Telemedicine for disaster management: Can it transform chaos into an organized, structured care from the distance?


  • Rifat Latifi, MD, FACS
  • Elizabeth H. Tilley, PhD



telemedicine, disaster preparedness, emergency response, trauma, crisis medicine


Background: Telemedicine and advanced technologies that ensure telepresence have become common practice and are an effective way of providing healthcare services.
Materials and methods: The authors conducted a traditional narrative review of English literature through search engines (Medline, Pub Med, Embase, and Science Direct) using mesh terms “telemedicine,” “telepresence,” “earthquake,” “disaster,” “natural disaster,” and “man-made disaster” published between January 1, 1980 and September 30, 2013. For our analysis, only published studies were selected when telemedicine or telepresence was reported for disaster management, both in real life and in mock and simulation situations. Original articles, clinical trials, case presentations, and review articles were considered. Books and book chapters were used as well. Data from the International Disaster Database were included in the review to provide a sense of worldwide disaster occurrence. Symposia and other meetings were searched and used when available.
Results: Between January 1980 and September 2013, 17,565 disasters recorded. During this study period, 878 articles, chapters, books, and presentations were reported. Of these, only 88 articles and books fulfilled our selection criteria. Six articles described the effectiveness of telemedicine in mock simulations and disaster drills, and 63 presented the need and discussed how telemedicine would be beneficial in disaster response. Only 19 articles provided examples of effective use of telemedicine in disaster response. However, these studies demonstrated telemedicine as a valuable tool for communication between front-line humanitarian aid workers and expert physicians at remote locations.
Conclusion: Telemedicine has not been used thus in the management of disasters, despite its great potential. There is an acute need for establishing telemedicine programs in high risk areas for disasters, so that when these disasters strike, existing telemedicine networks can be used, rather than attempting to bring solutions into a chaotic situation postevent.

Author Biographies

Rifat Latifi, MD, FACS

Professor of Surgery, University of Arizona, Tucson, Arizona; President and Founder, International Virtual e-Hospital Foundation, Tucson, Arizona; Surgery Consultant International, PLLC, Tucson, Arizona; Adjunct Professor of Clinical Surgery, Weil Cornell Medical College, Doha, Qatar.

Elizabeth H. Tilley, PhD

Research Assistant, Surgery Consultant International, PLLC, Tucson, Arizona.


Judkins DG, Latifi R, Hadeed GJ: Trauma and disasters as a worldwide problem: An overview. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House Publisher, 2010: 23-36.

EM-DAT: The OFDA/CRED International Disaster Database – Brussels, Belgium: Université Catholique de Louvain. Available at Accessed November 8, 2013.

USGS Global Seismographic Network Fact Sheet. Available at Accessed February 4, 2014.

International Human Development Indicators: United Nations Development Programme. Available at Accessed February 4, 2014.

Australian National Government. Travel Advice, Haiti. Smartraveller: The Australian Government’s Travel Advisory and Consular Assistance Service. Available at Accessed November 8, 2013.

Latifi R, Hadeed GJ, Rhee PM, et al.:Telemedicine for trauma and emergency care management. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House Publisher, 2010: 225-242.

Guha-Sapir, Hoyois P, Below R: Annual Disaster Statistical Review 2012. The Numbers and Trends. Available at Accessed November 8, 2013.

Merrell RC: Telemedicine and telesurgery in remote conditions. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA:Artech House, 2010: 109-118.

Field MF (ed.): Telemedicine: A Guide to Assessing Telecommunications in Health Care.Washington, DC: National Academy Press, 1996: 1.

Hjelm NM, Julius HW: Centenary of tele-electrocardiography and tele-phonocardiography. J Telemed Telecare. 2005; (11): 336- 338.

Bashshur RL, Shannon G, Krupinski EA, et al.: Sustaining and realizing the promise of telemedicine. Telemed J E Health. 2013; 19(5): 339-345.

Ferguson EW,Villasenor A, Cunnion S, et al.: A global health disaster network is needed. BMJ. 1995; 310(6991): 1412.

