Businesses increasingly conduct operations in remote areas where medical evacuation (medevac) carries more risk. Royal Dutch Shell developed a remote healthcare strategy whereby enhanced remote healthcare is made available to the patient through use of telemedicine and telemetry. To evaluate that strategy, a review of medevacs of Shell International employees was undertaken.
A retrospective review of medevac data that were similar in operational constraints and population profile was conducted. Employee records and human resource data were used as a denominator for the population. Analogous medevac data from specific locations were used to compare patterns of diagnoses.
A total of 130 medevacs were conducted during the study period, resulting in a medevac rate of 4 per 1,000 people with 16 per 1,000 for women and 3 per 1,000 for men. The youngest and oldest age-groups required medevacs in larger proportions. The evacuation rates were highest for countries classified as high or extreme risk. The most frequent diagnostic categories for medevac were trauma, digestive, musculoskeletal, cardiac, and neurological. In 9% of the total, a strong to moderate link could be made between the pre-existing medical condition and diagnosis leading to medevac.
This study uniquely provides a benchmark medevac rate (4 per 1,000) and demonstrates that medevac rates are highest from countries identified as high risk; there is an age and gender bias, and pre-existing medical conditions are of notable relevance. It confirms a change in the trend from injury to illness as a reason for medevac in the oil and gas industry and demonstrates that diagnoses of a digestive and traumatic nature are the most frequent. A holistic approach to health (as opposed to a predominant focus on fitness to work), more attention to female travelers, and the application of modern technology and communication will reduce the need for medevacs.