Rashid L. Bashshur and Matthew R. Dunn: Telemedicine as a Healthcare Delivery Solution on Seasteads


This paper proposes telemedicine as a solution to the problem of healthcare delivery on seasteads. The rationale stems from the expected role of telemedicine as a critical means to address the inequitable distribution of available healthcare resources in general and the attendant limited access to such resources by segments of the population. This discrepancy can be attributed to several factors, but we focus on the inequities that arise from geographic location. Rural and isolated areas are often unable to provide the same quality of care that is available in centralized locations, and this problem is highly pertinent to the development of seasteads, floating aquatic communities, which can be distant from any major population centers. Each source of the geographic maldistribution of healthcare is explained, including obstacles faced by both patient and provider. Rural health facilities suffer from limited resources and expertise.  Although medical care overall has benefited greatly from scientific advances and technological improvements, such advancements are not distributed equally. In addition, as medical practice has become more specialized, and thus more geographically centralized, isolated facilities are less able to deliver appropriate and necessary care. Even in instances where rural healthcare providers have the resources to maintain certain functions, the quality of care is generally lower to what is offered in urban areas. Rural patients must travel long distances between home and health facilities often resulting in disruptions of work or family responsibilities. The following section provides a brief history of telemedicine, noting significant moments in its development in the United States and Europe. The final section in this paper serves two purposes: First, there is a discussion of how telemedicine functions in practice, including an explanation of why telemedicine can take the form of synchronous or asynchronous. Second, we explain how telemedicine can be a solution to the problems that afflict rural healthcare.


The Authors

Dr. Rashid L. Bashshur currently works as the Senior Advisor for Telemedicine at the University of Michigan Health system. He is also Professor Emeritus at the University of Michigan School of Public Health, Department of Health Management and Policy. He has been a principal pioneer in the development of telemedicine, both in the United States and worldwide. In the 1970s, Dr. Bashshur worked as a consultant for the National Academy of Sciences, and was later commissioned by NASA to analyze the application of space technology in rural health care delivery. He has done extensive work for the American Telemedicine Association (ATA), including serving as the Scientific Program chair at the 1997 ATA annual meeting, co-chair in each annual meeting from 1998-2000, and as ATA president from 2000-2002.  Also in 2015, the ATA awarded Dr. Bashshur the first ever “ATA Medal: Distinguished Service Award.” Dr. Bashshur has contributed numerous works to telemedicine literature, perhaps most notably with his co-authorship of The History of Telemedicine, Evolution, Context and Transformation published in 2009.

Matthew R. Dunn is a premedical undergraduate student at the University of Michigan. His academic achievements include receiving the William J. Branstrom Freshman Prize for placing in the top five percent of his college class. He is interested in researching in the fields of telemedicine and cardiology.



Rashid L. Bashshur and Matthew R. Dunn (2017): Telemedicine as a Healthcare Delivery Solution on Seasteads, in: Victor Tiberius (Ed.) (2017): Seasteads. Opportunities and Challenges for Small New Societies, Zurich (vdf), pp. 213-220.

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