Back to Top Skip to main content Skip to sub-navigation

Navy tele-health supports Guam civilian hospital during COVID-19

Image of Woman sitting in front of several computer monitors. Click to open a larger version of the image. Trisha Lindsey, a nurse specialist assigned to Naval Medical Center San Diego's Joint Tele-Critical Care Network (JTCCN), provides support to a remote intensive care unit via tele-conference in the hospital's JTCCN office Sept. 17. The JTCCN provides critical-care support to remote, bedside intensivist teams, known as spoke sites, via state-of-the-art audiovisual communication and computer systems. (Photo by Navy Mass Communication Specialist Seaman Luke Cunningham.)

Recommended Content:

Coronavirus | Combat Support | Global Health Engagement | Coronavirus and the COVID-19 Vaccine | Nursing in the Military Health System

For the U.S. territory of Guam in the middle of the Pacific Ocean, the isolation can be challenging when you want to call for help. The U.S. Naval Hospital there is part of the emergency response network and accepts emergent cases on a regular basis if they are the closest hospital. But when more expertise is needed, Naval Medical Center San Diego (NMCSD) stepped in to provide tele-critical care (TCC) assistance across the distance.

The Department of Defense’s (DoD) first-ever telemedicine tasking for Defense Support of Civil Authorities or DSCA, began with a request from the hospital through the government of Guam to the Federal Emergency Management Agency (FEMA). FEMA requested telemedicine support for their medical operations in Guam because the number of critically ill COVID-19 patients in Guam exceeded both the number of available intensive care units (ICU) beds and the ability of on-site providers with critical care expertise to care for these patients.   The civilian hospital had well-trained medical professionals, but requested the extra expertise in critical care to ensure they were providing the best care possible to their patients amid a late summer surge in COVID-19 cases island wide.

While the use of telemedicine and virtual health (VH) have become hallmarks of patient care delivery during the pandemic, with both military and civilian providers significantly increasing options for virtual health care, this is the first-ever DoD tasking for telemedicine support in response to a request from civil authorities for aid.

“We were able to rapidly engage our expertise to support the hospital in Guam,” said Navy Capt. Konrad Davis, director of the Join Tele-Critical Care Network (JTCCN) for the Military Health System (MHS) and a Navy pulmonary and critical care physician at NMCSD. “Normally we deploy people and those people, along with the correct equipment and supplies create a capability. However, we now have the ability to leverage information and communication technologies to extend health care expertise. We now have the ability to provide a virtual health capability.”

Davis and his team started providing support to a civilian hospital in Guam in early September, leveraging novel software developed and funded by the DoD and the Department of Health and Human Services. The software, developed under the National Emergency Telecritical Care Network (NETCCN) project, is cyber-secure, compliant with patient privacy regulations, and can be accessed with a smartphone, tablet, or desktop computer.

NETCCN makes it possible for the Navy’s tele-critical care physicians and nurses to reach across the ocean and consult with on-site providers in Guam, many of whom are general practitioners and do not normally care for critically ill patients. Using the software, providers at both locations can securely communicate in real-time via instant chat or video messages, send pictures or video to each other, and share vital information such as lab results, radiology images, or electrocardiograms.

Davis’ team used the technology to help the providers in Guam manage critically ill patients requiring interventions such as mechanical ventilation, high-flow oxygen for acute respiratory failure, medication administration to support adequate blood pressure, or treatment for shock with active organ failure.

“Our nurses have been performing, on average, eight to 16 calls with Guam per 12-hour shift,” said Davis. “Our physicians typically respond to anywhere between two and 20 calls per shift. We are providing physician support mostly at night in Guam, but nurse support has been active 24/7.”

The tele-critical care program at NMCSD was launched in 2014 and has grown considerably over the years, according to Davis.

“Many years ago, we in the Department of Defense recognized that critical care is not defined by geography or the location of a patient,” Davis said. “It is defined by the patient’s condition wherever they may be. We may have critical care patients not just in a hospitals but also, because we are the military, located on a ship or in a deployed setting. We coined the phrase ‘tele-critical care’ instead of ‘tele-ICU’ to recognize the need to extend this expertise outside of traditional ICU settings.”

Davis added that NMCSD is the DoD lead for the Joint Tele-Critical Care Network and will be the primary tele-critical care hub in the future for providing on-demand, high-acuity synchronous VH support for both traditional, in-garrison ICU beds, and the operational space, which includes support of DSCA or humanitarian assistance missions.

