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This article provides an overview of some of the practical applications of Telemedicine in remote populations. It discusses some of the key advantages and disadvantages and a potential role that can help improve the quality of care in modern society.

Another alternative to Telemedicine that has its place in modern medicine can be seen in the vast expanses of the Siberian tundra.  Russia is the largest country in the world and populations that are not found in key cities like St. Petersburg and Moscow are often found in remote settlements scattered across this barren landscape.  Patients are often located thousands of kilometers away from the closest regional medical center so if any serious condition occurs, communities are often left on their own to treat their ill member.  Heart attacks and strokes in these areas are usually death sentences.  

The Russian Government has realized the difficulty in dealing with such a dispersed population and has created a solution to deal with this adversity.  Mobile hospitals have been constructed in the form of railway cars and these hospital trains often over 4 kilometers long traverse the barren Siberian landscape providing medical care for the isolated populations of Russians living in these areas.  These trains are fully staffed with doctors, nurses, and other healthcare providers to provide medical advice for people who would otherwise not receive it.

  The trains are divided into different wards like Pediatrics, Geriatrics, and even have cars specifically designed to provide some minor surgical procedures.  If a patient is gravely ill, he can be admitted to the Inpatient ward and can travel with the medical staff to a larger medical center that can provide more specialized care based on the patient's needs.  Patients will be able to visit physicians free of charge for yearly check-ups and can get imaging studies like X-rays and even CT scans during their visit.  The trains are often stationed in each town for a week at a time and populations have the opportunity to travel from their dwellings in a much more convenient set-up than if they needed to go to a larger city 3,000 miles away.  They spend 6 months travelling across the region and then return to their beginning point allowing for two visits throughout a year for patients if needed (1.)   

Although the classical cascade of patients traveling to a doctor in seek of medical advice is still the most desirable situation, the reality of society is that some patients will not be served based on limited access to medical consultations if they live in remote locations. If patients are unable to travel or have insufficient transportation to reach a medical center, technology should be used to bridge the gap.

Physicians can communicate with patients in remote locations using Skype and have meaningful conversations that would have been missed otherwise in most situations.  

Patients may receive life-saving advice after revealing some of the 'red-flag symptoms' they may have been experiencing and can have an adequate work-up to make a difference potentially if advised to go to a regional medical center urgently. Other nations should also mirror government-sponsored health-programs like the one run in the Siberian tundra.  A government should be responsible for the wealth-fare of their citizens and provide resources to all even if the infrastructure is lacking like in Siberia.  If train tracks over 6,000 kilometers long were able to be constructed over the unforgiving Russian topography, it should be much easier to bring this ingenuity to other parts of the world.  Telemedicine and mobile hospitals can work in synergy to improve the quality of healthcare in underserved and remote populations and benefit those who would have no hope based on the current medical model.  

  • 1.) Yaffa, Joshua. "Siberian Medical Train." The National Geographic. June 2014. http://ngm.nationalgeographic.com/2014/06/siberian-train/yaffa-text
  • Photo courtesy of freepik.com
  • Photo courtesy of freepik.com
  • Photo courtesy of tillwe: www.flickr.com/photos/tillwe/5303763774/

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