Telemedicine and medical care to ships without a doctor on board.

Providing medical assistance to ships at sea was probably one of the first practical applications of telemedicine. At present, about 200 different organizations worldwide give medical assistance to ships without a doctor on board. The activity of the Foundation Centro Internazionale Radio Medico (CIRM), which probably has the largest experience in the world of telemedicine applied to seafarers, is reviewed. Medical assistance to seafarers has not improved in parallel with advances in medicine and telecommunications. Possible initiatives for improving teledelivery of medical assistance to seafarers are discussed.