# The Use of Radio and Telemedicine by TMAS Centers in
###### Abstract  
_Objective_: From medicine via radio to telemedicine, personalized medical care at sea has improved significantly over the years. Currently, very little research has been conducted on telemedicine services and tools at sea. This study aims to review real-time case studies of seafarers' personalized treatment via telemedical devices published in medical journals. _Methods_: A literature search was conducted using three libraries such as PubMed (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), BioMed Central, and Google Scholar. The Medical Subject Headings (MeSH) were used for information retrieval and document selection was conducted based on the guidelines of preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 flowchart. Selected articles were subjected to quality checks using the Newcastle-Ottawa scale (NOS). _Results_: The literature search produced 785 papers and documents. The selection was conducted in three stages such as selection, screening, and inclusion. After applying predefined inclusion and exclusion criteria, only three articles on real-time medical assistance with telemedical tools were identified. It is reported that medical attention is delivered to seafarers in real time thanks to advancements in telemedicine, satellite technology, and video conferencing. _Conclusions_: By improving the quality of medical care and reducing response times for medical emergencies at sea, lives have been saved. There are still several gaps despite these advancements. Medical assistance at sea should therefore be improved to address many of the still unsolved issues. os 2023 13 1171  
medical services in the maritime environment. This approach has remarkably changed the provision of medical assistance at sea over time and has become relevant to ensure the safety and well-being of those on board. Delivering medical assistance at sea poses several challenges and issues due to the unique environment and logistical constraints. Ships, especially those on long voyages or in remote areas, can be far from medical facilities or specialized care. This makes it difficult to access timely medical assistance in case of need. Having limited medical resources and specialized equipment can hinder the delivery of comprehensive medical care onboard. Also, limited or unreliable satellite connections can hinder real-time consultations with onshore medical professionals and delay diagnosis and treatment. In case of medical emergencies, timely evacuation to a shore-based medical facility may be necessary. However, arranging medical evacuations at sea can be logistically complex and expensive, especially in adverse weather conditions. The use of telehealth on onboard ships helps deliver medical help minimizing the challenges and burdens encountered by seafarers. This is due to the limited medical knowledge of ship masters or onboard medical staff. Telehealth can also improve monitoring, time-liness, and communication within healthcare systems. Telemedical Maritime Assistance Service (TMAS) centers provide medical services based on radio codes through different channels such as email, marine radio, telephone, video conferences, and fax [5, 6, 7]. TMAS centers and seafarers began to use telehealth more frequently, especially, during the recent pandemic to reduce in-person contact [8, 9]. The doctors at TMAS centers communicate over the phone, email, or video, which is beneficial for both patient health and practice [10, 11]. Using digital medical devices, vitals are gathered, progress is monitored, external lesions can be viewed, and images of skin, ears, eyes, etc., can be captured and evaluated. The availability of digital devices like these has increased the effectiveness of telemedicine, overcoming the handicap of inaccurate information provided from the ship's side. In the past few decades, telemedicine has further transformed the field, enabling the remote medical diagnosis and treatment of patients in maritime environments.