Garshnek V, Burkle FM Jr: Applications of telemedicine and telecommunications to disaster medicine: Historical and future perspectives. J Am Med Inform Assoc. 1999; 6(1): 26-37.

Sailors RM, Duke JH, Wall JA, et al.: DREAMS™ (Disaster Relief and Emergency Medical Services) and digital EMS. Proc AMIA Symp. 2000: 1127.

Cabrera MF, Arredondo MT, Rodriguez A, et al.: Mobile technologies in the management of disasters: The results of a telemedicine solution. Proc AMIA Symp. 2001: 86-89.

Teich JM,Wagner MM, Mackenzie CF, et al.: The informatics response in disaster, terrorism, and war. J Am Med Inform Assoc. 2002; 9(2): 97-104.

Nelson BP, Chason K: Use of ultrasound by emergency medical services: A review. Int J Emerg Med. 2008; 1(4): 253-259.

Crawford I, McBeth PB, Mitchelson C, et al.: Telementorable, “just-in-time” lung ultrasound on an iPhone. J Emerg Trauma Shock. 2011; 4: 526-527.

Cooper DL, Smith GE, Regan M, et al.: Tracking the spatial diffusion of influenza and norovirus using telehealth data: A spatiotemporal analysis of syndromic data. BMC Med. 2008; 6: 16.

Van Woerden HC, Evans MR, Mason BW, et al.: Using facsimile cascade to assist case searching during a Q fever outbreak. Epidemiol Infect. 2007; 135(5): 798-801.

Simmons SC, Taylor CW: Telehealth in disaster and humanitarian assistance. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House Publisher, 2010: 191-206.

Johannesen J, Rasbury J: Evaluation of Critical Care Monitor Technology During the US Navy Strong Angel Exercise. Houston, TX: National Aeronautics and Space Administration, Johnson Space Center, 2003.

Burke RV, Berg BM, Vee P, et al.: Using robotic telecommunications to triage pediatric disaster victims. J Pediatr Surg. 2012; 47(1): 221-224.

Xiong W, Bair A, Sandrock C, et al.: Implementing telemedicine in medical emergency response: Concept of operation for a regional telemedicine hub. J Med Syst. 2012; 36(3): 1651-1660.

Nilsson H, Jonson C,Vikstrom T, et al.: Simulation-assisted burn disaster planning. Burns. 2013; 39(6): 1122-1130.

Ruggiero KJ, Resnick HS, Acierno R, et al.: Internet-based intervention for mental health and substance use problems in disasteraffected populations: A pilot feasibility study. Behav Ther. 2006; 37(2): 190-205.

Guha-Sapir D, Lechat MF: Information systems and needs assessment in natural disasters: An approach for better disaster relief management. Disasters. 1986; 10: 232-237.

Kiomoto H: The regional medical support by telemedicine for disaster stricken areas by Tohoku Medical Megabank Organization (ToMMo).Abstract.Paper presented at the 18th ISfTeH International Conference,Takamatsu, Japan, October 17-20, 2013.

Yamanda S, Hanagama M, Kobayashi S, et al.: The impact of the 2011 Great East Japan Earthquake on hospitalisation for respiratory disease in a rapidly aging society: A retrospective descriptive and cross-sectional study at the disaster base hospital in Ishinomaki. BMJ Open. 2013; 3(1): e000865.

Yu JN, Brock TK, Mecozzi DM, et al.: Future connectivity for disaster and emergency point of care point care. Point Care. 2010; 9(4): 185-192.

Brown SW, Griswold WG, Demchak B, et al.: Middleware for reliable mobile medical workflow support in disaster settings. AMIA Annu Symp Proc. 2006; 2006: 309-313.

Chipara O, Plymoth AN, Liu F, et al.: Achieving reliable communication in dynamic emergency responses. AMIA Annu Symp Proc. 2011; 2011: 238-247.

Graschew G, Roelofs TA, Rakowsky S, et al.: Interactive video communication and medical telepresence and their role in trauma, emergencies, and disaster management. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. 2010: 89-108.

