Featured Initiatives : Humanitarian and Disaster Response Telehealth
Humanitarian and Disaster Response Telehealth
Telehealth is a means of improving the conduct of humanitarian and disaster response (HADR) medical assistance. Telehealth can reduce the barriers to providing humanitarian medical assistance, including the time, lost productivity, and expense corresponding to on-site provision of humanitarian medical support. The required human “footprint” can be reduced, i.e. the travel, logistical support (food, shelter, and housing), and health and safety risks associated with foreign travel as medical expertise is provided at a distance. Specialized expertise that might only occasionally be required can be provided only when needed. This is also a key factor in the sustainability of medical services, as the workload can be shared among multiple providers from many organizations independent of their geographic location, covering different shifts and timezones.
Haiti Earthquake Relief
UM has employed telehealth in supporting the University’s response to the Haitian earthquake, which has been operational from January 2010 until the present. Within 24 hours of the January 2010 Haiti earthquake the University of Miami (UM)/Project Medishare team set up a field medical facility within the UN-secured zone on the grounds of the Port Au Prince airport. Ten days later, a 220-bed, tent based field hospital was established within the airport’s grounds. In June 2010, the field hospital was disassembled and its resources were relocated to an existing facility, Bernard Mevs Hospital. The facility is still supported by the University of Miami and Project Medishare and continues to be the primary trauma and critical care hospital in Port Au Prince, including neonatal and pediatric critical care. Patients are received from medical facilities throughout the region, and medical staff routinely travel to these other faciliies to provide assistance.
Figure 1. The UM/Medishare management team in the command center in Lois Pope Life Center on the UM medical campus communicates by videoconference with the initial field medical facility on the UN compound near the Port Au Prince airport.
Figure 2. A view from Haiti — the other side of the videoconference shown in Figure 1.
Telehealth has played a critical role in the University of Miami/Project Medishare response to the Haitian earthquake since the first few days after the earthquake. A combination of donated high-bandwidth satellite links and leased Haitian wireless internet services provided the telecommunications backbone for telehealth. Specific telehealth capabilities include teleradiology, videonferencing-based interactive telehealth sessions, and store-and-forward (asynchronous) teleconsultation. Daily interactive sessions have been conducted with University of Miami trauma and critical care specialists for bedside rounds for adult and pediatric patients. Interactive telehealth consultations have also been conducted with UM pediatric cardiologists and oncologists. These telehealth capabilities continue to perform since their initial deployment and have transitioned into the new cooperative clinical facility at Bernard Mevs in Port Au Prince.
Figure 3. A UM pediatrician and pediatric cancer specialist consult with the medical team at the UM/MediShare field hospital in Port Au Prince from the Holtz Children’s Hospital in Miami.
Collaboration with US Southern Command
The US Southern Command (SOUTHCOM) is one of the 10 combatant commands in the US Department of Defense, with a geographic area of focus (AOF) in the Caribbean and Latin America. HADR is an important component of SOUTHCOM’s mission. UM and SOUTHCOM have a formal agreement to collaborate with and advise the command in matters related to telehealth in the SOUTHCOM AOF. To that end, UM TeleHealth has conducted two prior telehealth demonstrations in conjunction with SOUTHCOM:
(1) in the Dominican Republic associated with the Continuing Promise mission in October 2008
Figure 4. A US military physician in the Dominican Republic consults with a pediatrician in the US via satellite.
(2) in Guyana in July 2009 associated with the Crisis Management IV disaster training activity.