Telemedicine

Telemedicine Occupational Medicine Specialist

Dr. Brian Bourgeois’ practice is closely tied to the offshore petroleum and blue water shipping industries. He performs physical examinations for US Coast Guard, UKOOA, Marshall Islands, and Vanuatu Island licenses just to name a few. Dr. Bourgeois trains and interacts daily with safety personnel and paramedics in these industries and specializes in controlling and eliminating when possible OSHA Recordable Incidents and loss work time.

Dr. Bourgeois also serves as a special government employee on the United States Coast Guard (USCG) Mariner Medical Advisory Committee.

Dr. Bourgeois is a licensed medical review officer and also a Medical Director for international companies involved in the petrochemical industry. He is active in the education of offshore medics and safety personnel and lectures frequently on many topics including MRSA infections, identifying OSHA Recordable Incidents and controlling or eliminating loss work time.

He is a NOAA Certified Dive Medical Officer and a member of the Undersea and Hyperbaric Medical Society (UHMS). He is also certified in fitness to dive examinations. Dr. Bourgeois serves on the Medical Standards and Advisory Board of the Association of Diving Contractors International. Dr. Bourgeois is also certified in the management of complex decompression illness and hyperbaric injuries through the National Oceanic and Atmospheric Association. Dr. Bourgeois is an affiliate member of the US Gulf of Mexico Diving Safety Work Group.

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Telemedicine:

can be extremely beneficial for people working in isolated conditions and remote regions and is currently being applied in virtually all medical domains. Patients who live and work in such areas can be seen by a doctor or specialist, who can provide an accurate and complete examination, while the patient may not have to travel or wait the normal distances or times like those from conventional hospital or GP visits. Recent developments in mobile collaboration technology with the use of hand-held mobile devices allow healthcare professionals in multiple locations the ability to view, discuss and assess patient issues as if they were in the same room. Remote monitoring through mobile technology could reduce annual US drug costs by 15 percent by reducing outpatient visits, verifying prescriptions, and overseeing patient drug administration. Barriers to widespread adoption of remote monitoring include equipment costs, technical training and evaluation time. For example it has been estimated that a teledermatology consultation can take up to 30 minutes which contrasts sharply with the 15 minutes allowed for a traditional consultation. Additionally, poor quality of transmitted records, such as images or patient progress reports, and lack of access to relevant clinical information are quality assurance risks that can compromise the quality and continuity of patient care for the reporting doctor.

Telemedicine can be used as a teaching tool, by which experienced medical staff can observe, show and instruct medical staff in another location, more effective or faster examination techniques. It improved access to healthcare for patients in remote locations. “Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases,shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.” Several studies have documented increased patient satisfaction of telemedicine over the past fifteen years.[12]

The first interactive telemedicine system, operating over standard telephone lines, designed to remotely diagnose and treat patients requiring cardiac resuscitation (defibrillation) was developed and launched by an American company, MedPhone Corporation, in 1989. A year later under the leadership of its President/CEO S Eric Wachtel , MedPhone introduced a mobile cellular version,the MDPhone. Twelve hospitals in the U.S. served as receiving and treatment centers.[13]

Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. In general, a patient will have a number of monitoring devices at home, and the results of these devices will be transmitted via telephone to the health care provider. Telemonitoring is a convenient way for patients to avoid travel and to perform some of the more basic work of healthcare for themselves.

In addition to objective technological monitoring, most telemonitoring programs include subjective questioning regarding the patient’s health and comfort. This questioning can take place automatically over the phone, or telemonitoring software can help keep the patient in touch with the health care provider. The provider can then make decisions about the patient’s treatment based on a combination of subjective and objective information similar to what would be revealed during an on-site appointment.

Some of the more common things that telemonitoring devices keep track of include blood pressure, heart rate, weight, blood glucose, and hemoglobin. Telemonitoring is capable of providing information about any vital signs, as long as the patient has the necessary monitoring equipment at his or her location. Depending on the severity of the patient’s condition, the provider may check these statistics on a daily or weekly basis to determine the best course of treatment.

The first Ayurvedic telemedicine center was established in India in 2007 by Partap Chauhan, an Indian Ayurvedic doctor and the Director of Jiva Ayurveda. Teledoc used Nokia phones running Javascript to link mobile ayurvedic field techs with doctors in the Jiva Institute clinic; at its peak, Teledoc reached about 1,000 villagers per month in Haryana province, primarily treating chronic diseases such as diabetes.

Monitoring a patient at home using known devices like blood pressure monitors and transferring the information to a caregiver is a fast growing emerging service. These remote monitoring solutions have a focus on current high morbidity chronic diseases and are mainly deployed for the First World. In developing countries a new way of practicing telemedicine is emerging better known as Primary Remote Diagnostic Visits, whereby a doctor uses devices to remotely examine and treat a patient. This new technology and principle of practicing medicine holds significant promise of improving on major health care delivery problems, in for instance, Southern Africa, because Primary Remote Diagnostic Consultations not only monitors an already diagnosed chronic disease, but has the promise to diagnose and manage the diseases patients will typically visit a general practitioner for.