# The Use of Radio and Telemedicine by TMAS Centers in
## 3 Results
### Study Characteristics
#### 3.4.2 Telemedicine Technologies  
Seven studies are associated with the use of telemedicine, where medical professionals can now communicate with ships (via email, telephone, video conferencing, and web applications). This allows them to diagnose and treat medical conditions in real time [8; 17; 18; 19; 20; 21; 24]. Ships can contact TMAS by phone or by e-mail to provide a verbal description of a crew member's medical condition, followed by an email with images. There are, however, still several problems to be solved. In general, the doctor ashore does not talk directly with the patient or does not see him, as contact is mediated through the captain or the ship's officer with medical duties on board. This does not help to establish the fundamental patient-doctor relationship in the provision of medical assistance. On the other hand, the medical skills of the people with duties of medical assistance at sea are quite limited, and therefore this makes the delivery of medical assistance mediated by a third person complex. In an epidemiological study of seafarers' injuries, telemedicine was found to provide remote access to medical care for those suffering from health issues while at sea [24]. With telemedicine, physicians can provide medical consultations and \begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Study Type** & **Sample** & **Year** & **Medical Advice** & **Observations** & **Ref** \\ \hline Retrospective cohort & 1401 & 2019 & Medical advice for injuries among seafarers & Danish-flagged merchant ships carry an increased risk of injuries to non-officers and European seafarers. & [22] \\ \hline Retrospective cohort & 11,481 & 2020 & Proposing prevention measures in COVID-19 Control & Fever, sore throats, and shortness of breath appeared to be more common during Coronavirus outbreaks & [8] \\ \hline Epidemiological & 423 & 2021 & Assistance to control injuries and diseases among seafarers & Non-officers reported significantly more injuries and diseases than officers & [24] \\ \hline Cross-sectional & 420 & 2022 & Diagnosis of marine workers’ dermatological diseases & Highlighted insufficient remote management of dermatological conditions. & [19] \\ \hline Observational & 384 & 2022 & Diagnosis of COVID-19 & Promotes social distancing and quarantine procedures at sea to limit the spread of the pandemic & [20] \\ \hline \hline \end{tabular}
\end{table} 
Table 3: _Cont._treatment to individuals aboard ships or boats via secure remote connections. For instance, with telemedical devices (presented in Figure 3), medical information (or knowledge) can be shared between sailors and onshore doctors. Some studies have shown that physicians can examine and diagnose medical problems miles away from patients via telephone communications from a TMAS center [17; 20]. Handling seafarers' medical records with email technology allows healthcare workers access to patient medical records, which helps determine appropriate treatment protocols [8; 19; 21]. In this way, seafarers obtain in-depth medical care regardless of where they are, and individuals at sea continue to benefit from telemedicine as technology advances. Different contact possibilities are currently available for medical assistance at sea. The most popular is the store and forward method, which involves taking images or videos of a patient and transmitting them to a specialist for consultation [19; 20; 25]. Live telemedicine involves real-time audio-visual interaction between the provider and patient, similar to a video call. Remote patient monitoring involves collecting data from medical devices worn by patients and transmitting them to healthcare providers for analysis. This allows healthcare professionals to properly and continuously monitor patients' health status and intervene, if necessary. Mobile health (mHealth) uses mobile devices such as smartphones and tablets to remotely deliver healthcare services [26; 27]. These include educational resources, appointment scheduling, and virtual doctor visits.