DrChrono Blog

Worse things happen at sea

Alaska Maritime Physicians is working with DrChrono to provide electronic health records (EHR) solutions to its physicians, who use this in conjunction with iPads and iPhones to provide treatment to patients remotely at sea. Doctors handle treatment, recovery and triage using Apple’s technologies and DrChrono.
Communication technologies (radio, cellular, satellite, and internet networks) underpin the solution, but even though these continue to improve, these tools must handle some unique challenges.
“Imagine being in the remote regions of the Bering Sea as close to Russia as you are far from Alaska and having a medical emergency with storms and rolling seas,” R Scott Lord, vice president of operations at Alaska Maritime Physicians, told me.
“With a vessel in rolling seas it can be very difficult to make a solid satellite connection. AMP’s physicians have to be extremely versatile in working through urgent and emergent cases serving the maritime industry,” he said.

Unique industry challenges

While most larger vessels have medically trained personnel aboard, smaller vessels (or even larger vessels with small crews) may not have such luxury. Not only that, but even when trained medical officers are available, it’s likely they only support a limited scope of care.
That’s where this system comes into its own. It enables fully trained practitioners to dispense qualified advice remotely with reference to the case notes and medical histories of individual patients.
Another problem solved through provision of access to credible treatment is that it improves the relationship that exists between operators and the crew.
“If one crew member gets hurt or sick and the vessel is in the middle of a mission, or if they break off to get medical help for the injured or sick crew, then the mission can fail and become unprofitable,” explained Lord.
Access to treatment means operators can maintain their legal/ethical duty to their staff while also managing risk to the company in part because access to professional advice may help assist any necessary insurance claims.
“The transformation is helping manage risk for the operator/owner while caring for the sick or injured,” Lord said.

In the absence of appropriate skills, a sick or injured crew member may be required to languish for a very long time before help is received.
The new system means medical assessments and treatment can begin almost immediately.
“We are able to leverage the medically trained crew members on-board to administer care and treatment from our physician’s treatment plan,” Lord said.
Alaska Maritime Physicians finds that one of the biggest challenges when providing remote treatment is staying organized. DrChrono’s solution eases that problem, as it enables doctors to document and follow up each case effectively through the app.
This leads to other benefits.
Not only does this make it much easier to help remote patients keep to treatment plans, but the reporting features make it possible to more easily identify trends on a specific vessel, company or across the entire fleet.
“We recently had a frostbite case on a vessel, followed by a second. Shortly thereafter we got a third frostbite case on a second vessel,” Lord told me. “We identified this trend, worked with the safety teams on best practices and were able to communicate these to the crews on-board. This was all possible because of DrChrono’s reporting tool.”
That’s not to be underestimated and I think illustrates how connected (yet private) data analysis can help fight infectious disease.

What the Apple/DrChrono system does

The service, which will be announced soon, has been available in quiet mode for a few months, with 350 patients treated.
Clients benefit from knowing there’s a doctor on call 24 hours a day and that if they are called, medical professionals will be able to securely access patient data on their Apple device.
The system handles consultations, treatment plans, diagnosis and referrals, and it includes tools to help analyze some of the most common medical scenarios that happen at sea. (These include burns, lacerations, frostbite, and broken bones.)
One thing that is no different at sea than it is on land is the need to protect patient confidentiality. That security is essential in healthcare and mandatory under HIPAA.
Apple’s big platform advantage in the provision of security was one of the big reasons the medical group opted to standardize its service around the platform.
“We looked at many other platforms but kept coming back to iOS because of Apple’s dedication to privacy and security,” Lord said.
He also likes the fact that physicians can access the solution using biometric ID (Touch/Face ID). This “eliminated the brain damage of entering lengthy complex passwords,” he said.

An Apple advantage

“Would a service like this be possible without Apple’s solutions?” I asked Lord.
“With a lot more difficulty, it would,” he said. “Apple was our preferred platform from the beginning with its elegant and consistent user interfaces, intense focus on privacy and security, biometric access, excellent hardware, and support. We were very excited to discover DrChrono was Apple based.”
What about the future of healthcare as digital transformation takes hold?
“If you have the medical intelligence, then machines could be made to diagnose and treat, perhaps organs, fingers, legs could be printed on machines and used for transplant?
“I don’t know if I want to get into some robotic surgical machine on a vessel churning in the Bering Sea just yet, but who knows what the future holds. …” said Lord. here