Norsk olje&gass 34th Joint International Health Meeting June 3rd 2014 in Oslo

Telemedicine in Statoil

6 June 2014

• Offshore oil & gas exploration is a risky business!

• Hydrocarbons, industrial environments, weather, very complex operations, time

pressure

• Despite safety precautions & procedures: Injuries do occur

• Despite careful employee selection: Acute illness happen

Background

6 June 2014

6 June 2014

We may experience this kind of weather

6 June 2014

We also work offshore on these kind of projects!

What is this?

Do anyone know?

One-Column Format

Integrated Operations

Collaboration across all boundaries

People

Technology

Organisation

Connectivity gives us the ability to develop new work processes and link the right

people with the right information at the right time.

More effective drilling Rig support from shore

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7

-

After

Parallel

Multidiscipline teams

Decisions based on Real-time data

Proactive

Independent of location

Serial

Single discipline

Dependent of physical location

Decisions based on experience data

Reactive

Before

Integrated Operations Work processes

2012-08-15

6/6/2014

6 June 2014

Stjørdal

LAN Local area network

Heidrun

Gullfaks A

Visund

Statfjord C

Snorre B

Snorre A

Sandsli

Stavanger

”Responsible MD”

”Responsible MD”

”Responsible MD”

”Hospitals, others”

Statoil

Telemedicine pilot 2007/2008

6 June 2014

Medical emergency resourses

AWSAR Helicopter during drilling

operations

AWSAR Helicopter

and Emergency vessel

2 x AWSAR Helicoters

3 x Emergency vessels

AMK-St. Olavs hospital

AMK- Haukeland university hospital

AMK-Stavanger university hospital

1 AWSAR Helicopter UK sector-JigSaw/Miller

6 June 2014

AMK-UNN Tromsø

AMK Finnmark i Kirkenes

Response matrix

6/6/2014 11

Priority

Ref. Norwegian Index of Emergency Medical Assistance

Red response

(Emergency)

1

Life-threatening injury or illness

Immediate medical evacuation with first

available helicopter, accompanied by

competent medical personnel after acquired

medical stabilisation and safeguarding of

vital medical functions.

Examples:

Cardiac arrest. Heart attack

Serious circulatory disorder

Extensive second and third degree burns

High-energy impact injuries

Serious head, neck and spinal injuries

Suspicion of a stroke

Respiratory disorder

Yellow response

(Urgent)

2

Serious injury or illness

Medical evacuation ordered by on duty doctor

due to undetermined conditions that may

deteriorate and where early examination and

treatment will yield clear benefits.

Medical observation in infirmary and during

medical evacuation by competent medical

personnel.

Examples:

Acute abdomen

Acute infections

Fractures of major joints

Head, neck and spinal injuries

Psychosis

Green response

(Routine transport)

3

Medical evacuation in order perform medical

examination and treatment by agreement,

continuous observation by medical personnel

on-board the platform.

To be sent ashore as regular passenger,

stretcher or ambulance transport

accompanied or unaccompanied in

agreement with on duty doctor.

Examples:

Prolonged high temperatures and

respiratory infections

Minor fractures and crush injuries

Back pain

WR1149 Medical evacuation

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6 June 2014

Integrated operations

TELEMEDICINE IN STATOIL

Telemedicine - «A giant step forward»

14

Transfer of realtime

patientdata, image and

live video to on duty

doctors and hospitals

onshore

Next step may be

videoassisted

ultrasound realtime

examinations and

realtime communication

from SAR-helicopters

Telemedicine

equipment onboard all

Statoil installations

since Q1-2009

Telemedical equipment in use

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6 June 2014

Medical Unit – Crestron w/print function

Medical Unit at Haukeland university hospital

17 6 June 2014

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Asembled 3 functionel parts with

wireless communication

Corpuls3

Defibrillator og monitoring

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Electronic otoscope

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Telemedicine onbord Heidrun and at Haukeland university hospital

Heidrun

AMK Haukeland university hospital

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0

5

10

15

20

25

30

35

40

45

50

1 2 3 4 5 6

User survey:

Do you find the telemedicine equipment user friendly? (1 = Bad – 6 Very good)

Percent

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0

5

10

15

20

25

30

35

40

1 2 3 4 5 6

Percent

User survey :

Has the use of telemedicine resulted in more secure medical diagnosis? (1 = Bad – 6 Very good)

6 June 2014

0

5

10

15

20

25

30

35

40

1 2 3 4 5 6

Percent

User survey :

