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The MLC 2006 Code isn?t easily de ned or satis ed. Nevertheless, DigiGone?s Shipboard Video Telemedi- cine service and GWU?s Medical Faculty Associates have been doing just that, for years. The service actually goes much further. Title 4 of MLC 2006 requires that health protection and med- ical care for seafarers must include prompt access to necessary medicines, medical equipment and facilities for diagnosis and treatment. RatiÞ ed by more than 30 member states reß ecting more than 33 percent of world gross tonnage, MLC 2006 came into effect in August 2013. The document applies to more than 1.2 million seafarers. Since 1989, a service for ship operators has provided Shipboard Telemedicine services through the Maritime Medical Access Program at the George Washington University (GWU). Subscribers enjoy access to more than 550 physicians and specialists at the GWU Medical Faculty. The use of Digi+Doc is an innovative way to meet the MLC 2006 healthcare requirements, but in truth, it does so much more. In the early days, the service involved simple telephone calls between doctors and clients. Today, the kit facilitates real-time transmission of data from ships to a remote clinician. Digi+Doc subscribers can also take advantage of encrypted video and au- dio conferencing, video streaming, Voice over IP (VoIP), IM Chat and Þ le transfer, optimized for maritime satellite channels. Eas- ily installed on most PCs, laptops, tablets or smartphones, it can work over a multitude of networks, with satellite airtime costs much lower than other commercial teleconferencing services. Getting Started ? Almost 25 Years of Service James Betz, Innovative Program Manager for Maritime Medical Access (MMA) with the Department of Emergency Medicine at George Washington University, told MarPro, ÒWe started with a couple of physicians who were interested in see-ing how they could extend their emergency medicine skills. We found one or two shipping companies that were interested in utilizing our services, mounted a telephone in our emer- gency department and started to take calls. Now, we have a dedicated communications center which takes in these mari- time calls and connects them to physicians who are on call.Ó Betz continued, ÒInitially, we got things done via telephone and by E-mail, once that became a possibility on board ships. With E-mail, we found that we could send still photos and therefore could deliver a lot better medical advice. But, the limits of ÔstillÕ photography limited our ability to really prac- tice medicine to the fullest extent. We were looking for a video product that would work well, but all the ones we looked at werenÕt secure or they were inefÞ cient with their bandwidth. We found one company that had a kit, but it was proprietary and very expensive and our clients werenÕt interested in hav- ing something that would just be for medical use.Ó Eventually, MMA found DigiGone. And, for the past few years, the two have been working together to develop a kit that can be used for telemedicine. Betz says, ÒWe started deploy- ing it to our existing clients and weÕve had good success in providing better medical services, using video.Ó The technology provides real value to users. For example, a recent case involved a sailor on board a ship in the Mediterra- nean Sea who had suffered a head injury. Betz explained, ÒThe ship and our physician were concerned with symptoms, so we initiated a video conference. Our doctors were able to walk them through a thorough neurological exam using the DigiGone kit. It was like being there in person. The patient was more comfort- able.Ó In the end, the physician was comfortable that they could continue Ð avoiding a costly diversion and medevac for the vessel. Diagnosis and treatment are the most obvious beneÞ t, but ship operators are seeing merit in preventative medicine, as well. Doc- tors can sometimes see someone who is trying to hide a medical condition; Òtough it outÓ so as not to be labeled a non-performer. Betz says, ÒIt is important to get that person medical attention and avert something far more serious for the mariner and the vessel.Ó The beneÞ ts extend beyond initial care and treatment Ð DigiGone and the GWU physicians follow up on each case. The initial impetus for U.S. vessels was rooted in Jones Act requirements. Lately, DigiGone and MMA are seeing increased interest because of the new MLC requirements. Betz adds, ÒMany new subscribers are reporting that they did so because of the MLC Code. They, for the most part, feel that this should cer- tainly satisfy their ß ag-state requirements.Ó For U.S. ß ag opera- tors, future, potential Jones Act maintenance and cure expenses can likely be amortized against the cost of service. Carrier Agnostic & High-Tech, too Michael Dunleavy, President & CEO of DigiGone, explains the nexus of the innovative service. ÒWe started out in the spe- cial operations and intelligence community. This grew from that to doing remote video surveillance and we were then ap- proached by Maersk to assist with some anti-piracy missions. This involved adapting our low bandwidth capability for cost savings but also dialing into existing CCTV systems. That led to parties asking us to build CCTV systems for maritime envi- ronments for their ships. One of the unique things that we have is the ability to compress entire transmissions of video/audio with encryption. It works extremely well with ß eet broadband.Ó DigiGoneÕs unique system leverages their extremely ro- bust encryption (important for HIPAA privacy reasons) and crunches the video/audio package into a very small stream to MedicalMLC MEDICAL Meeting MLC ? and More MBy Joseph Keefe 54 | Maritime Professional | 3Q 2013MP #3 50-63.indd 54MP #3 50-63.indd 549/10/2013 12:04:24 PM9/10/2013 12:04:24 PM