Effect of Telemedicine in Military Medicine: A Literature Review

Military forces are exposed to certain diseases and hazards due to occupational conditions. This review study was conducted to investigate the effect of telemedicine in military medicine.

Methods and Materials: 

A systematic literature review of the studies was conducted by searching for relevant keywords in the title, abstract and related keywords of Embase, Web of Science, Scopus and PubMed in the authoritative scientific databases. English-language articles related to the development, role and effect of telemedicine in military medicine were included in the study on December 30 in 2021 without time limit. Exclusion criteria included review articles, full-text abstracts, letters to the editor, and lack of access to the full text of the articles. Eligibility criteria were independently screened by two authors. The same checklist was used to extract data such as reference, year of publication, country name, first author name, telemedicine approach, outcome, or training strategy.

Initially, 250 studies were retrieved from database searches and 19 studies were included in this study. Twelve studies were conducted in barracks or military areas. Four of them were performed in navy and three of them were done in war zone. Outcomes in studies including the use of telemedicine in orthopedic services (n= 4) intensive care (n= 3), psychology and surgical psychiatry (n= 5), physiological and biological monitoring of soldiers (n= 2), decision system for biological casualties (n= 1), physician training program (n= 4) including trauma were the predominant specialties that used telemedicine. Communication approachesused by telemedicine included online video conferencing, email, telephone, wearable technology, websites, and mobile applications. Most approaches were synchronous through the online video conferencing platform and websites. All studies reported the positive effects of telemedicine on the consequences of providing health care in the military. Among the major challenges facing the widespread implementation of telemedicine in operational environments were network constraints and cybersecurity concerns. Reliable communication, high bandwidth, low latency and security are essential to facilitate and make better use of telemedicine capabilities.

Telemedicine in military medicine has a very high potential in caring for this type of patient. This potentially not only maintains the operational readiness of reliable caregivers, but also improves the patient experience by minimizing deprivations of health care. Given the security constraints as the most important challenge, it must develop and train a full range of telemedicine support options, including high-bandwidth and secure solutions.