“We are really just at the beginning of realizing what is possible,” Davis said. “We have a current capability that supports just under a dozen hospitals. As a result of collaboration with the Army and Air Force, and through the Defense Health Agency’s sponsorship and funding, we are working to expand the tele-critical care program to the entire MHS.”

Naval Medical Forces Pacific (NMFP) has oversight of 11 Navy Medicine Readiness and Training Commands located on the West Coast and throughout the Pacific Rim that train, man, and equip medical forces, primarily in military treatment facilities, including the one in Guam.

You also may be interested in...

Future of Nursing: Telehealth, More Innovation and Maybe Some Robots

Second Lt. Nina Hoskins, 81st Surgical Operations Squadron operating room nurse, briefs Col. Debra Lovette, 81st Training Wing commander, and other base leadership on robotics surgery capabilities inside the robotics surgery clinic at the Keesler Medical Center June 16, 2017. (Photo: Kemberly Groue, U.S. Air Force)

The future of nursing is here due in part to changes brought by the COVID-19 pandemic.

Recommended Content:

Nursing in the Military Health System | Coronavirus

How One Military Nurse Persevered Through the COVID-19 Response

Air Force Capt. Courtney Ebeling, a medical-surgical nurse at Joint Base San Antonio-Randolph Family Health Clinic, Texas, was deployed to support the COVID-19 response in Afghanistan in 2021. They administered vaccinations to U.S. citizens, service members, and foreign military members as well as supported the preparation to withdraw from the country. (Photo: Courtesy of Air Force Capt. Courtney Ebeling)

Nurses across the Military Health System have played a vital role in providing routine patient care and meeting the needs of the COVID-19 pandemic.

Recommended Content:

Nurses Week Toolkit: United In Service, Rooted in Strength | Coronavirus | Nursing in the Military Health System

‘I Love the Intensity’ – One Nurse Recalls Three COVID-19 Deployments

In 2020, Air Force 1st Lt. Tiffany Parra, an ICU nurse at the 633rd Medical Group, on Joint Base Langley-Eustis, Virginia, was deployed to a North Dakota hospital to support a FEMA COVID-19 mission. In the photo, she trains on equipment used for critical patients in a North Dakota ICU. (Photo: Courtesy of Air Force 1st Lt. Tiffany Parra)

Nurses are unique, they follow a calling to care for others. Military nurses do that as well as serve their nation. For Nurses Week, the MHS highlights some of their own.

Recommended Content:

Nurses Week Toolkit: United In Service, Rooted in Strength | Nursing in the Military Health System | Coronavirus

Pandemic Spotlights the Vital Role of Military Lab Workers

U.S. Air Force Staff Sgt. Ashley Solomon, 18th Medical Support Squadron NCO in charge of microbiology, unloads blood samples from a centrifuge at Kadena Air Base, Japan, Jan. 31, 2019. (Photo: Tech. Sgt. Matthew B. Fredericks, U.S. Air Force)

MHS clinical labs produce results.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus

Helping Your Child to Cope with Grief and Losses Related to COVID-19

Shirley Lanham Elementary School students perform Taiko drumming during a Month of the Military Child celebration aboard the Naval Air Facility Atsugi, Japan, April 6, 2022. (Photo: Petty Officer 2nd Class Ange-Olivier Clement, Naval Air Facility Atsugi)

Many military children have lost loved ones to COVID-19. How parents can help with the grief.

Recommended Content:

Month of the Military Child - Celebrating Military Kids | Children's Health | Psychological Fitness | Coronavirus and the COVID-19 Vaccine | Coronavirus

How to Help Military Children Reconnect After Two Years of the Pandemic

Airman 1st Class Rocio Romo, Space Launch Delta 30 public affairs specialist, and her son pose for a photo at Cocheo Park on Vandenberg Space Force Base, California, March 25, 2022. During the month of April, we celebrate Month of the Military Child to highlight the sacrifices military children make on the home front while their parents serve the United States. (Photo: Airman Kadielle Shaw, Space Launch Delta 30 Public Affairs)

How parents can help children stressed by more than two years of COVID-19.

