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Rugged Computing Case Studies

Rugged technology enhances remote healthcare management for shipping crews
by Brynna King

Seafaring is often recognized as one of the world's most hazardous occupations. Crewmembers contend with machinery, heavy equipment, slippery surfaces and harsh outdoor conditions that increase the risk of injury on the job, and illnesses often spread quickly in confined spaces. But one primary factor makes working on a ship especially perilous: isolation from medical facilities.

Telematic Medical Applications, based in Athens, Greece, is improving access to healthcare for shipping companies and other employers in remote locations. Its TMA Telemedicine Case, featuring Handheld Group's Algiz 10X rugged tablet computer, is enabling workers on offshore oil ships, cargo fleets and other vessels to consult with physicians across long distances. The results are impressive from both personal and business perspectives: healthier crews, decreased worker downtime, better employee retention and more selective use of expensive emergency healthcare resources.

In case of emergency

The TMA Telemedicine Case supports many healthcare efforts, including preventive checkups and care for basic illnesses and injuries -- essentially, the kinds of issues a family doctor would address. But one of its most important functions is to facilitate patient evaluation during emergencies.

Not every injury is an emergency, and without a qualified physician on-site to determine whether an incident warrants emergency care, the burden of crewmembers' welfare is often placed on first responders. Erring on the side of safety leads to well-intended but excessive use of emergency resources, which can add up to exorbitant costs for shipping companies.

"In extreme remote situations, we work directly with first responders to confirm that emergency evacuations are necessary," says Dr. Philip Sotiriades, general director of Telematic Medical Applications. "Virtual consultations allow a physician specialist to work in conjunction with first responders and determine which injuries are truly emergent and require costly transportation, and which can be handled on-site."

A rugged, mobile healthcare solution

The TMA Telemedicine Case is watertight, crush-proof and sealed against dust particles. It comes equipped with a general examination camera along with a telephonic stethoscope that delivers high-quality heart and lung sounds to a remote physician; a 12-lead electrocardiogram (EKG) that measures heart activity; and a spirometer, which measures lung function. It can be configured to include a wide range of additional devices.

The case also houses the fully rugged Algiz 10X, a tablet computer designed specifically for outdoor data collection and mobile communication in tough environments. The compact Algiz 10X is only 32 millimeters thick and weighs just 1.3 kilograms, but it carries an IP65 rating and meets stringent MIL-STD-810G military standards for protection against dust, water, drops, vibrations, extreme temperatures and varying altitudes.

Carrying out a physician consultation with the TMA Telemedicine Case is easy and intuitive. When a responding crewmember powers up the Algiz 10X, a workspace appears within AGNES Interactive, a web-based application from AMD Global Telemedicine in Massachusetts, USA. This software provides access to more than one thousand physicians, including specialists in offshore occupational medicine, through US Telehealth, a remote medical management provider based in Austin, Texas, USA.

Within AGNES Interactive's interface, the responder and a physician collect data from medical devices connected to the Algiz 10X, share documents and images in real time, and participate in live videoconferencing. After evaluating the patient, the care provider advises crewmembers about treatment and emergency transportation.

The Algiz 10X effortlessly facilitates these interactions with its built-in 5-megapixel camera and LED flash, along with a 10.1-inch touchscreen that adjusts backlighting automatically for comfortable viewing at night or in bright daylight. The tablet also features a microphone jack and several connectivity options including USB 2.0, VGA and RS232 ports that allow crews to connect virtually any telemedical device a physician requires. And there's no lag time, thanks to LTE capability -- the entire consultation takes place over the fastest cellular network available.

When a session is over, physicians enter patient data into AMD Global Telemedicine's Telehealth Consult software -- a patient record system also installed on the Algiz 10X that's specifically designed for telemedicine consultations, with workflow management tools for both live and deferred sessions. This application can also generate important reports for company management, such as the number of patient cases by site over a period of time.

Care where you need it

The telemedicine case's portability also makes the initial trauma assessment safer for patients.

"After an incident, it's difficult for crewmembers to know how to respond and whether to move the patient," Sotiriades explains. "The TMA Telemedicine Case is completely transportable and self-contained, allowing a thorough assessment wherever the patient is lying."

The importance of carrying out a patient evaluation at the incident site can't be overstated. Many container ships are at least 300 meters long -- the length of about three FIFA-sanctioned soccer fields -- with multiple decks and many different rooms and cargo holds. Moving an injured worker creates risk of further harm and is a liability concern.

Of course, the case's usefulness in harsh shipping environments depends on its reliable performance in variable outdoor conditions that include storms, water sprays, strong wind gusts and long periods of direct sunlight. Operating most technology outdoors ranges from inconvenient, such as squinting to read screens in bright daylight, to impossible: An ill-timed downpour can damage conventional handheld computers beyond repair. But TMA's telemedicine solution has proved to be completely dependable, allowing first responders and physicians to focus solely on medical care and critical decision-making.

Safety and savings

The benefits of using a reliable telemedicine solution are many. In addition to emergency consultations, the TMA Telemedicine Case helps crews maximize uptime and productivity by making it convenient to perform preventive health checkups, address illnesses before they spread, or treat minor injuries before they become more serious.

Having access to reputable healthcare options on board makes it easier to recruit and retain good employees who have health concerns. It also minimizes resources spent on administrative tasks related to Occupational Health and Safety Administration (OHSA) incident-reporting requirements. And it saves money by placing decisions about the use of emergency resources into the hands of qualified physicians.

"With real-time video streaming to accompany the transfer of valuable patient data, this modern rugged equipment enables physicians to perform accurate patient assessments despite barriers of distance and time," Sotiriades says.

When a medical incident occurs many miles and hours from professional care, having a tool that essentially brings that care instantly onboard helps keep both workers and businesses healthy and productive. The Algiz 10X and the TMA Telemedicine Case are keeping doctors and patients connected, improving patient outcomes, minimizing healthcare expenses and increasing productivity and profits in some of the toughest, most remote environments in the world.

Handheld Group AB
Kinnegatan 17A
531 33 Lidköping, Sweden
Tel: +46 (0) 510 54 71 70
Fax: +46 (0) 510 282 05
Email: info at

See full review of the Handheld Algiz 10X