Article published in Sea Technology (June 2014) issue:
Doctors Without the Office
Telemedicine Brings Medical Care to Remote Job Sites
By Dr. Michael Garcia and Dr. Thomas Falterman
A company’s overall productivity directly depends upon the individual productivity of its employees. Employee illness, in the form of both physical absence from work and reduced productivity due to illness while present at work, costs hundreds of billions of dollars annually. Employers in all industries need to take steps to invest more heavily in the health of their workers, for the benefit of individuals as well as their company’s own financial health.
In the offshore and remote onshore oil and gas industry in particular, there are numerous opportunities for workers to sustain injuries or illnesses that result in short or long term conditions that can prevent them from doing their job. Typical injuries can include falls from elevation, back strains, fractures and overexertion. When a worker falls ill in a remote job site location (as is common in the modern day oil and gas industry), it can present a stressful and often expensive situation for both the employee and the employer respectively.
Fortunately, nowadays there are companies that can harness the cutting edge of modern technology to provide a service that can not only extend communications to those remote locations, but provide fast and effective health care directly to those workers in need. The service is known as ‘telemedicine’. The goal of telemedicine is to provide quality medical care remotely for those in need at offshore, or isolated onshore, worksites. Furthermore, the unique telemedicine service offered by Worldwide Telemedicine (WWTM) goes even further in that it can also assist in reducing a company’s OSHA recordables during the handling of each individual case.
Reaching out to those in need
WWTM is a company, based in South Louisiana, created with the aim of being virtually present at any medical emergency. The company’s technology provides the most comprehensive medical care available in the industry, to reduce the need for costly emergency transportations and effectively manage emergencies and injuries in real-time. The company employs board-certified physicians and trained paramedics who utilize the cutting edge technology inherent in WWTM ‘Telemedicine Units’ to communicate with the remote work location in real-time via satellite or Wi-Fi. Via the Telemedicine Units, all of the Emergency Physicians at Leonard J. Chabert Medical Center (CMC) (an Acute Care Hospital opened in 1978) are able to be ‘virtually present’ at a client’s job site to successfully address any medical emergency. Essentially, the WWTM Telemedicine Unit functions just like a doctor’s office, without the office, eliminating or reducing unnecessary lost time accidents and evacuations on behalf of offshore clients.
The technology also allows for a case manager to be ‘patched-in’ in real-time to immediately record an employee’s incident report, which can greatly increase the accuracy of any OSHA recordables. This capability is unique to WWTM’s Telemedicine Unit, and provides added value to clients who are conscientious about maintaining and reducing their OSHA records.
WWTM’s comprehensive service provides immediate response to emergency situations in the remotest of locations around the globe, and keeps employees safe and well cared for while they are performing their jobs in frequently high-risk or remote locations.
The benefits of remote care
WWTM’s telemedicine system provides a range of comprehensive benefits. With board-certified ER physicians, specially trained on-site paramedics, a state of the art Telemedicine Unit and turnkey case management abilities, all of WWTM’s services are geared toward the safety and health of its clients’ employees, while also assisting clients with effective cost management measures. Packages can be modified to meet specific company and job site requirements, and variables generally consider are: the number of job sites, hours of client coverage required per day, service to a stationary vs. floating rig vs. vessel and geographical location of the job site.
By enabling the doctor to attend directly to the patient via the Telemedicine Unit, companies will fundamentally decrease their expenditure on worker evacuations for unnecessary ER visits, observe a dramatic reduction in lost time incidents and appreciate the value (and not to mention peace of mind) attached to having 24/7 access to board-certified ER physicians with the aim of getting a worker fit to resume his/her job.
The process: A breakdown
When an offshore incident occurs, WWTM doctors provide immediate consultation and guidance to on-site paramedics for a thorough and accurate diagnosis, care and treatment at the job site. Unlike other telemedicine service companies who dispatch only the telemedicine unit to a site, and therefore place the onus on an unskilled worker to operate it and initiate doctor-directed treatment, WWTM’s OSHA-trained, occupational medical, ER doctors are physically present next to the Telemedicine Unit to answer a call when it comes through; they are more than just ‘on-call’. This means there is zero downtime between a call for assistance being placed by the client and the client receiving a response from the doctor. There is no wait time involved in the doctor taking time to arrive physically at the scene and getting prepared. With WWTM’s Telemedicine Unit, the doctor is already ‘on location’ and ready to assist.
Additionally, WWTM provides actual paramedics onsite performing doctor-directed tasks, rather than emergency medical technicians (EMTs). Many people are not aware of the differences between the two roles. Whereas EMTs usually receive between 120 – 150 hours of training and are restricted from administering injections or intravenous lifelines, paramedics are usually subject to between 1200 – 1800 hours of training, the completion of 2-year degree programs, and are certified to break the skin of patients in administering shots and IVs, as well as performing advanced airway management to support the breathing of patients in potentially life-threatening conditions. The paramedics that are provided by WWTM are trained in the use of 30 – 40 medications and can go well beyond the basic EMT sphere of activity, which is largely restricted to administering oxygen, glucose, asthma inhalers and epinephrine auto-injectors.
Although both basic EMTs and paramedics can respond to emergency medical incidents, EMTs are specialized only in the most important elements of emergency medical training. By offering more advanced paramedic level training in its services, WWTM can address supportive care, provide follow-up examinations via the WWTM Telemedicine Unit and maintain patients after the initial emergency recovery, ensuring that the care offered does not end when the emergency or initial illness is over. A huge amount of expense can therefore be avoided by circumventing emergency transportation costs back to the mainland, as in many cases the patient can be treated in-situ. Traditional telemedicine services that rely on unskilled workers to carry out the instructions of a doctor remotely often do little to negate the need for eventual patient evacuation at substantial expense to the client.
If evacuation is in fact deemed necessary, the mobile Telemedicine Unit, with certain upgrades, can provide continuous monitoring by a board-certified physician during the evacuation. In addition, WWTM has a partnership with an occupational medical clinic (OMC) in Houma, Louisiana, where the patient can be transferred for continued care rather than to an ER facility, if this is preferable under the circumstances. OMC facilities are typically more knowledgeable about industry OSHA requirements than standard ER facilities, and can therefore help manage OSHA recordables for the client in an informed and helpful manner.
Another benefit provided by the WWTM system is the ability to patch-in a case manager to record an account of the incident or illness in real-time. Occasionally, accident accounts can become altered or skewed in the aftermath of the event and in the period of time between the incident and consultation with a case manager back onshore. By recording an accurate account of the incident immediately after it occurs, the case manager is able to record and preserve important details while they are fresh in the minds of those involved. This ability can greatly help a company maintain its OSHA records.
In a survey of oil and gas company presidents, directors and managers conducted by WWTM in November 2013, most respondents claimed that although WWTM was a name they were well familiar within the telemedicine market, ‘overall cost’ was the main reason they did not employ a telemedicine service from any provider of services in this field. Although telemedicine services are not currently mandated by regulation, the value of such a service lies in the reduction of lost time incidents and the boosting of worker productivity.
Preserving the welfare of the workforce with the best and most responsive medical care at all times of day and night is an essential prerequisite for any company looking to minimize downtime and protect their reputation as a responsible employer in the industry. Telemedicine services dramatically decrease the cost of emergency medical transportations. In addition, WWTM’s technology saves the client money by increasing the accuracy of any OSHA recordables and offering a turnkey service without cutting corners. When these points are properly considered, it is clear that investment in a comprehensive telemedicine service, such as WWTM’s unique offering, is also an investment into the wellbeing of your organization’s financial health.