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SPE 108553

Utilising E-Medicine in Remote Location


Vincenzo Nicosia, Frano Mika, Sabatino De Sanctis, Alessandro Lesma, and Massimo Consentino, Saipem
Copyright 2007, Society of Petroleum Engineers
This paper was prepared for presentation at the SPE Asia Pacific Health, Safety, Security and
Environment Conference and Exhibition held in Bangkok, Thailand, 1012 September 2007.
This paper was selected for presentation by an SPE Program Committee following review of
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presented, have not been reviewed by the Society of Petroleum Engineers and are subject to
correction by the author(s). The material, as presented, does not necessarily reflect any
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Saipem is one of the biggest contractor company


in Oil and Gas industry. Within its organisation,
and as part of the QHSE, Saipem has developed
an in-house medical department, whose main
objective, apart the management of medical
emergencies, is prevention, health protection and
promotion. In order to make these principals
available and applicable at all 119 working site
scattered world wide Saipem decided to initiate
and develop the implementation of e-medicine in
its daily operations. The aim of Saipems emedicine project is to provide assistance to
physicians working in remote areas, where
medical equipment is often the basic one and the
local health care system is mostly rudimentary.
Groups like Saipem have a very high percentage
of International employees working in foreign
countries, as well as local staff. In sites like
offshore drilling platforms or desert production
fields, it is often difficult to manage health care
needs and prevention. Local surveys are carried
out before any operations in a new region begin,
in order to evaluate: 1) Local medical
epidemiological issues with data relating to the
morbidity and mortality of the main endemic
pathologies. 2) geographical and environmental
risk factors. 3) Risk factors related to the
operational activities. 4) Hygiene conditions in
the workplace, accommodation, recreational
areas, canteen, stores and warehouses. 5)
Supply, conservation and distribution of food and
water. 6) Waste disposal. 7) Availability,
accessibility, effectiveness, quality and reliability
of local medical facilities and local doctors. 8)
Management of medical emergencies and medical

evacuations. 9) Impact and effect of industrial


activities on the health of local community.
Saipem ensure healthcare and medical assistance
to its workforce by means of agreements with
local
health
facilities
responding
to
the
Corporates Minimum Standards of quality,
partnership
with
International
Companies
operating in the same area and in house setting
and running its own health programs and its own
medical facilities.
The model of Saipems Physician for remote
locations is to be the ALL OLOGIST (Medical
Officer, Hygienist, Traumatologist, Cardiologist,
etc.). This is not possible but Saipem Med for a
better support to all Medical team worldwide is
developing a new approaches that is practical,
innovative,
imaginative
and
ambitious.
Implementing the existing corporate health
related projects, (e- medicine, Gipsi, e
learning), new information & communication
technologies (ICT) can help to overcome the
physical and cultural distances among the
individual operators, standardize procedures and
methods in health management, increase the
efficiency of the services and encourage the
sharing of knowledge by: 1) Continuous Medical
Education (CME) programs 2) Real Time
medical Information: GIPSI (Gestione Informatica
Prestazioni Sanitarie Individuali) is an house
created software especially developed to meet
Saipem Med requirements throughout its
organization and its scope: Health Monitoring. It
is a coded and protected application fully
assuring medical confidentiality and individuals
privacy. The program allows management of all
health related medical data concerning Individual
health, Related Medical Costs, Quality of living
standards, related Medical statistics.3) Medical
Specialist
support
for
Emergency
and
consultation.
Targets of e-Medicine project is:
1) A Corporate model to support the Company
Physicians activity in the operational sites in Italy
and abroad.

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SPE 108553

2) An advanced occupational health and medical


support management system. It consist in a pre
employment accurate medical examination to
assess the workers fitness against the risks
related to geographical area and occupational
activities to prevent illness or injury. Before
departure, the worker is informed about local
risks (through leaflets, presentation, etc) and will
get all the protective means (vaccination, malaria
prophylaxis, etc) he will need. Health surveillance
program is hold during the stay period, and
repeat every year. At the end employment
medical examination assess the workers fitness.
Also a health promotion program is available. It
include formation and information about lifestyle,
smoke policy alcohol and drugs policy, sexual
transmitted disease. Il starts at the pre
employment medical meeting and will finish at
the end employment examination.
3) A teleconsultation and telemonitoring network
in cooperation with reference centres in Italy and
all over the world.

