Telecommunication Methods for Implementation of Telemedicine Systems in Crisis

Disaster management utilizes diverse technologies to accomplish a complex set of tasks. Despite a decade of experience, few published reports have reviewed application of telemedicine (clinical care at a distance enabled by telecommunication) in disaster situations. Appropriate new telemedicine applications can improve future disaster medicine outcomes based on lessons learned from a decade of civilian and military disaster (wide-area) telemedicine deployments. Emergency care providers must begin to plan effectively to utilize disaster specific telemedicine applications to improve future outcomes. Telemedicine encompasses the diagnosis, treatment, monitoring, and education of patients, and provides convenient, site independent access to expert advice and patient information. Transmission modalities include direct wired connections over standard phone lines and specialized data lines, and wireless communications using infrared, radio, television, microwave, and satellite-based linkages. This paper reviews the history of telemedicine activities in actual disasters and similar scenarios, as well telemedicine innovations that may be applicable to disaster situations in the future.