Grant I: Medicinal compounds. III-Vs Rev. 2005; 18(1): 34-39.

Rafiq A, Merrill RC:Telemedicine in extreme conditions: Disaster, war, and remote sites. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House Publisher, 2010: 161-172.

Pakistan Space and Upper Atmosphere Research Foundation: Available at Accessed November 8, 2013.

Lewis ER, Thomas CA,Wilson ML, et al.: Telemedicine in acutephase injury management: A review of practice and advancements. Telemed J E Health. 2012; 18(6): 434-445.

International Telemedicine/Disaster Medicine Conference: Papers and presentations, Bethesda, MD, December 9-11, 1991. Washington, DC: NASA, 1992.

Ryan JM, Baldock C, Lawson-Smith R: Accident and emergency medicine—Making waves on the Internet. J Accid Emerg Med. 1997; 14(6): 392-397.

Masellis A, Atiyeh B: Burnet project. Ann Burns Fire Disasters. 2009; 22(4): 171-174.

Nekooei Moghadam M, Saeed S, Khanjani N, et al.: What do we need to do for better casualty support in disasters? Iran Red Crescent Med J. 2011; 13(7): 512-513.

Casscells W, Mirhaji P, Lillibridge S, et al.: Houston biosecurity: Building a national model. Trans Am Clin Climatol Assoc. 2004; 115: 405-417.

Bravata DM, Sundaram V, McDonald KM, et al.: Evaluating detection and diagnostic decision support systems for bioterrorism response. Emerg Infect Dis. 2004; 10(1): 100-108.

Wootton R, Bonnardot L: In what circumstances is telemedicine appropriate in the developing world? JRSM Short Rep. 2010; 1(5): 37.

Wilson JM, Polyak MG, Blake JW, et al.: A heuristic indication and warning staging model for detection and assessment of biological events. J Am Med Inform Assoc. 2008; 15(2): 158-171.

Free C, Phillips G,Watson L, et al.: The effectiveness of mobilehealth technologies to improve health care service delivery processes: A systematic review and meta-analysis. PLoS Med. 2013; 10(1): e1001363.

Li J, Seale H, Pradeep R, et al.: e-Health preparedness assessment in the context of an influenza pandemic: A qualitative study in China. BMJ Open. 2013; 3(3): e002293.

Borgohain B, Khonglah T: Developing and organizing a trauma system and mass casualty management: Some useful observations from the Israeli trauma model. Ann Med Health Sci Res. 2013; 3(1): 85-89.

Rezai-Rad M, Vaezi R, Nattagh F: E-health readiness assessment framework in Iran. Iran J Public Health. 2012; 41(10): 43-51.

Whitten P, Holtz C, LaPlante: Telemedicine: What have we learned? Appl Clin Inform. 2010; 1(2): 132-141.

Graziplene LR: The Rationale and Plans for a Rural Based Emergency Medical Network: A Report by the Center for Rural Resurgence. North Java, NY: Center for Rural Resurgence, 2005.

Aparajita D, Soumya D: Telemedicine: A new horizon in public health in India. Indian J Community Med. 2008; 33(1): 3-8.

Pian L, Gillman LM, McBeth PB, et al.: Potential use of remote telesonography as a transformational technology in underresourced and/or remote settings. Emerg Med Int. 2013; 2013: Article ID 986160.

McCurdy NJ, Griswold WG, Lenert LA: RealityFlythrough: Enhancing situational awareness for medical response to disasters using ubiquitous video. AMIA Annu Symp Proc. 2005; 2005: 510-514.

Arisoylu M, Mishra R, Rao R, et al.: 802.11 Wireless infrastructure to enhance medical response to disasters. AMIA Annu Symp Proc. 2005; 2005: 1-5.

Detmer DE: Building the national health information infrastructure for personal health, health care services, public health, and research. BMC Med Inform Decis Mak. 2003; 3: 1.

Grasso MA: Handheld computer application for medical disaster management. AMIA Annu Symp Proc. 2006; 2006; 932.

