FRONTIERS IN EMERGENCY MEDICINE. 2022;6(4):e53 Mohammadzadeh et al . REVIEW ARTICLE DOI: https://doi.org/10.18502/fem.v6i4.10440 Telemedicine and natural disasters: various services, re- quirements, challenges, and general framework Niloofar Mohammadzadeh , Soheila Saeedi , Sorayya Rezayi * Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. *Corresponding author: Sorayya Rezayi; Email: s_rezayi@razi.tums.ac.ir Published online: 2022-05-31 Abstract: Providing early health care services in natural disaster is one of the essential applications of telemedicine. This narrative review aims to investigate the applications, advantages and challenges of telemedicine in natural disaster-stricken areas. Medline (through PubMed), Web of Science (WOS), and Scopus databases were searched for related articles published from beginning to 2022. The keywords used for the search included "telemedicine" and "natural disaster." After removing duplicate papers, irrelevant review articles and letters to editors, 44 rele- vant papers were selected and reviewed. Information sharing through audio, visual, and data-oriented services is among critical approaches that telemedicine services mainly use. Teleconsultation, tele-education, remote interpretation, tele-psychiatry, and tele-surgery are among measures that can be implemented in emergencies like earthquakes, fires, floods, storms, and drought. The fundamental requirements of a telemedicine-oriented system for providing emergency services in natural disasters include wireless scales, conversation tools, blood pressure monitor, respiratory rate monitor, spo2 sensor, glucometer, portable ultrasound unit, wearable ther- mometers, virtual stethoscopes, portable three leads electrocardiograph monitor, and digital otoscopes. Simple telemedicine systems can have many advantages in the natural disasters. However, the main challenge in this regard is to adapt the necessary communication systems to a telemedicine paradigm. Another critical challenge is to interpret and apply the summary of acquired information and the inevitable interaction outcomes at the required time and place. Keywords: Communication; Natural Disasters; Information Technology; Telemedicine Cite this article as: Mohammadzadeh N, Saeedi S, Rezayi S. Telemedicine and natural disasters: various services, requirements, challenges, and general framework. Front Emerg Med. 2022;6(4):e53. 1. Introduction Telemedicine is the use of electronic and digital technology to provide medical and health care to patients living far from the treatment center (1). The extent of these concepts is such that telemedicine, before being regarded as a service, is also considered as a culture of using the features of com- munication to provide health care services (2). Telemedicine approaches provide the possibility of improving the quality and accessibility of health services regardless of geographi- cal location. The following are four main factors that influ- ence the provision of telemedicine aids; proper infrastruc- ture, providers’ motivation, ongoing and continuous invest- ment, and technical support (3). It is an undeniable fact that in conjunction with scientific and health advances, pollution, diseases, potential dangers, and natural emergencies threaten people, and to have a healthy and disaster-free world, there is no choice but to use scien- tific exchanges and joint interaction (4). Providing health care services in natural disasters is one of the essential appli- cations of telemedicine. In the event of disasters, local health facilities can be severely damaged or local hospitals and clin- ics may be spoiled or inaccessible, so various telemedicine services can be used (5). On the other hand, the impossibil- ity of communicating with the affected area has always been one of the main problems facing health care delivery in nat- ural disasters (6). Consequently, increasing the time of ren- dering services to the affected people is considered a neces- sity. Fortunately, with the advancement of technology, this problem has been somewhat alleviated, and telemedicine is now an approach to speeding up treatment, providing clin- ical care and health care services to people in natural disas- ters (7). In short, the lack of safety in the affected area, the low number of physicians, and the lack of easy access to the affected area to help the injured are the reasons for the im- portance of telemedicine in natural disasters (8). The main purpose of this narrative review is to investi- gate the various applications, advantages and challenges of telemedicine in natural disaster-stricken areas. 2. Evidence acquisition This research was conducted in the form of a narra- tive review. To analyze the papers related to the use of telemedicine in natural-environmental disasters, Med- line (through PubMed), Web of Science (WOS), and Sco- pus databases were searched for related papers published from 1980 to 23 April 2022. In this study, keywords such as Copyright © 2022 Tehran University of Medical Sciences This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license (https://creativecommons.org /licenses/by-nc/4.0/). Noncommercial uses of the work are permitted, provided the original work is properly cited. 1