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4 Years at Sea with University of Miami Teledermatology

Enhancing employee health benefits to over 30,000 crew members of Royal Caribbean Cruise lines at sea, UM TeleHealth is the provider of teledermatology using an encrypted HIPPA compliant telemedicine software; a consultative service that was started in 2010. Since 2012, UM also provides a teledermatology consultations to Carnival Cruise Lines employees at sea.
Dermatologic care for a geographically dispersed employee population is a challenge for global cruise lines. With the goal of improving cutaneous disease diagnosis and management, reducing shoreside dermatology referrals, and cos avoidance, the University of Miami store-and-forward teledermatology service to two major cruise lines was started over four years ago. Rapid access to UM dermatologists for crew and guests with severe skin conditions on ships around the world is provided with routine and urgent consults.

A fleet-wide rollout for each cruise was smoothly implemented. UM provided training instructions for the health care staff and offered technical support during the launch and continues on an ongoing basis. Referred cases have included common dermatoses and neoplasms as well as rare inflammatory and infectious diseases. Consultant reports provide diagnosis or differential diagnosis, targeted workup and treatment recommendations. Improvement in dermatology diagnosis and treatment skills of the referring medical staff has been evident in consults sent since implementation. The percentage of cases referred for an in-person dermatologist evaluation has changed.
Store-and forward teledermatology is an effective method for proving remote services to a worldwide employee population. UM Teledermatology allows cruise line medical staff to effectively manage skin diseases for employees and guests on their ships, to decrease the need for shoreside dermatology visits and effectively make medical decisions for routine cases and urgent cases where isolation and evacuation are being considered. Lessons learned have been related to technology, human factors issues and ongoing education for medical personnel.

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