Has the introcuction of telemedicine improved quality of the health services? (1 = Bad – 6 Very good)

6 June 2014

Extra issues regarding helicopter

transportation

Environment and weather

conditions as other earlier

operations

Standard exploration wells alike earlier drilling in the Barentz Sea

Low pressure and temperature Normal waterdepths

Longer distance from shore compensates with:

Extra messures regarding

medical preparedness

Advanced standby ships

EXPLORATION IN THE HOOP AREA

Standard exploration wells – large distance from shore

Corpuls CPR

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Corpuls CPR

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Corpuls3 og Corpuls.web

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• Alle health offices offshore use the equipment today

• Corpuls.web communicate directly through video towards the following hospitals:

- Stavanger university hospital (SUS)

- Haukeland university hopspital (HUS)

- St. Olavs hospital (STOLAV)

- University hospital in Northern-Norway (UNN), Tromsø

- AMK Finnmark in Kirkenes (planned)

• Ongoing cooperation with GS og Alere AS regarding electro medical equipment

• Install Corpuls CPR when ready for market

• Considdering videoassisted ultrasound examination onboard installations

Wireless communication

Corpuls CPR Corpuls3

Future installations and improved communication possibilities: In-flight video transfer of data and image

6 June 2014

GSM Satellitt

Corpuls3 - Inflight real time video transmission Issues to be considered

6 June 2014

• Bandwidth will be an issue via satellite

- Therefore we need different priorities for each signal such as live date,

audio, video and so on

- Different resolutions need to be investigated

- Maybe a decreased image refresh rate will have a bigger impact than low

resolution and not result in difficulties for example to diagnose from shore

- The system should be able to adopt to changing circumstances

- In the beginning of May GS will look at a technology that´s currently

developed and may be able to deliver Satellite-coverage more or less on

demand

- GS don´t know about fast moving vehicles like helicopters yet, but they

will keep us informed.

• Packaging of data needs to investigated an used wherever possible

Corpuls3 - Inflight real time video transmission Different aircrafts

6 June 2014

• We need to keep in mind that we need to certify the system for every

aircraft

• GS will talk to their partner in Hamburg (P3 Voith Aerospace) how we

could manage this process

• P3 Voith Aerospace is mainly working with EADS so it is good news

that Statoil use Eurocopter for AWSAR missions

• Speed should not be a general issue since they have installed this

system in jets before (not with Corpuls3, just data)

Stetoscope The future?

• “Ultrasound is the Stethoscope of the future”: Thomas Gentile, President of

GE healthcare

6 June 2014

«Why would I want to hear «lub-dub» when I can see

everything I want?»

Offshore Telementored

Ultrasonography

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Point-of-care ultrasonography

• Focused examinations performed

at the patient’s bedside.

• Development of small hand-held

ultrasound machines.

• An important adjunct to the clinical

examination in some settings

• Potentially life-saving

Telementored ultrasonography

• Myocardial infarction

• Heart failure

• Hypovolaemia

• Pulmonary Thrombosis

• Pericardial effusion

• Tamponade

Focus assessed transthoracic echocardiography (FATE)

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Focused Assessment with Sonography for Trauma

(FAST)

• Bleeding

- Abdomen / thorax

• Hypovolaemia

• Aortic aneurysm

Extended Focused Assessment with Sonography for Trauma

(E-FAST)

• Pneumothorax

• Pulmonary oedema

Project Telementored Ultrasonography

• ~30 volunteering workers at Statfjord C

• Expert located on shore with standard 46’’ monitor

• FATE and E-FAST

• Storage of video of about 6 seconds for every position (14)

• Scoring by independent experts in ultrasonography

• Scoring system: 1-5; clinically useful: 3-5

Conclusions

• Full scale telemedicine implemented on Statoil-operated installations

on the NCS in 2009

• Integrated with defibrillator/monitoring unit, othoscope

• User satisfaction is high (including MD on-call)

• Improvement of the communication

• Better and safer primary diagnosis

- Avoid unnecessary use of SAR-helicopter

• Telementored ultrasonography is a feasible option

• Important: The receiver must have the appropriate competence

• Equipment; how far do we go and where?

6 June 2014 43

Arne M.C. Evensen

Advisor

amce@statoil.com

Tel: +4741476054 www.statoil.com

6 June 2014

Open

Courageous

Hands on

Caring

Thanks Telemedicine in

Statoil Norsk olje&gass

34th Joint International Health Meeting

June 3rd 2014 in Oslo