Navy hospital commander advocates for telemedicine


Capt. Frederick McDonald envisions a time when a Navy wife worried about her sick baby at 2 a.m. could get help immediately on the Seaplane Base in Oak Harbor.

She could enter a clinic “pod” staffed by a technician and visit face-to-face virtually with a doctor at a hospital elsewhere.

We’re not there yet, but health care is moving in that direction, said McDonald, commander of Naval Hospital Oak Harbor. The base hospital already is taking advantage of advances in telemedicine that make health care more accessible to patients and save money.

Not long after McDonald took command in 2014, the base started offering virtual behavioral health services. Patients talk to a provider remotely via video conferencing technology. A technician is onsite with the patient if they need assistance.

This option isn’t right for everyone or every situation, but it’s helped solved a problem for the hospital, which struggled to attract a mental health provider willing to take a modest salary and live in a rural location. There’s a high demand for mental health services statewide and stiff competition for providers in the civilian sector.

“This created an opportunity to think about out-of-the-box coverage,” he said.

Naval Hospital Oak Harbor is averaging around 10 telemedicine behavioral health visits a month with fluctuations based patient needs, psychiatry manning and deployments, said Cdr. Andrew Mortimer, a staff psychiatrist. Telemedicine is available to active duty personnel and dependents.

“It’s an additional tool to help with access to care but has limitations based upon patient preference and acuity,” he said.

Telemedicine in its more rudimentary forms is nothing new, especially in the military when sailors and soldiers can be far removed from hospitals and specialists. Many times when McDonald was deployed at sea, he called specialists for a consultation.

“The military has been a lead on this because of the way we work and where we work,” he said. “We’ve been doing things like this a long time because we needed to.”

What’s changing is how technology allows for face-to-face contact with a specialist anywhere in the world.

That’s particularly important at Naval Hospital Oak Harbor, which is a long drive from the specialists at Naval Hospital Bremerton or Madigan Army Medical Center in Tacoma. These facilities may seem close as the crow flies, but patients can be traveling for up to four hours to see a specialist.

The foray into telemedicine is working so well, the base hospital is expanding the option for other specialties. Right now they also offer some dermatology services. Diagnosis works best face-to-face, McDonald said, but for chronic conditions when patients just need to check-in, a tele-appointment is faster and easier than waiting a month for an appointment in Bremerton.

The hospital is looking to expand telemedicine offerings to rheumatology, pulmonology and endocrinology.