United Seeks New Telemedicine Technology

By Woodrow Bellamy III  | June 15, 2015
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[Avionics Today 06-15-2015] Medical flight diversions are extremely costly for airlines and can be difficult to deal with based on the route and diversion airport or area in which an operator has to land. However, as United Airlines Senior Vice President of Corporate Safety Michael Quiello discussed during a presentation at the 2015 Global Connected Aircraft Summit last week, telemedicine technology could help airlines save millions of dollars annually by avoiding unnecessary medical diversions, or those that do not result in a passenger being ultimately transferred to a medical care facility. 
Michael Quiello, SVP, Corporate Safety, United Airlines, gives a presentation about Telemedicine at the Global Connected Aircraft Summit. Photo: Vincent Lim.
During his presentation, Quiello described both the current situation facing airlines and possible technological solutions that could solve the problem. Currently, the main problem facing carriers such as United is the inconvenience of diverting off the course of a scheduled route, and finding an alternate airport that can accommodate their aircraft. Some medical diversions also cause airlines to incur the cost of finding local hotels for their flight crews and passengers to stay at hotels overnight due to regulatory requirements for rest in between commercial flights by most civil aviation authorities. 
Of course the ultimate goal of the airline is to provide adequate treatment for the affected passenger, but the overall cost of the diversion itself can be extremely expensive and time consuming. This has lead to United's search for a solution that could avoid unnecessary medical diversions.
"We had about 142 medical diversions last year. That’s about one every other day and they can get dicey at times, some of them are critical and some of them are not so critical. The measure of success is whether that individual gets immediate medical attention from the hospital," said Quiello. "If the person walks off the flight and goes to their hotel, then we probably diverted for no good reason. Each diversion at United, you can probably put a cost on it around $20,000."
The United executive estimates that about 50 percent of those diversions are pilot initiated, meaning the aircraft is diverted to the nearest airport as soon as possible without any discussion between the flight crew and a medical professional about all of the possible solutions that could ultimately address a passenger’s medical condition in flight.
United isn't the only airline facing this problem. According to a 2013 New England Journal of Medicine study, in-flight medical emergencies occur on an estimated one in every 604 flights. In 2013 and 2014, Emirates diverted over 100 flights for medical emergencies, costing more than $12 million. 
What Quiello believes could solve the costly problem of unnecessary medical flight diversions is a device that would increase communication between the flight attendants and passengers that are providing the treatment that they can to the passenger in-flight. With a system like this in place, ground-based medical personnel that can make a definitive decision as to whether a flight absolutely needs to be diverted.
"How do we increase that communication so that we’re getting plenty of information back and forth and if the medical professional recommends we divert than we divert immediately?" asked Quiello. "A solution to this problem could be very valuable not only to United Airlines, but also to the airlines of the world, especially to the international airlines, the real large international airlines. Think about diverting an A380 for a passenger event, and the cost of an A380 at an offline airport for a medical diversion."
The solutions that have been evaluated by United so far have been too costly, and would actually be more expensive than undergoing the actual flight diversion itself in some cases, Quiello said. What United and others would like to see is a less costly solution that takes advantage of the existing cabin-based Wi-Fi link to increase communication with ground-based personnel to provide them with information about the passenger's vital signs that, which would determine whether or not a flight diversion needs to occur.

"We have a Wi-Fi solution onboard right now, it would be great if we could have a link from the back of the cabin directly to the facility itself, whether that’s via satcom or Wi-Fi connection, having a dedicated pipe back there for a lot of things other than just passenger entertainment or Wi-Fi Internet capability, it would be great for us," said Quiello. 

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