Improving Healthcare in Remote Environments Via a New Integrated, Online Communication Platform

Abstract

International SOS delivers integrated medical solutions to remote and extreme remote onshore and offshore projects worldwide, using highly trained and experienced medics with a robust system of protocols, procedures and clear escalation criteria to our Topside support centres.  To enable improved medical escalations from the remote sites, we have developed a customised, online communication tool called the Digital Topside Platform (DTP).  The system was designed to allow simplified telemedical interaction, improved data security, and enable integrated patient care from initial presentation to return to work, with a focus on managing the case on-site, and patient confidentiality. The design process included a focus on user experience and workflow optimisation, and an iterative development methodology.  The system includes multiple components including:  management dashboards, interoperability with existing case management systems, messaging, video and file transfer features, and case data including medical and contextual information via a mix of auto-populated and manual entry data points.  The solution was designed for non-urgent cases, which represents >80% of case escalation volume. Initial deployment of the solution to offshore oil rigs in West Africa and the Intl.SOS Johannesburg Response Centre has demonstrated four key improvements over baseline data. A preliminary analysis of our data shows that 70-80% of the case escalations use the system, demonstrating a high rate of user adoption. The improvements shown were: (1) reduced need for urgent medical evacuation for non-life threatening conditions; (2) increased adherence to evidence based guidelines via more efficient clinical governance processes; (3) faster escalation processes via profile management and system integration; and (4) early escalation of work related injury cases resulting in reduced time off work.  Based on evidence to date, the system facilitates improved healthcare management for patients in the remote offshore environment.  The system continues to be deployed to additional sites and regions globally, which will generate a statistically significant dataset for further evaluation.