to port is required. This is where the Telemedicine Case – the solution contained inside the cargo – comes into play. Inside is a diagnostic tablet that connects via Bluetooth to a range of digital devices including a cardiograph (ECG), blood pressure meter, thermometer and oximeter. Also included are troponin (protein) and glucose tests, as well as an otoscope to examine the eardrum and outer ear.
If an emergency arises, the ship’s captain or officer can reach a 24/7 medical team that includes emergency specialists and doctors. Under guidance, the officer runs a series of fact- and measurement-based diagnostics while the tablet collects the data and sends it to the support center for analysis and action.
For the crew member, the solution provides almost “real-time” medical treatment; for the captain it can reduce liability for medical cases; and for the shipping company, it helps avoid unnecessary deviation costs of around $10,000 per day. Such telemedicine assistance can be implemented in other isolated environments, such as mining or exploration camps.
Doctors Without Borders uses telemedicine five to ten times a day to seek advice from its 280 specialists around the world on difficult cases in remote, often war-torn areas. From sea to land
We are, however, at a point where telemedicine solutions will have far wider applications throughout society. The demographic and social changes that western societies are undergoing means that many once populous areas are being drained of people. Meanwhile, those that remain – often the elderly and the young – face increasing isolation and declining local services.
In France, my home, people living in the countryside often face waiting for weeks or months if they want to consult a specialist. It is not difficult to imagine that the digital revolution represented by the Telemedicine Case could be used to bridge critical gaps in services for local communities.
When you examine the technological trends that are coming together – remote diagnosis capabilities, cloud storage and support algorithms that assist doctors during diagnosis – you can see the way healthcare and, ultimately,
health insurance provision is changing.
No one who purchases health insurance actually wants to invoke the policy. Given the choice, people would rather be healthy. Today, we have this potential literally in our hands. Apps on the smartphones and tablets we all use have the ability to collect data on our wellbeing. When combined with more comprehensive analysis, such as a regular visit to a general practitioner, this can help build a total picture of an individual’s health. Switch from curative to preventative
This information can enable individuals to have more direct control over their health. It also helps create a system that is not only curative but works to prevent people from becoming sick. Providing individuals with more control over health measurement and linking this to medical and insurance systems can allow for in-time interventions.
Is this painting an unrealistic view of the future? I don’t believe so. In 2015, there were 800,000 virtual consultations in the US alone. In 2016, according to
BCC Research, this nascent global telehome and telehospital/clinical market was estimated to be worth nearly $23.8 billion and is expected to grow to $55.1 billion by 2021.
Clearly people are willing to embrace remote consultations. When powered by fast internet connections, linked to smart devices and supported by changing insurance standards, this will lead insurance more in the direction of healthcare services.
In the early stages, patients can use devices to monitor blood pressure, heart rate and other vital signs and send it to their doctor who can provide health coaching and preventive programs. In the primary care and diagnosis stage, it is possible to provide tele-triage and telemedicine advice, while in the treatment stage technology can assist with disease management and medication adherence, as well as with outpatient and ambulatory care.
As populations age, such solutions will play an important role in providing continuance in quality service while preventing an explosion in healthcare costs. Doctors are already able to link up with patients by phone, email and webcam on Skype. Today, prescriptions can be delivered online and even linked to pharmacies so that medicines can be delivered to your door. This is a vision that is not so much rapidly approaching as already here and being rolled out. It will fundamentally change the way you receive healthcare.
Allianz provides an interlinked chain of services for the shipping industry, including the Telemedicine Case, medical consultancy via a dedicated 24/7 call center, as well as repatriation and evacuation, and medicine delivery services. This is already operational in one fleet of 15 ships and the solution can be delivered with or without full ship and cargo insurance, as well as crew and family health plans