Wilderness medicine and telemedicine seemingly exist at opposite ends of the clinical
continuum. However, these 2 specialties share a common history and the literature
abounds with examples of successful deployment of telemedicine to resource limited
settings. The recent widespread adoption of telemedicine has important ramifications
for wilderness providers. Telemedicine is inherently reliant on some sort of technology.
There is a wide spectrum of complexity involved, but in general these systems rely
on a hardware component, a software component, and a network system to transmit information
from place to place. Today, connectivity is nearly ubiquitous through access to cellular
networks, Wi-Fi, or communication satellites. However, bandwidth, defined as the amount
of data which can be transmitted through a given connection over time, remains a limiting
factor for many austere settings. Telemedicine services are typically organized into
4 categories: 1) live/interactive; 2) store and forward; 3) remote patient monitoring;
and 4) mHealth. Each of these categories has an applicable wilderness medicine use
case which will be reviewed in this paper. Though the regulatory environment remains
complex, there is enormous potential for telemedicine to enhance the practice of wilderness
medicine. Drones are likely to transform wilderness medicine supply chains by facilitating
delivery of food, shelter, and medicines and are able to enhance search and rescue
efforts. Remote consultations can be paired with remote patient monitoring technology
to deliver highly specialized care to austere environments. Early feasibility studies
are promising, but further prospective data will be required to define future best
practices for wilderness telemedicine.
Keywords
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Article info
Publication history
Published online: April 19, 2022
Accepted:
February 22,
2022
Received:
June 30,
2021
Identification
Copyright
© 2022 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
