MONS, Belgium - The requirement for physical distancing during the recent COVID-19 pandemic has given rise to the use of Virtual Health across Army Medicine. At Landstuhl Regional Medical Center, the only forward-stationed medical center for U.S. & Coalition Forces, the use of virtual medicine has multiplied five times over to continue providing patients access to care during restriction of movement.The concept of virtual healthcare is similar to modern social media communications or video conferencing, using audio-video technology to enable communication between a healthcare provider and the patient.“Virtual health is a fantastic program that not only helps the joint warfighters, but also their families,” said U.S. Army Lt. Col. Robert Cornfeld, medical director for the Virtual Medical Center Europe at LRMC. “Virtual health literally brings the medical center to the point of care where it's needed. Using today's technology, we can now go directly to (the beneficiary’s) house and bring the services and specialties of LRMC to their front door.”To further enable remote patient monitoring using technology, medical professionals at Supreme Headquarters Allied Powers Europe (SHAPE) Healthcare Facility produced a kit designed to make telemedicine possible in any network-covered location.“The (Telehealth in a Bag) kit is a backpack designed to make telemedicine mobile,” said Libby Beck, telehealth program manager, SHAPE Healthcare Facility. “Essentially the presenter who is physically with the patient establishes a video connection via VTC with a distant provider to facilitate an encounter.”The Telehealth in a bag, or THIAB, is a self-contained kit consisting of digital stethoscopes, allowing heart, lung, and bowel sounds to be saved online, and streamed for medical providers to review, an electrocardiogram, allowing providers to remotely diagnose a heart attack, a digital streaming camera, a telemedicine camera (a handheld 60 FPS, HD camera which can be maneuvered around and inside the patient), a laptop and a Wi-Fi hotspot. The kit is designed to be set up and connected with a medical professional in 10 minutes.Through a network of more than 165 specialty providers across 38 specialties, patients can even receive certain specialty care in the comfort of their own homes.“THIAB was originally designed to be used by medics in the field. It allows forward-deployed combat medics to extend their capabilities by getting expert consultation from a licensed provider,” said Beck, a native of Yakima, Washington. “This can mean the difference between airlifting a possible appendicitis vs. watching the patient through video encounters to see how the illness is progressing. It also means the provider can walk the medic through any advanced procedures that may be necessary to stabilize a wounded patient (needle decompression, bone setting, securing an airway).”Although combat medics undergo training in life-saving procedures, the added capability would allow advanced medical procedures to be conducted at the point of injury, possibly saving lives of wounded service members.The need for the mobility was realized during COVID-19 operations at SHAPE, to further protect providers from direct contact with possible COVID-19-positive patients while also protecting the community at large from the spread of the disease through quarantine home visits.“Licensed providers are an extremely precious asset, the THIAB allows the providers to still see and provide medical care to patients without potential exposure to COVID-19,” said Beck. “When (virtual presenters) go into the (suspected COVID-19 patient’s) home, they follow all the same protective measures that are taken here in the clinic – N95 mask protection, disposable gown, gloves, shoe coverings, and face shield if warranted. If the THIAB in a bag is used, the patient does not need to do anything other than sign an informed consent that telemedicine is being used.”While the kit has been used a limited amount of times, Beck believes it’s addition to SHAPE Healthcare Facility’s arsenal will better prepare the clinic in case of a second wave of COVID-19 cases occurs.“It’s an extension of the existing Telehealth Program at SHAPE. We use telemedicine to connect to the 32 specialties at LRMC, but we also use it for our own specialty clinics,” said Beck. “Due to COVID-19, many departments at SHF have started using Telehealth and have seen great success with it– primary care, behavioral health, perinatal care, EFMP, and physical therapy are all equipped to provide virtual encounters to the patients assigned at SHAPE and Brussels.”