Welch G, Sonnenwald DH, Fuchs H, et al.: 3D medical collaboration technology to enhance emergency healthcare. J Biomed Discov Collab. 2009; 4: 4.

Toomey RJ, Ryan JT, McEntee MF, et al.: The diagnostic efficacy of hand-held devices for emergency radiological consultation. AJR Am J Roentgenol. 2010; 194(2): 469-474.

Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events: Medical Surge Capacity: Workshop Summary.Washington, DC: National Academies Press (US), 2010.

Institute of Medicine (US) Forum on Medical and Public Health Preparedness for Catastrophic Events: Crisis Standards of Care: Summary of a Workshop Series. Washington (DC): National Academies Press (US), 2010.

Royston G: Meeting global health challenges through operational research and management science. Bull World Health Organ. 2011; 89(9): 683-688.

Kost GJ, Kost LE, Suwanyangyuen A, et al.: Emergency cardiac biomarkers and point-of-care testing: Optimizing acute coronary syndrome care using small-world networks in rural settings. Point Care. 2010; 9(2): 53-64.

Gagnon M, Labarthe J, Legare F, et al.: Measuring organizational readiness for knowledge translation in chronic care. Implement Sci. 2011; 6: 72.

Osain MW: The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems. J Pharm Bioallied Sci. 2011; 3(4): 470-478.

Bajwa SS, Kaur J, Bajwa SK, et al.: Designing, managing and improving the operative and intensive care in polytrauma. J Emerg Trauma Shock. 2011; 4(4): 494-500.

Kost GJ, Curtis CM: Optimizing global resiliency in public health, emergency response, and disaster medicine. Point Care. 2012; 11(2): 94-95.

Piette JD, Lun KC, Moura LA Jr, et al.: Impacts of e-health on the outcomes of care in low- and middle-income countries: Where do we go from here? Bull World Health Organ. 2012; 90(5): 365- 372.

Li J, Seale H, Ray P, et al.: Issues regarding the implementation of eHealth: Preparing for future influenza pandemics. Interact J Med Res. 2012; 1(2): e20.

Koenig KL, Schultz CH: Koenig and Schultz’s Disaster Medicine: Comprehensive Principles and Practices. Cambridge, New York: Cambridge University Press, 2010.

Séror AC: A case analysis of INFOMED: The Cuban National Health Care Telecommunications Network and Portal. J Med Internet Res. 2006; 8(1): e1.

Augusterfer EF: Clinically informed telemental health in postdisaster areas. In Myers K, Turvey CL (eds.): Telemental Health. Oxford: Elsevier, 2013: 347-366.

Kost GJ, Hale KN, Brock K, et al.: Point-of-care testing for disasters: Needs assessment, strategic planning, and future design. Clin Lab Med. 2009; 29(3): 583-605.

Lippert SC, Nagdev A, Stone MB, et al.: Pain control in disaster settings: A role for ultrasound-guided nerve blocks. Ann Emerg Med. 2013; 61(6): 690-696.

Bhaskaranarayana A, Varadarajan C, Hegde VS: Space-based societal applications—Relevance in developing countries. Acta Astronaut. 2009; 65(9-10): 1479-1486.

Nelson BP, Melnick ER, Li J: Portable ultrasound for remote environments, Part I: Feasibility of field deployment. J Emerg Med. 2011; 40(2): 190-197.

Benedek M, Ursano RJ: Military and disaster psychiatry. In Smelser NJ, Baltes PB (eds.): International Encyclopedia of the Social & Behavioral Sciences. Oxford: Pergamon, 2001: 9850-9857.

Waeckerle JF, Lillibridge SR, Burkle FM Jr, et al.: Disaster medicine: Challenges for today. Ann Emerg Med. 1994; 23(4): 715- 718.

Jayaraman V, Chandrasekhar MG, Rao UR: Managing the natural disasters from space technology inputs. Acta Astronaut. 1997; 40(2-8): 291-325.

