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BAMC Mobile Medics deploy in support of hurricane victims

By Maj. Dan Yourk | BAMC Virtual Medical Center | Oct. 27, 2017

HUMACAO, Puerto Rico —

Two mobile medics from Brooke Army Medical Center and one nurse from Dwight D. Eisenhower Army Medical Center deployed to Puerto Rico to provide virtual health support to the disaster response effort there.

In coordination with the BAMC Virtual Medical Center, or V-MEDCEN, Capt. Becky Lux, Sgt. Andrea Bloom and Spc. Christian Bark, along with transportable telehealth equipment, were embedded with the 14th Combat Support Hospital from Fort Benning, Ga.

Hurricane Maria, a category 5 hurricane, hit Puerto Rico Sept. 20 causing a level of devastation and hardship rarely seen in American history.  Island-wide power outages, flooding, structural damage and a lack of clean drinking water and food continue to plague this small island territory over one month later.

In response to the decimated infrastructure and failing healthcare system, the 14th CSH was deployed to establish medical support in Humacao, Puerto Rico.

The 14th CSH established clinical operations in the Humacao area Oct. 12 and started providing care to the local population.  The CSH emergency room was quickly occupied with hundreds of local patients seeking care and medical support. 

In response to the overwhelming volume of patients, in excess of 150 a day, the mobile medics coordinated with the BAMC V-MEDCEN to establish daily virtual health provider support from the BAMC Internal Medicine Clinic at Joint Base San Antonio-Fort Sam Houston and providers at Dwight D. Eisenhower Army Medical Center in Fort Gordon, Ga. 

“This shows the versatility of virtual health and eliminates the tyranny of distance that so frequently diminishes the medical community’s ability to leverage access to provider support from almost anywhere in the world,” said Lt. Col. Sean Hipp, BAMC V-MEDCEN director.

The BAMC V-MEDCEN has also coordinated with the Naval Medical Center San Diego and the U.S. Naval Ship Comfort to provide on-demand, synchronous critical care and specialty virtual health support to the providers and medics at the 14th CSH as needed. 

The mobile medics successfully completed a synchronous virtual health encounter Oct. 20 with Army Lt. Col. Jennifer Stowe, an optometrist located at the BAMC V-MEDCEN. 

The initial report received indicated that the Soldier was experiencing right eye pain, redness, loss of vision and a cloudy haze over his eye. The mobile medics connected with Stowe and provided high-definition, synchronous images of the Soldier’s eye using an optical exam camera and web-based video teleconferencing capability. 

Based on her conversation with the patient and the physical exam using the virtual health equipment, Stowe was able to establish a diagnosis, prescribe a recommend course of treatment, schedule a follow-up appointment and keep the Soldier from being evacuated to a higher level of care. 

Stowe was extremely impressed with the audio and video quality.

“Without the ability to adequately evaluate the patient’s eye and discuss the symptoms with the Soldier, I would have likely recommended immediate evacuation to a higher level of care,” she said. “Instead, he is able to continue fulfilling his mission in support of the efforts in Puerto Rico and I’m able to virtually follow-up on his progress.” 

The mobile medics continued to leverage their virtual health capabilities by connecting with Maj. Sharen Denson, a physician assistant, at the BAMC Internal Medicine Clinic Oct. 23 to provide on-demand synchronous support to the patients in the 14th CSH emergency room.  The mobile medics presented, and Denson treated, eight local civilian patients with various types of presenting medical issues.

All of the patients expressed a high level of satisfaction with the exam and treatment and expressed their gratitude for the support. 

As the mission continues to expand and evolve, the mobile medics will push further out into the community and the Area Support Medical Companies to provide virtual health support in remote and rural areas throughout Puerto Rico. 

In addition to the outstanding support provided by the mobile medics, this effort marks the first time that Army Virtual Health has used the full complement of available virtual health capabilities to support a disaster response effort, Hipp said.

The 14th CSH and other medical assets in PR have access to the Pacific Asynchronous TeleHealth portal and the Health Experts On-Line Portal for non-urgent asynchronous virtual heath consultation support.  They also have access to the ADvanced VIrtual Support to OpeRational Forces system that provides 24/7/365 on-demand telephone and synchronous video consultations with on-call specialty services that include critical care, emergency department, burn care, orthopedics, general/trauma surgery, pediatrics, toxicology, infectious disease and several other specialty providers coordinated though the BAMC V-MEDCEN. 

“The ADVISOR system is a truly tri-service capability that has the potential of shaping future operational healthcare delivery models across the Department of Defense,” Hipp said. 

“This is an exciting time to be a part of the virtual health community,” Hipp added. “We are looking forward to building a virtual health capability that will support operational forces anytime, anywhere around the world while bringing the full might of Army medicine to the greatest point of need.”