The Pacific Island Health Care Project

Abstract

Introduction/Background: US Associated/Affiliated Pacific Islands (USAPI) include three freely associated states: Marshall Islands, Federated States of Micronesia, Palau, and three Territories: American Samoa, Guam, and Commonwealth of the Northern Mariana Islands.Objective: The Pacific Island Health Care Project (PIHCP) provides humanitarian medical referral/consultation/care to >500,000 indigenous people of these remote islands.Methods: In the mid-1990s, we developed a simple store-and-forward program to link the USAPI with Tripler Army Medical Center. This application allowed image attachment to email consultations.Results: More than 8000 Pacific Islanders have benefited from the program. Three thousand Pacific Islanders prior to telemedicine (1990–1997) and since store-and-forward telemedicine (1997-present), the PIHCP has helped an additional 5000. Records post dynamically and are stored in an archival database.Conclusion: The PIHCP is the longest running telemedicine program in the world delivering humanitarian medical care. It has bridged the Developing World of the remote Pacific Islands with advanced medical and surgical care available at a major US military teaching hospital. (The opinions expressed here are those of the author and not that of the Army, Department of Defense, or the US Government.)

The impact of electronic consultation on a Canadian tertiary care pediatric specialty referral system: A prospective single-center observational study

“…Our results are comparable to the only other pediatric eConsult system, Electronic Children’s Hospital of the Pacific (ECHO-Pac), based out of the Tripler Army Medical Center in Hawaii. [ 18 , 19 ] Despite servicing different populations (civilian urban versus rural and military urban) we report similar high rates for surgical consultations requests and short wait times to access specialist advice. Our lower rates of eConsults per 1000 children per month, (0.17 versus 1.0) may be due to different directives provided to the users on cases and conditions eligible for eConsult services or the fact that their service was established for several years prior to their study.…”

“…Our lower rates of eConsults per 1000 children per month, (0.17 versus 1.0) may be due to different directives provided to the users on cases and conditions eligible for eConsult services or the fact that their service was established for several years prior to their study. [ 16 , 18 ] Indeed, the number of pediatric eConsults were only half that observed over the same timeframe in the adult BASE eConsult service, suggesting that this service was not yet as established. In addition, we may not have accounted for the relative exclusion of enrolled community pediatricians who function as PCPs for some families and pediatric questions answered by adult-based specialists during this pilot period.…”

Human papillomavirus genotypes in Pacific Islander cervical cancer patients

“…Shortly thereafter, Hawaiian senator Daniel Inouye used this compact of free association as inspiration for a bill that allowed Pacific Islanders to receive medical care at Tripler Army Medical Center. Since the inception of the Pacific Island Healthcare Project, many patients with cervical cancer have received care in Hawaii ( Person, 2014 ). The objective of this study was to determine the HPV genotypes in this unique population of cervical cancer patients from the Pacific Islands.…”

A Retrospective Analysis of Pediatric Cases Handled by the MSF Tele-Expertise System

“…Some pediatric case reports have been provided. ( 10 ) Email has been used for pediatric orthopedics in Djibouti. ( 11 ) As far as we are aware, there are few other reports concerning store-and-forward telemedicine for pediatric work in low-resource settings.…”