How To Improve Health Care In Remote Areas

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Noel Ward
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1 E-Health Communications Solution Gilat Whitepaper, Nov-2010 Introduction One of the healthcare challenges that many countries are facing is that the level of medical services in remote regions is worsening compared to medical services in the large cities. This problem is intensified by the fact that the demand professional medical services and medical aid is increasing primarily in those same remote areas. The trend is that skilled doctors from rural health centers and clinics are draining to the more developed urban hospitals where they can be close to their professional peers and to the nation s medical experts. The use of common telecommunications and multimedia technologies for improving the medical and healthcare services has become more common but is usually restricted to the large central areas, thus widening the gap between urban and rural healthcare even further. This whitepaper discusses these challenges, examines various aspects of E-Health and presents a number of case studies that describe the technology that organizations have used to overcome the challenges. Sharing Knowledge and Medical Data Video Conferencing The use of Video Conferencing for E-Health is primarily in the field of Medical Tele-Education and Medical Tele-Training. Doctors and healthcare professionals can get trained, updated and informed by a wide range of medical specialists from the leading medical institutes and hospitals. This saves the travel time and costs, creates a broader range of medical fields that can be covered and addresses a much larger group of trainees. A communications system that supports long distance video conferencing along with the appropriate applications can raise the level of the health system starting from the main hospitals and spreading the knowledge out to the remote clinics and health centers. Virtual Experts Video is applied in E-Health not only for training but also for consultation, diagnosis and treatment. Realtime video applications are now used for Tele-mentoring and Tele-surgery. This is when a team of experts assist remotely located surgeons during surgery that requires several surgical sub-specialties. Likewise, physicians and specialists at the main hospitals can receive patients medical data and test

VSAT Satellite Terminals which provide a link to the patient data base and to the computerized drug utilization review program which can identify contraindications, potential drug interactions and

2 results from remote clinics through real-time data communications systems and provide instant consultation and diagnosis. Case study Maccabi HealthCare Services Maccabi's Healthcare Services in Israel have linked their 42 owned pharmacies and 650 private pharmacies to the Maccabi central computer system using Gilat s VSAT Satellite Terminals which provide a link to the patient data base and to the computerized drug utilization review program which can identify contraindications, potential drug interactions and dosage errors. The prescription filled in by Maccabi s physicians is entered into a system and that can be accessed by any affiliated pharmacy via the VSAT allowing the pharmacy to assess any possible contraindications before actually dispensing the drug. The newest innovation in this pharmacy system is the extension of the electronic prescription that enables the patient, to order his drugs online at the pharmacy of his choice. When the patient arrives at the pharmacy to pick up his medication, it is already packaged and waiting for him. Emergency Response In the tragic event of a natural disaster or contagious disease outbreak, hospitals and health clinics are seldom able to deal with the additional flow of patients requiring immediate treatment and many of the victims are not able to reach nearby hospital. In order to be prepared for such an event, governments set up mobile healthcare facilities that can be deployed wherever the disaster strikes. These mobile clinics or field hospitals need to be equipped with a communications system that can operate even when the terrestrial infrastructure has been damaged or destroyed. Here are a few examples of such systems. Mexico Field Hospitals Mexicans know natural disasters all too well. The country lies in a region of seismic activity and has been struck repeatedly by major earthquakes. In 1985, an earthquake of 8.1 force struck Mexico City, causing the deaths of around 10,000 people. Hurricane Wilma, the most intense Atlantic storm ever recorded, hit Mexico in In response, the Mexican Ministry of Health established mobile field hospitals equipped with Gilat VSAT technology to provide reliable broadband, voice and data services during times of epidemics or disasters. These selfcontained field hospitals are designed to handle different types of disasters and to operate independently for extended periods of time. They include a communication room equipped with the

The link is invaluable in enabling high speed data transfer, such as laboratory results, server synchronization, ordering supplies and other data applications.

3 VSAT and all related communication equipment. This technology provides VoIP phones for telephony services, video conferencing when doctors need the help of medical specialists, and high-speed Internet access. The link is invaluable in enabling high speed data transfer, such as laboratory results, server synchronization, ordering supplies and other data applications. Rhode Island Hospital Mobile Emergency Communications System After the September 11 attacks in the US, the Joint Commission on Accreditation of Healthcare Organizations mandated that hospitals provide backup communications services, and establish alternative healthcare sites. These sites, often in schools, typically lack the robust communications systems required for effective disaster response. When planning its backup communications solution, Lifespan, Rhode Island's health system, decided to build a highly portable system that would be easy and to set up rapidly in any location, even by a layperson and based on commercial off-the-shelf (COTS) components. The system that they designed with the Cisco Rapidly Deployable Communications technology that provided complete voice and data communications capability to hundreds of users through a direct satellite broadband service provided by the Gilat US subsidiary, Spacenet. Missouri Hospital Association To be prepared for periods of communications downtime, the Missouri Hospital Authority in the USA has established 16 mobile hospital units, all of which are fully equipped with Gilat VSATs for data and video connectivity. These units take over when victims of accidents or natural disasters cannot get to a hospital in time. Enabling real-time video conferences and consultations with doctors elsewhere during medical procedures, the vehicles serve as miniemergency rooms.

4 Telemedicine Telemedicine is the provision of medical aid from a distance using data communications and multimedia technologies. An efficient way of implementing Telemedicine centers is in the form of mobile telemedicine centers that are equipped with all of the necessary IT applications and telecommunications devices for remote diagnosis, treatment and the transfer of medical data, and can move from place to place providing medical support for a larger region and based upon need. VSAT technology provides an effective solution for mobile telemedicine centers due to its unmatched coverage and availability. The case study below shows how VSAT technology was used for this purpose. OSU Mobile Telemedicine Clinic Oklahoma State University (OSU) Center for Health Sciences offers programs in osteopathic medicine, biomedical sciences and forensic sciences and together with their affiliated teaching hospital support one of the largest statewide telemedicine programs in the US. OSU Center for Health Sciences Telemedicine Center uses a satellite network service provided by Spacenet, a Gilat subsidiary for its new Mobile Telemedicine Clinic. The Mobile Telemedicine Clinic can provide healthcare services care to patients located anywhere in the country. The vehicle includes a clinic with an examination room and Telemedicine applications such as interactive video and real-time telemetry. The OSU Mobile Telemedicine Clinic uses a combination of ICT equipment including Gilat s Satellite Terminals and Cisco equipment to support its mobile medical facility. This Mobile Telemedicine Clinic can establish broadband connectivity virtually anywhere in the United States and has already logged more than 20,000 miles, travelling to, and serving the health needs of Oklahomans. The OSU telemedicine program includes 35 regional hospital and clinic partners and is one of the largest state-wide telemedicine programs in the US.

5 Gilat s E-Health Solution Overview Summary Healthcare authorities are taking major steps to improve their level of service to the community and a critical factor in this undertaking is the ability to exploit the most up-to-date medical knowledge and to deliver high-level healthcare services to the remote and rural population. Gilat s broadband VSAT system features the key elements for creating a communications platform that enables the various facets of E-Health discussed in this paper. For more information, please visit

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