- Telehealth services delivered through a mobile EHR platform are improving access to care for those who sail on and work in the frigid waters off Alaska.
Alaska Maritime Physicians, an Anchorage-based provider serving a wide variety of commercial and recreational maritime companies, recently partnered with DrChrono to coordinate its connected care services through the latter’s mHealth-based EHR platform. The collaboration is expected to improve a care delivery platform that serves one of the planet’s most inhospitable regions.
“Our niche is urgent and emergent telemedicine,” says R. Scott Lord, Vice President of Operations for AMP, whose clients ranges from small fishing vessels, fleets and associations to commercial barges, tugs and processing ships. “When we get a call, it could be anybody. It could be a captain on a really small fishing vessel with no training and zero resources to someone on a 100-person (vessel) with resources” but not the expertise.
Popularized on TV in shows like “Deadliest Catch,” the waters of the northern Pacific and the Bering Sea are a popular and lucrative spot for fishing, both recreational and commercial, as well as the shipping of goods to and from Alaska and a good-sized sailing and cruise ship industry. But rough seas, unpredictable weather and frigid temperatures make this region extremely hazardous, not to mention adding challenges to healthcare access.
AMP launched in 2015 to tackle those challenges, primarily through a phone-based telemedicine platform that enables clients to instantly connect with a licensed physician and send images through a store-and-forward portal.
“It’s hard to get a really good Internet connection out there,” Lord notes. “The barrier we’re dealing with every day is equipment and connectivity. And when you’re doing triage, you want that connection to be good. They need to give care; they don’t need to be fighting with technology.”
“We also needed a way to document and record all of our occurrences,” he adds, as the medical record can be used for insurance claims and workmen’s compensation – and to identify trends that could be used to support health and safety initiatives at sea.
The deal with DrChrono takes the platform to the next level, adding iPad and iPhone functions that enable better communications, access to more resources and, in some cases, video. That platform may also include digital health devices that can relay vital signs and other data back to AMP’s Anchorage clinic.
“We envision a world where there will be toolkits of apps, hardware, and IoT devices that a provider can simply connect to their EHR,” says Daniel Kivatinos, the co-founder and Chief Operating Officer of DrChrono, one of several EHR companies with a mobile-first platform designed for care providers working in remote locations. “I would love to allow doctors to be able to do fully remote consultations, leveraging telehealth, allowing them to walk a patient through a procedure, sharing their screen and drawing on an iPad Pro with an Apple pencil on an educational diagram. In turn on the patient side, the patient interacting, also sharing data from FDA approved devices connected to the patient with that data in real time being given right to the provider. As we break down more barriers, patients can get more from amazing doctors from all around the world, creating global care teams for a patient.”
The alternative to a telemedicine platform is expensive, even deadly. Minor injuries or illnesses might not be dealt with until the vessel returns to port, delaying care that could create more complications down the road. More significant injuries would require an extraction by helicopter, which costs upwards of $100,000 and can also be weather-dependent.
“These mariners might not be getting any care at all, or they might not be getting the appropriate care,” Lord says.
Since going live on the new telemedicine platform in 2018, AMP has answered more than 350 calls for assistance, ranging from frostbite, lacerations and illnesses to broken bones and serious injuries.
Frost says the platform has also allowed those on board to give better care, with the support needed to improve triage. One company, he notes, required eight emergency extractions in one year prior to working with AMP; last year that same company only needed three.
And they’ve saved lives.
Frost says AMP received one call for a vessel’s captain who wasn’t feeling well. It turns out the man was experiencing a heart attack, but didn’t think it was serious enough to merit immediate care. He changed his mind after being examined by the AMP physician.
“That saved his life,” Frost says. “Absolutely.”