Such an arrangement has the following advantages:
A3.1 Greater pooling of experience
Providing a larger amount of telemedical advice at sea increases the experience of the medical team in a particular centre. The centralization of information from advice records allows a single epidemiological monitoring of the seafarer population.
A3.2 Provision of a single medical contact for seafarers of a particular nationality or language.
The development of modern means of maritime communications allows exchange of data, images, etc. Nevertheless, the dialogue between the doctor and the person responsible for treatment (sometimes the patient himself) remains the essential basis of medical action and benefits from being in the language of the two parties.
The existence of a national reference centre for a given population of seafarers is likely to assist such a dialogue (same language, same cultural approach to the problem, adaptation to national training programmes) and to reinforce the essential relationship of trust between the person responsible for treatment on board, the patient and the doctor.
A3.3 Provision of a single point of contact for other bodies concerned with seafarers' health.
The experience gained in a maritime telemedical centre is useful to the national administrations concerned, in developing the content of official medical chests, national operational procedures, safety regulations, and training programmes for those responsible for providing treatment.
A3.4 Economies
The need for permanent operation, thus the permanent presence and availability of trained doctors, and specific logistics (documentation, means of telecommunication, computers) involves operating costs which a proliferation of centres would help to swell for no purpose. Wherever possible, sharing medical facilities with an existing structure can help to reduce costs.
It is thus desirable to create a centre providing TMAS within an existing medical establishment (e.g. emergency department in a large hospital), so as to have access to facilities already in place: staff, specialized medical services, logistical services.
Care should be taken to ensure the provision of the required facilities (see above), particularly training of the centre's doctors in the special features of medical assistance at sea. Provided that they are available to give telemedical advice at sea, the doctors concerned can have other tasks in the medical establishment if the maritime activity does not occupy them full time.
Finally, it is recommended that a link-up with another State (for example, one with the same language) should be sought, to create a common centre.
