Abstract
BackgroundTelemedicine services have been successfully used in areas where there are adequate infrastructures such as reliable power and communication lines. However, despite the increasing number of merchants and seafarers, maritime and Arctic telemedicine have had limited success. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges.ObjectiveThe purpose of this review was to assess and analyze the current status of telemedicine services in the context of maritime conditions, extreme weather (ie, Arctic weather), and remote accidents and emergencies. Moreover, the paper aimed to identify successfully implemented telemedicine services in the Arctic region and in maritime settings and remote emergency situations and present state of the art systems for these areas. Finally, we identified the status quo of telemedicine services in the context of search and rescue (SAR) scenarios in these extreme conditions.MethodsA rigorous literature search was conducted between September 7 and October 28, 2015, through various online databases. Peer reviewed journals and articles were considered. Relevant articles were first identified by reviewing the title, keywords, and abstract for a preliminary filter with our selection criteria, and then we reviewed full-text articles that seemed relevant. Information from the selected literature was extracted based on some predefined categories, which were defined based on previous research and further elaborated upon via iterative brainstorming.ResultsThe initial hits were vetted using the title, abstract, and keywords, and we retrieved a total of 471 papers. After removing duplicates from the list, 422 records remained. Then, we did an independent assessment of the articles and screening based on the inclusion and exclusion criteria, which eliminated another 219 papers, leaving 203 relevant papers. After a full-text assessment, 36 articles were left, which were critically analyzed. The inter-rater agreement was measured using Cohen Kappa test, and disagreements were resolved through discussion.ConclusionsDespite the increasing number of fishermen and other seafarers, Arctic and maritime working conditions are mainly characterized by an absence of access to health care facilities. The condition is further aggravated for fishermen and seafarers who are working in the Arctic regions. In spite of the existing barriers and challenges, some telemedicine services have recently been successfully delivered in these areas. These services include teleconsultation (9/37, 24%), teleradiology (8/37, 22%), teledermatology and tele-education (3/37, 8%), telemonitoring and telecardiology (telesonography) (1/37, 3%), and others (10/37, 27%). However, the use of telemedicine in relation to search and rescue (SAR) services is not yet fully exploited. Therefore, we foresee that these implemented and evaluated telemedicine services will serve as underlying models for the successful implementation of future search and rescue (SAR) services.
Highlights
The advent of information and communication technology (ICT) has revolutionized various aspects of health care services, including the practice of telemedicine
The condition is further aggravated for fishermen and seafarers who are working in the Arctic regions
In spite of the existing barriers and challenges, some telemedicine services have recently been successfully delivered in these areas
Summary
The advent of information and communication technology (ICT) has revolutionized various aspects of health care services, including the practice of telemedicine. Adoption of onshore technology and research results in offshore conditions might seem like a quick remedy for the case This requires careful investigation of each service so as to identify the underlying difference between the onshore and offshore scenarios. Pedersen et al [5] highlighted the different factors, namely, access, quality of care, cost effectiveness, and emergency care, for transferring knowledge from onshore to offshore, by justifying the case with the medical application tested and implemented on an operative basis in Northern Norway Despite these differences, it is important to note that there is an area where direct adoption of onshore telemedicine services can be fruitful, such as patient-targeted telemedicine interventions, radio-consultation equipped with pictures and video, and video conferencing [9]. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges
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