Wachtel TL, McQueen KAK: Burn management in disasters and humanitarian crises. In Herndon DN (ed.): Total Burn Care. 3rd ed. Edinburgh:W.B. Saunders, 2007: 43-66; chap 5.

Budd C: Informatics and telecommunications in Disaster. In Ciottone GR, Anderson PD, Der Heide EA, Darling RG, Jacoby I, Noji E, Suner S (eds.): Disaster Medicine. Philadelphia: Mosby, 2006: 130-138; chap 20.

Hick JL, Hanfling D, Cantrill SV: Allocating scarce resources in disasters: Emergency department principles. Ann Emerg Med. 2012; 59(3): 177-187.

Potin M, Senechaud C, Carsin H, et al.: Mass casualty incidents with multiple burn victims: Rationale for a Swiss burn plan. Burns. 2010; 36(6): 741-750.

Walderhaug S, Håkon Meland P, Mikalsen M, et al.: Evacuation support system for improved medical documentation and information flow in the field. Int J Med Inform. 2008; 77(2): 137-151.

Garshnek V, Burkle FM Jr:Telecommunications systems in support of disaster medicine: Applications of basic information pathways. Ann Emerg Med. 1999; 34(2): 213-218.

Koudelka O, Schrotter P: Satellite services for disaster management and security applications. Acta Astronaut. 2007; 60(12): 986- 991.

Zimmermann H: The use of satellite telecommunications in disaster relief operations. Acta Astronaut. 1995; 37: 437-446.

Caruso DM, Matthews MR, Kreisheimer-Caruso DM, et al.: A burn disaster network for mass casualty events. Burns. 2009; 35(Suppl 1): S26.

Noji EK, Reis ND, Berlin DE: Manual of Disaster Medicine: Civilian and Military. FRG: Springer-Verlag, 1989: 475 p.

Otsu Y, Choh T, Yamazaki I, et al.: Experiments on the quickrelief medical communications via the Japan’s domestic communication satellite CS-2 for the case of disasters and emergencies. Acta Astronaut. 1986; 13(6-7): 459-466.

Mathers N, Thompson L: Using inflatable antennas for portable satellite-based personal communications systems. Acta Astronaut. 2007; 61(7-8): 659-663.

Brand H, Hollederer A,Wolf U, et al.: Cross-border health activities in the Euregios: Good practice for better health. Health Policy. 2008; 86(2-3): 245-254.

Haller HL, Peterlik C, Gabriel C: Burn management in disasters and humanitarian crises. In Herndon DN (ed.): Total Burn Care. 4th ed. London:W.B. Saunders, 2012: 57-79.e3; chap 5.

Poropatich RK, Lappan C, Lam DM: Operational use of US Army telemedicine information systems in Iraq and Afghanistan— Considerations for NATO operations. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House, 2010: 173-182.

Maull KI, Tuma MA, Abdelrahman H: Informatics in disaster, terrorism, and war. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House, 2010: 335-344.

Huffer LL, Bauch TD, Furgerson JL, et al.: Feasibility of remote echocardiography with satellite transmission and real-time interpretation to support medical activities in the austere medical environment. J Am Soc Echocardiogr. 2004; 17: 670-674.

Patterson V, Swinfen P, Swinfen R, et al.: Supporting hospital doctors in the middle east by email telemedicine: Something the industrialized world can do to help. J Med Internet Res. 2007; 9(4): e30.

Yang C, Yang J, Luo X, et al.: Use of mobile phones in an emergency reporting system for infectious disease surveillance after the Sichuan earthquake in China. Bull World Health Organ. 2009; 87(8): 619-623.

Krever M: Fundamental humanitarian constraints exposed by Philippines Typhoon UN Official says. CNN News. Available at = allsearch. Accessed November 13, 2013.

Marshall ARC: Typhoon Haiyan: Was the government prepared? The Christian Science Monitor. Available at Accessed November 13, 2013.

Dara SI, Farmer C: Preparedness lessons from modern disasters and wars. Crit Care Clin. 2009; 25(1): 47-65.

