How to Get Specialty Consults/Assistance While Deployed

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It is always good to know how to get help when you are deployed.  During one of my deployments, I had a patient develop Mollaret’s meningitis, which I had never heard of, and using resources like those below I was able to get advice and provide the best care I could in a resource-limited environment.  If you are going to deploy, make sure you are aware of these services that will allow you to get some help:

HEALTH EXPERTS ON-LINE PORTAL (HELP)

This system will allow you to get specialty consults and turn the consult into a patient movement request.

(HELP PDF Information Sheet)

Background: Health Experts onLine Portal (HELP) is a web-based, HIPAA-compliant, secure, asynchronous, teleconsultation system started up by Naval Medical Center Portsmouth (NMCP) in June 2014. Naval Medical Center Portsmouth serves as the DoD’s tertiary medical care facility for Navy Medicine East Military Treatment Facilities (MTFs) in the eastern United States, Europe, Middle East, and their regionally associated Fleet and Marine assets. Many of these MTFs have limited or no access to local specialty consultation services. This vast region spans 11 time zones, making real-time synchronous teleconsultation impractical. This unique medical and geographic situation created the need for asynchronous teleconsultation capabilities. Health Experts onLine Portal was built upon the existing, tested, and proven Pacific Asynchronous TeleHealth (PATH) System in use at Tripler Army Medical Center since 2000.

System Description: HELP is a web-based, asynchronous (store-&-forward), HIPAA-compliant platform used for provider-to-provider teleconsultation, patient movement, and case management. The HELP website allows remote providers to submit patient demographics, clinical data, and supplementary multimedia as dictated by the clinical scenario. Consultations are screened by consult managers and forwarded to the appropriate subspecialist or Fleet Liaison for input. All case discussion is done on the web- based platform, with notification of new case activity via HIPAA-compliant e-mail.

Effectiveness/System Impact: HELP is based on the Pacific Asynchronous TeleHealth (PATH) system which first demonstrated improved healthcare access and quality with significant cost savings (Arch Ped Adol Med 2005 & Telemedicine and e-Health 2011). In February 2016, HELP demonstrated improved access and quality of care, while saving over $580,000 within its first year (SAGE Open Medicine 2016). Other associated benefits include HIPAA-compliance, proper documentation in the patient’s electronic health record, workload credit for specialty consultants, reduced testing, improved patient movement request coordination, and provision of continuing education to remote healthcare providers. In mid-2016, HELP brought providers and liason assets from Landstuhl Regional Medical Center and Walter Reed National Military Medical Center on board.

Patient Movement Functionality: Patient movement function was activated in February 2015 to allow outside MTFs and the Fleet improved visibility on their patients transferred to NMCP. It allows requests for information in a secure and HIPAA-compliant format, continuous situational awareness for consults, appointments, and patient arrival at NMCP. For more information on the patient movement functionality, please contact the NMCP Fleet Liaison office.

E-MAIL TELECONSULTATION SERVICE

This system is purely e-mail based, not HIPAA compliant, and cannot be turned into a patient movement request.  That said, it is still available and will allow you to get a specialty consult so I wanted to make sure the information/service was available.  The e-mail addresses and procedures to get a consult are all in this Powerpoint:

Teleconsultation Quick Reference Guide

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