Healthcare delivery for oil rig workers: telemedicine plays a vital role.

O il rig workers know the dangers presented by their jobs. Most, fortunately, do not experience the trauma faced by their brethren on the Deepwater Horizon in the Gulf of Mexico. However, lacerations, sprains, fractures, and minor injuries come with the territory, and despite their remote locations, oil workers are not immune to upper respiratory infections, kidney stones, heart attacks, or other acute conditions. For years, oil companies have staffed the rigs and platforms with a paramedic, emergency medical technician, or nurse who would assess the worker and telephone findings to a physician on shore. Without the ability to examine the patient or closely monitor him or her, physicians often ordered evacuations to onshore providers. Many workers returned the next day, after receiving treatment. Now that drilling rigs and oil platforms are equipped with Internet and satellite connections, several entities are offering telemedicine services. Emergency medicine and other specialty physicians on shore can exam the patient and order electrocardiograms (ECGs) and laboratory tests, allowing them to more accurately assess the patient and determine a plan of care. ‘‘Telemedicine’s greatest advantage is to bridge access to care, and that is what it is doing for [the people on] these oil rigs,’’ says Alexander Vo, Ph.D., executive director of the Center for Telehealth Research and Policy at the University of Texas Medical Branch (UTMB) in Galveston, which began piloting oil rig telemedicine services several years ago as part of its employee-health program. ‘‘Oil rigs do not have medical specialists on board, so telemedicine is a means to bringing specialists on board and treating the patients,’’ Vo says. ‘‘There is value to the patient and the corporation.’’ UTMB no longer provides telemedicine services to the oil-industry market, although it continues to provide other telemedicine services. Its physicians saw more than 80,000 patients through videoconference last year. Vo refers interested oil companies to NuPhysicia, based in Houston. Three of the university telehealth center’s leadership staff left to establish NuPhysicia 3 years ago. Glenn G. Hammack, O.D., M.S.H.I., serves as president of NuPhysicia; Oscar W. Boultinghouse, M.D., M.P.H., and Michael J. Davis, M.D., M.B.A., serve as senior vice presidents. NuPhysicia aims at bringing proved UTMB telemedicine systems to new global markets. Its InPlace Medical Solutions division provides telemedicine to remote locations, including about 20 oil rigs in the South China Sea off Malaysia, the Persian Gulf off Saudi Arabia and Kuwait, the Atlantic off Brazil and South America, the southeastern Caribbean near Trinidad and Tobago, and the Gulf of Mexico. It is also working for a company producing oil in a remote, landbased Iraq location. NuPhysicia is not the only provider of telemedicine services on oil rigs. Remote Medical International in Seattle began providing telemedical care to the oil industry about 5 years ago. Chris Kenney, director of the equipment and supply and telemedicine group for Remote Medical, would not release the number of oil-industry installations for which it provides telemedicine services. The company also offers telephone-based care, evacuations, and other services in remote locations. The Maritime Medical Access program at the George Washington (GW) University Medical Faculty Associates Department of Emergency Medicine, an affiliate of GW University Medical Center in Washington, DC, provides physicians for telemedical care on one oil rig and on ships cleaning up the BP oil spill in the Gulf, reports Kyle Keenan, R.N., B.S.N., director of Remote Medical Programs and Maritime Medical Access for GW Medical Faculty Associates. Abermed in Aberdeen, Scotland, provides occupational health services to about 100 offshore oil installations and to 25 diving support, survey, and pipe-laying vessels. It has made limited use of telemedicine, due to the cost, but the company is aware of developments in the field, says James Miller, chief executive of Abermed. ‘‘The oil and gas industry has a particular interest in technology, as it is an industry driven by the use of new technology and is made up of engineers and technical people, and so are amenable to solutions that they perceive are bound to be of benefit,’’ Miller adds. ‘‘If there