Aung E, Whittaker M: Preparing routine health information systems for immediate health responses to disasters. Health Policy Plan. 2013; 28(5): 495-507.

WHO Emergency and Essential Surgical Care. 2003. Available at Accessed November 8, 2013.

WHO Generic Essential Emergency Checklist. 2003. Available at Accessed November 8, 2013.

WHO Needs Assessment and Evaluation Form. 2003. Available at Accessed November 8, 2013.

Wootton R, Vladzymyrskyy A, Zolfo M, et al.: Experience with low-cost telemedicine in three different settings. Recommendations based on a proposed framework for network performance evaluation. Glob Health Action. 2011; 4: PMC3234078.

Greenwood JE: Burn injury and explosions: An Australian perspective. Eplasty. 2009; 9: e40.

Merrell RC, Lee A, Kwankam SY, et al.: Satellite applications for telehealth in the developing world. J Telemed Telecare. 2006; 12(6): 321-324.

Carter CJ, Cooper A, Coren A: Typhoon Haiyan: No medicine, little aid at Tacloban clinic. CNN News. Available at Accessed November 13, 2013.

Thompson F, Bysouth K, Crawford P, et al.: CAER Cluster Evaluation Pakistan Earthquake. Canberra,ACT: AusAid, 2006.

Turner R, Baker J, Oo ZM, et al.: Inter-Agency Real Time Evaluation of the Response to Cyclone Nargis. United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA), 2008. Available at Accessed February 4, 2014.

IASC: Response to the Humanitarian Crisis in Haiti following the 12 January 2010 Earthquake: Achievements, Challenges and Lessons To Be Learned. 6-Month Report. Geneva: Inter-Agency Standing Committee, 2010.

HMN: Framework and Standards for Country Health Information Systems. 2nd ed. 2008. Available at Accessed November 8, 2013.

Aqil A: PRISM Case Studies: Strengthening and Evaluating RHIS. Available at Accessed November 18, 2013.

Aqil A, Lippeveld T: PRISM Tools for Assessing, Monitoring, and Evaluating RHIS Performance. 2010 ver 3.1.

Aqil A, Lippeveld T, Hozumi D: PRISM framework: A paradigm shift for designing, strengthening and evaluating routine health information systems. Health Policy Plan. 2009; 24: 217-228.

Cermak M: Monitoring and support in remote and extreme environments. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House Publisher, 2010: 119-146.

PAHO. General effects of disasters on health. In Natural Disasters: Protecting the Public’s Health. Washington, DC: Pan American Health Organization, 2000: 1-10; chap 1.

PAHO. Disaster preparedness. In Natural Disasters: Protecting the Public’s Health. Washington, DC: Pan American Health Organization, 2000: 17-23; chap 3.

Gupta A, McHugh M:Keeping up with industry development in telemedicine. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House: 2010: 373- 388.

Timbie JW, Ringel JS, Fox DS, et al.: Allocation of Scarce Resources During Mass Casualty Events. Evidence Reports/ Technology Assessments, No. 207. Rockville, MD: Agency for Healthcare Research and Quality (US), June 2012.

Yuce M:Wireless technologies: Potential use in emergencies and disasters. In Latifi R (ed.): Telemedicine for Trauma, Emergencies and Disaster Management. Norwood, MA: Artech House, 2010: 69-88.

Boniface KS, Shokoohi H, Smith ER, et al.:Tele-ultrasound and paramedics: Real-time remote physician guidance of the focused assessment with sonography for trauma examination. Am J Emerg Med. 2011; 29: 477-481.

Abdul Karim R, Zakara NF, Zulkifley MA, et al.: Telepointer technology in telemedicine: A review. Biomed Eng Online. 2013; 12: 21.



How to Cite

Latifi, MD, FACS, R., and E. H. Tilley, PhD. “Telemedicine for Disaster Management: Can It Transform Chaos into an Organized, Structured Care from the Distance?”. American Journal of Disaster Medicine, vol. 9, no. 1, Jan. 2014, pp. 25-37, doi:10.5055/ajdm.2014.0139.