This system is created for supporting a


teleconsultation medical services allowing the
interactive on-line consultation between remote
clinics and the reference centres. The doctor has
the possibility to refer directly to the centres for
cardiology, dermatology, orthopaedic, surgery,
paediatric, pneumology, radiology, infectious and
tropical disease.
The normal medical routine doesnt change.
Teleconsultation is utilized only with problems
that Saipems Doctors are not able to resolve
definitively.
This system was validated by Eni S.p.A. and
University of Ancona in 2002. The results are
summarized in the pie N 1. The validation was
lead on 100 cases and 84 was successfully
closed. The remaining 16 cases were not
completed due to different reasons, the main of
which were need to repatriate the patient anyway
and data transmission problem.

Real use: 84

A telemedicine station in remote area consists in


a ECG (12 derivation), a Monitor, a digital
camera, X ray scanner and x ray monitor. During
emergencies, it is possible to monitor a patient
from the reference hospital: the system allows
transmission and visualization of the patients
information in real time.
Using it for handling ordinary problems, the
doctors proceeds to the data acquisition phase
with the aid of adequate instruments. The
different acquisition interfaces are integrated into
the same user interface. The system transfers
the data automatically within the date set,
guaranteeing their integrity and safety. During
the
consultation
doctors
share
medical
information on their respective monitors and can
proceed to a cooperative processing (graphic and
textual annotations, manipulation of images,
etc.) in order to reach the correct diagnosis.
When the medical report is complete, all the data
are saved on CD-R.

Internal Medicine:
Cardiologic
Patient Monitoring:
Orthopaedic:
Dermatology:
Chirurgic:
Paediatrics:
Physiatrical
ENT

17
17
11
15
14
6
2
1
1

In 2006 Saipem Med in agreement with Telbios Ospedale San Raffaele Milan have developed an
online service for telecardiology assistance in
remote area. It is available 24/24 h. x 365 days.
This service is provided utilizing a normal
telephone line and a small device that records
and transmits 1/12 Ecg derivation.
There are two level of assistance:
1) Emergency. In five minutes there is an
Ecg with report and an online consultation
with a Cardiologist.
2) Routine. Ecg and Medical cardiologist
report within 24 hours for normal cases
and the follow up of employees with risk
factors (Hypertension, diabetes, etc.).
These tools could be offered also to International
Health
Care
professionals
operating
in
cooperation projects in remote areas and
developing countries. Up to now telecardiology
consultations , both emergency (3) and routine
(88), were used in 91 cases. After the program
has been implemented, we can anticipate that we

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SPE 108553

noticed the reduction in repatriations cases due


to cardiovascular diseases in respect of previous
years, no matter statistic results could be
published only at the end of the year.
Regarding e-learning From July there is the first
edition of MIOGATE (Master in Oil and Gas
Telemedicine), fully developed in cooperation
between Saipem Med and University of Camerino
(Italy). The whole Master is done on an e-learning
platform, except the final thesis that is presented
directly at the University, in order also to preserve
the tradition of this one founded in 1336.
Within Saipems Intranet systems it is possible
for all employees to receive information related
to the geographical area he she/ is assigned to
(travel
risks,
vaccination
program,
epidemiological data, environmental conditions,
local Saipems medical support, etc.) as well as
training and information regarding certain health

topics (STD, no smoking policy, malaria control


program, hearing protection, etc..)
Conclusion
No matter only recently implemented within
Saipems operations e-Medicine proved to be a
useful help, for all Saipems doctors, especially
for specialistic area, and consequently a benefit
for all our employees. It is also an important
psychological support fro both health care
practitioners and health care users who have at
their disposal a 24/7/365 back up system It
gives the possibility to decrease the Medevac, a
good support for emergencies management,
increase work and improves the life style in
remote area, guarantee a high quality of medical
assistance and help the medical staff and
paramedics for Continuous education programs
and teaching and training on line for First Aiders.
Further improvements and extension of use of ehealth in health information, training, monitoring
and particularly in health related Sustainability
programs are foreseen for the next years.

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