簡介：海洋平臺現在可以使用遠程醫療服務了。在2月份，遠程醫療服務提供商NuPhysicia 公司，發布了一項名為“現場醫療解決方案”的技術，該技術方案針對海洋石油平臺而設計，能夠將遠程醫療服務通過互聯網和衛星寬帶，傳送到以前認為很危險的現場平臺上，確保作業人員的人身健康和安全。

The oil and gas industry discovered the value of remote operations more than a decade ago, and since that time, there has been dramatic progress toward increasing field production and reducing the number of onsite personnel through integrated operations.

In February, NuPhysicia LLC, a provider of telemedicine health services, launched a service called InPlace Medical Solutions that takes remote operations to the next level. InPlace Medical Solutions is the first offshore medical service that connects remote workers with physicians through live, two-way videoconferencing.

According to Shannon Caldwell, NuPhysicia executive director of offshore and remote services, several factors led to the development of InPlace Medical for the offshore oil and gas industry. “From the technical perspective, it was improved telecommunications to the rig ? Internet capability and other satellite bandwidth improvements. From the business needs perspective it was a combination of exploration moving into more and more remote locations, as well as the advancing personnel demands of scarcity and aging of the offshore workforce.”

The service combines advanced telemedicine technology and medical services to improve workforce health and safety and lower risks. The end result is that offshore rig and remote workers gain access to advanced healthcare, direct physician attention, and improved medical technology.

“Using InPlace Medical Solutions, any rig with Internet capability can have instant attention from world class board-certified physicians through telemedicine,” Caldwell said. Physician-driven care allows injuries and illnesses to be assessed properly on the rig and managed better, which reduces the number of unnecessary helicopter evacuations and the risks associated with them. “With InPlace Medical Solutions,” he said, “patients are evacuated only if medically necessary, and their care is better managed while a helicopter is en route. A significant portion of helicopter evacuations from drilling units in the Gulf of Mexico (GoM) in 2007 were due to non-work related medical incidents ranging from ear infections to heart attacks.”

From past to present 

In 1995, the University of Texas medical branch took on one of the biggest healthcare challenges facing the state of Texas ? how to make quality healthcare available in places that are hours away from the nearest doctor. This was the same year the Internet came of age, so a digital network was created based on high-resolution imaging and teleconferencing. The result was the ability to put patients and doctors in the same room even though they were miles apart.

This telemedicine system was able to deliver high-quality medicine to more than 3,000 workers in Antarctica over a period of 13 years and 120,000 inmates in more than 100 correctional facilities in Texas. The systems also are installed on offshore production platforms in the GoM and on pipe-lay vessels worldwide. In 2008, more than 60,000 patients were treated using this approach to healthcare.

Telemedicine at work

The delivery model for telemedicine places specially qualified medics, advanced equipment, medical quality videoconferencing, and an electronic medical record (EMR) system for record keeping on the rig. Each rig is supplied with 128 prescription medications, including vaccines and 20 types of antibiotics.

Unlike a medic supported by a doctor by telephone, a medic using InPlace Medical Solutions has access to live two-way videoconferencing that allows the physician to see and talk to the patient and do examinations with video scopes and a digital stethoscope.

There are seven physicians that work on a rotating schedule to provide 24-hour coverage. Each offshore location is provided with set sick call hours, normally consisting of two hours in the morning and two hours in the evening since the crews work 24-hour shifts. During these times, anyone who visits the clinic has access to a physician.

“Between sick call hours, the medic is still available to treat minor illnesses based on written protocols,” Caldwell said. “Any person seen by the medic is scheduled for a follow-up with the physician at the next scheduled sick call. If the medic feels that the complaint requires a physician, the same physician is on call and must respond within 15 minutes.

“InPlace Medical Solutions also provides services previously not easily available on rigs,” Caldwell said. These include voluntary health risk assessments, occupational medicine, preventive care, and health and wellness programs.

Establishing offshore service

The service has been implemented successfully offshore, but accomplishing that objective was not without challenges. “With any use of technology in medical services there are lots of ways to do things wrong, and offshore remote medicine is no exception,” Caldwell said. “While technology challenges continue to fall away, the most significant barriers that emerge are the process, the training, and the working method of effective clinical care. It is often easy to do something once ? the thousands of patients examined and treated during the development of InPlace Medical Solutions’ methods mean that services are effective and reliable.”

There are some differences between how the technology was applied in remote places onshore and in how it is being applied offshore. “The technology is the same only smaller,” Caldwell explained. “The major difference is the amount of medications and medical equipment we supply for this environment. Since we are not able to write a prescription for the person to take to their local pharmacist, we carry significantly more diagnostic tools and medications to provide comfort and cure. We are able to do this because the physician is the one doing the exam and providing the diagnosis.”

In the places where the technology is being put to work, it has worked well. “So far it has been very positive,” Caldwell said. “Everyone we have spoken to has agreed that this has been a long time coming.”

Now, more areas of the world are taking advantage of the service. “We have one customer operating off the coast of Borneo in the South China Sea,” Caldwell said. “In addition, one of the companies we sell our equipment to as a trusted partner is using our equipment on two locations in the US GoM. This, of course, is not including the numerous applications from the university program that span the globe, including Antarctica.”

Pushing the limits

The biggest value of this service, Caldwell said, is that it vastly expands the area where operators can safely work. “This service will allow companies to go into areas they may have previously considered too risky. More importantly, we give companies the opportunity to improve the overall health of the workforce, decrease cost and risk, and improve the longevity and tenure of the current workforce.”

Dr. Glenn Hammack, president of NuPhysicia, said, “Multinational oil companies are grappling with a shortage of specialized labor for offshore rigs that promises to get worse. InPlace Medical allows them to have confidence that their offshore workforce safely stays where it needs to be ? keeping the rig productive ? rather than being diverted by minor medical issues.”

Additional information about InPlace Medical Solutions is available at www.inplacemedical.com