development increases in the world, these locations become far more accessible, and in turn tourist fi gures will rise,” he said. “In the assistance fi eld, it’s in everybody’s interests to know of providers in these locations who are ready to help. T ere is a lot to be prepared for; for example, repatriation of mortal remains (RMR) requirements from remote locations can sometimes be forgotten about. We see a number of assistance companies covering all areas – including RMR – within their remote location assessments, but it’s interesting to see those which do not.” For First Assistance in New Zealand, its key factor in managing and delivering remote assistance has been its investment in medical expertise. “We have found having a strong team of skilled physicians and nurses is the cornerstone of responding to remote assistance cases,” explained Dr Denyer. “What’s required is a 24/7 pool of broad generalist medical expertise that includes a variety of specialist skills such as tropical, hyperbaric, altitude and aviation medicine. Technology to deliver this expertise, such as telemedicine systems, is also important, but our experience is that such systems work well only where pre-planning and pre-investment is possible; remote oil rigs and luxury yachts are examples. Currently, advanced telemedicine systems do not work

well in practice for general remote travel assistance cases that are widely distributed and reactive. T is will change in time as smartphone technology and worldwide data networks evolve, but currently our experience is that medical expertise, delivered by the lo-fi means of email and phone, matter more than technology in delivering quality remote medical assistance.” T at said, it’s important to remember that the provision of remote assistance services is as much about logistics as it is about medicine, noted Dr Denyer, as more often than not, evacuation to a higher level of care is the outcome. An advanced understanding of the logistical options available for a remote case is paramount and will often dictate options in spite of medical need: "A prime example is Antarctica and large parts of the Southern Ocean where, with the exception of the Antarctica Peninsula, response remains largely the preserve of national Antarctic programmes. Without an understanding of – and a connection to – those programmes, little can be achieved by an assistance provider in that environment.” Homeland International’s Sam Tester believes that many assistance companies are thinking more carefully about the partners that can be relied on with diffi cult cases in remote locations. “Some providers might be


s witzerland s witz erland

Your assistance and TPA partner in

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| 35 International Travel & Health Insurance Journal

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