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Telemedicine advances put to the test during pandemic

Image of Uniformed service member stands behind wall of computer screens . Click to open a larger version of the image. Virtual health exercise at Madigan Army Medical Center. (U.S. Army photo)

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In the wake of the COVID-19 crisis, the Telemedicine and Advanced Technology Research Center continues to develop technology that increases medical capabilities and provides rapid, flexible critical care expertise at the point of need.

During a recent Medical Museum Science Café, held virtually by the National Museum of Health and Medicine in Silver Spring, Maryland, TATRC director Army Col. Jeremy Pamplin described the implementation of the National Emergency Tele-Critical Care Network (NETCCN) and how telemedicine can improve outcomes for disaster response.

COVID-19 has led to the need for physical distancing and has overwhelmed the capacities of health systems, compelling many to adopt telehealth solutions. Clinicians discovered how telemedicine can enhance communication efforts, reduce exposure and personal protective equipment consumption, improve efficiency and quality of care, increase access to specialty services, and in some cases lower costs and optimize the use of resources.

However, as Pamplin mentioned, the findings fluctuated due to the complex nature of the U.S. health system, which is an intricate mix of local, state, and federal policies and diverse expectations, cultures, and belief systems. For example, the implementation of telehealth may improve outcomes for one organization, whereas the same implementation elsewhere may not.

Pamplin described how he and his colleagues studied the implementation of telemedicine in a military environment.

“Telemedicine in the military has consistently enabled military clinicians around the world to work beyond their typical scope of practice while deployed in austere, resource limited environments by providing reach-back capability to military experts working in referral centers across the globe,” he said.

Pamplin then looked at the potential use of a telecritical health system for large-scale military operations. According to Pamplin, telehealth technology could be adapted to a variety of care contexts including large-scale combat situations or natural disasters that rely on military aid.

Partnering with the civilian sector, Pamplin and his colleagues developed NETCCN, a telehealth system that could consolidate telehealth networks and manage a high patient capacity during an emergency or a national crisis.

When COVID-19 emerged, Pamplin and his team began the implementation of NETCCN to help respond to the current stressed health care system. According to Pamplin, the network brings remote critical care expertise to the point of care, providing e-consult support, remote home monitoring, relief coverage, tiered staffing, and specialty services.

“The NETCCN addresses the lack of critical care clinicians across our nation by shifting these resources where and when needed,” Pamplin said. “In a dynamic, flexible fashion, NETCC links remote expertise to frontline providers, often working beyond their scope of training, using secure, HIPAA compliant applications on mobile devices, thus bypassing the lengthy process of purchasing and installing expensive hardware packages.

Said Andrea Schierkolk, NMHM’s public programs manager: “TATRC’s efforts to address the benefits and challenges of telemedicine were put to the test during the COVID-19 pandemic, and documenting these innovations in military medicine contributes to NMHM’s mission to share the value of the nation’s investment in programs like those of TATRC.”

For more information on TATRC and its initiatives, please visit at www.tatrc.org

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