December 2012
Although the war in Afghanistan is winding down, and the United States plans to have most of its troops removed from the country by the end of 2014, soldiers are still killed and injured every day in the conflict. According to the Defense Department, 17,939 soldiers have been wounded in action in Afghanistan and 1,686 have been killed. To its credit, the Army has been employing telemedicine quite effectively to provide remote treatment to critically wounded soldiers in both the conflicts in Afghanistan and Iraq. The last soldiers left Iraq last year, and one of the great success stories of the Iraq war has been the number of lives the Army was able to save by using telemedicine services. In particular, remote treatments for PTSD were especially effective on the battlefield in Iraq, and the Army has been making good use of the system in Afghanistan as well.
The Army first began using telemedicine on the battlefield during the first Gulf War. Although its initial fielding was regarded as successful by the Army, the lack of interest by commanders on the battlefield and the relatively short duration of the conflict meant that the program was not used to great effect. It was not until the conflict in Somalia in 1993 that the U.S. Army really began using telemedicine. The logistical difficulties of that conflict severely limited the Army’s ability to bring in medical supplies and medical staff to its soldiers on the ground, and the Army used telecommunication equipment to send x-rays and high definition digital photographs to doctors and staff at Walter Reed Medical center. They mainly used this information to help treat broken bones and eye injuries.
In the Iraq War, telemedicine was expanded greatly to not only help medical staff on the ground to get emergency treatment to wounded soldiers. It was also expanded to provide diagnosis and treatment for conditions that only affected the soldiers in that particular theater. For instance, hundreds of soldiers during the Iraq War were infected with leishmaniasis, which is a parasite that is transmitted from the bite of certain sand flies. This parasite can cause ulcerous lesions on skin and cause injury to internal organs and affect bone marrow production in the bones.
Telemedicine also made it possible for the Army to bring telepsychiatry services to soldiers in the theater for the treatment of PTSD. The Army regards this as one of its great success stories, and sees it as being responsible for changing soldiers’ attitudes toward counseling and mental health on the battlefield. Teams of medical staff were initially only 20, but were expanded to 40 or more once the toll of PTSD was beginning to be noticed by commanders. The Army would deploy these teams all across the forward operating bases in Iraq, and they would consist of psychologists, psychiatrists, nurses, counselors, and occupational therapists. These teams provided mental health evaluations to wounded soldiers and determine which ones needed more specialized care at Walter Reed Medical Hospital. Instead of using resources to ship those soldiers back to the states, the Army used telemedicine to provide individual face to face counseling through video conferencing.
Telemedicine is regarded by medical staff as a natural extension of the application of information technology to clinic health care. The Army has made great use of telemedicine to provide treatment for its soldiers on the battlefield, and it has been credited with saving lives and resources, especially in the mental health field where qualified staff is limited.
Michelle Winters writes for apexrx.com where you can read more about telemedicine and war.