Recommended Content:

Month of the Military Child - Celebrating Military Kids | Children's Health | Psychological Fitness | Coronavirus and the COVID-19 Vaccine | Coronavirus

COVID-19 Booster Effectiveness Remained High During Omicron Surge

Hospital Corpsman 1st Class Mary Ashcraft, assigned to the combat ship USS Tulsa, administers a COVID-19 vaccine booster to Aviation Machinist Mate 1st Class Anthony Johnson Jan. 10, 2022, at Apra Harbor, Guam. (Photo: Mass Communication Specialist Petty Officer 1st Class Devin M. Langer, Command Destroyer Squadron 7)

Two new studies of active-duty service members show COVID-19 booster vaccines are effective, but uptake rates in the military community lagged behind the civilian population.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | COVID-19 Vaccine Efforts

8 Tips to Help Kids Adjust to Change during the New Pandemic Phase

A parent comforts his child while she receives a pediatric dose of the COVID-19 vaccine at Kadena Air Base, Japan, Jan. 28, 2022. (Photo: Airman 1st Class Anna Nolte, 18th Wing Public Affairs)

Parents should prepare their kids for the new normal of the ongoing pandemic, recognizing that the status of the disease can change quickly as new variants of COVID-19 emerge.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | Children's Health

Military Medical Officials Back FY 23 Budget Before Senate Appropriations Committee

Marines with Marine Wing Headquarters Squadron, 3rd Marine Aircraft Wing take precautionary measures by cleaning and disinfecting their hands during field day on Marine Corps Air Station Miramar, Calif., March 20, 2020, to mitigate the spread of COVID-19 while continuing to perform mission-essential tasks. (Photo: Marine Corps Lance Cpl. Jaime Reyes)

Military Medical officials, including Army Lt. Gen. (Dr.) Ronald J. Place, Defense Health Agency director, back FY 23 Budget before the Senate Appropriations Committee, March 29, 2022.

Recommended Content:

Public Health | Coronavirus

How COVID-19 Made the Military Medical Community Stronger

Image of a service member being treated

Lessons learned from the COVID-19 pandemic has made the military medical community stronger and will help when confronting the next crisis, whether that’s another pandemic, a new conflict or natural disaster

Recommended Content:

Combat Support | Coronavirus and the COVID-19 Vaccine | Coronavirus

COVID-19 Responses Underscore Importance of Patient Safety

Every day, patient safety is one of the top priorities for the Defense Health Agency. Patient safety means providing ready, reliable care to service members, veterans, and dependents no matter the circumstances. (Photo: Defense Health Agency)

Patient safety is a topmost concern of MHS, and Patient Safety Awareness Week 2022 focuses on Ready, Reliable Care.

Recommended Content:

Patient Safety | Patient Safety Awareness Week | Coronavirus and the COVID-19 Vaccine | Coronavirus | Patient Safety Awareness Week

Top Military Health Leaders Discuss Future Readiness

An Air Force C-17 Globemaster III at Joint Base Pearl Harbor-Hickam, Hawaii, prepares to transport U.S. Army medical personnel to Guam in support of the global COVID-19 response on April 13, 2020.

Top military health leaders highlight the importance of preparing for the future to ensure both a medically ready force and a ready medical force.

Recommended Content:

Combat Support

Answering Your Questions About COVID-19 Testing

Military personnel performing a COVID-19 Test

COVID-19 continues to spread, now as the Omicron variant. Getting vaccinated is the most effective way to protect you and your family from getting seriously ill, getting hospitalized, or dying. You should also make sure you’re up to date with your vaccines. Testing is another important step you can take to protect yourself and others.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | At-Home COVID-19 Tests

Defense Department Announces Distribution of COVID-19 Tests for Military Beneficiaries

A Soldier assigned to the Connecticut National Guard helps load a shipment of at-home COVID-19 testing kits into a truck at a regional distribution point in North Haven, Connecticut, Jan. 3, 2022. These kits were picked up by representatives from local towns and municipalities to be handed out to their communities.

The Department of Defense will offer at-home COVID-19 tests for military beneficiaries at military hospitals or clinics, on a supply available basis, in the coming weeks.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | At-Home COVID-19 Tests | Coronavirus

Military Medical Units Support Civilian Hospitals Strained By COVID-19 Surge

Air Force Staff Sgt. Bradley Gorman, a medical technician assigned to a military medical team deployed to Yuma, Arizona performs a nasal swab at the Yuma Regional Medical Center’s COVID testing drive-thru in Yuma, Jan. 17, 2022.

Thousands of service members have been supporting civilian hospitals with testing, vaccinations and treatment of seriously ill patients.

Recommended Content:

<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 26

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.