Page 51: of Maritime Reporter Magazine (April 2017)

Case Study

Maritime

Dr. Joseph T. Sera Jose, MD

Physician Medical Case Manager, Future Care

Recently a Future Care-registered ves- sel had an emergency issue while at sea, approximately four days from the near- est port. (The vessel, the captain and the female crew member’s identity have all been withheld due to privacy and HIPAA regulations.) The female crewmember

And if something goes wrong, your crew member that mutually determine complained of abdominal pain, epigas- imagination can start to kick-in and when the mariner is again ? t for duty.” tric in location. The case started with the make an illness seem much worse than crewmember feeling anorexic with an ap- it is.” Technology parent loss of appetite, and low-grade to

Desimone points to a ‘large tanker VIRTUAL Software moderate grade fever. This was initially ? eet’ that she said uses the service When asked to discuss the de? n- treated as a case of Acute Gastritis, to rule to full effect. “If a crew member ap- ing technology that has impacted her out Appendicitis. Oral medication was advised, with accompanying supportive proaches and says he’s having symp- business, Desimone was quick to cite measures.The symptoms then progressed to moderate to severe abdominal pain toms of illness or injury, scratch or cut, “Virtual Software,” as it has most sig- located at the right lower quadrant, with intermittent vomiting episodes. Pain they contact FutureCare immediately” ni? cantly helped to improve the speed scale at 7-9/10 at its most intense. Treated with high dose antibiotics and sup- to share information and perhaps im- and accuracy of diagnosis, treatment portive measures. No pain reliever was provided because the consideration was ages, so that they get an accurate ac- and resolution. an Acute Appendicitis. count of the problem and start working Future Care has also started provid-

Future Care’s physician rendered treatment instructions of High dose antibiot- towards a solution. She said that in a ing Wellness Exams for crews, creat- ics, supportive measures and close monitoring every two hours until the vessel majority of cases the medical prob- ing and securely housing electronic reached the nearest port. On medical debark and subsequent transport and admis- lems are manageable, with just 12 to medical records that can transfer to sion into the hospital, a con? rming diagnosis of acute appendicitis was made and 15% falling under the “injury” catego- new companies and ships with the subsequently surgically treated. ry, and the rest falling in the derma- crew member, and also be used pri-

Future care received the commendation of the attending physician, that due to tology, respiratory, gastro intestinal or vately when the mariner is on vacation the primary care and immediate initial treatment and supportive measures pro- muscle strain category. or at home. Most importantly perhaps, vided to the crewmember, while onboard and in transit, this contributed to the

Desimone is quick to stress the part- in the case of emergency that results in delay in the progression of the illness for several days, and prevented a possible nership nature of the service: “We are a shore side doctor or hospital visit it ruptured appendicitis incident, hence saving the life of the female crewmember.

really physician advisors to the cap- can save valuable time and minimize tain: he’s the gatekeeper, he’s the ex- miscommunication with established aminer, and it is the captain and the records available electronically.

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