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An overview of telehealth resources available in American Samoa
The Territory of American Samoa, the only US soil below the equator, sits approximately 2,400 miles from Hawaiʻi and 4,800 miles from California.
As of April 1, 2020, the population of American Samoa was 49,710, representing a decrease of 10.5% from the 2010 Census population of 55,519. American Samoa is made up of the islands of Tutuila, Aunu’u, Ofu, Olosega, and Ta’u and two coral atolls Swain Island and Rose Island located just below the Equator. There are three districts: Eastern, Western, and Manu’a. The seven islands of American Samoa lie just below the equator and the only United States Territory in the Southern Hemisphere.
The majority of the population lives on the main island of Tutuila. Tutuila is nearly 18 miles long and just less than 3 miles wide at its widest point with a total land area of 56 square miles. Manu’a Islands are located approximately 80miles each of Tutuila. The total land area of American Samoa is 75 square miles.
Healthcare services in American Samoa are based out of the American Samoa Medical Center Authority (ASMCA) Lyndon Baines Johnson Tropical Medical Center (LBJ Tropical Medical Center) and the American Samoa Department of Health (ASDOH). American Samoa is home to ~1,000 veterans who are serviced through the VA American Samoa Community Based-Outpatient Clinic (CBOC) with many off-island referrals to Hawaiʻi and other states.
The ASMCA, the only hospital in American Samoa, provides all acute medical services and includes outpatient clinics as well as inpatient hospital care. The ASMCA provides outpatient care at the Emergency Room, Primary Care Clinic, Pediatric Clinic, Obstetrics and Gynecology Clinic, Surgical Clinic, Medical Clinic, Ear Nose Throat Clinic, Dialysis Clinic, Psychiatry Clinic, Dental Clinic, and the Eye Clinic. The inpatient services include 150 patient beds in six wards: Labor and Delivery, Nursery, Maternity, Internal Medicine, Surgical, Intensive Care Unit, Pediatric and Psychiatry.
The ASDOH operates six Community Health Centers across American Samoa, four on the main island of Tutuila and two on the outer islands of Manu’a, Ofu and Ta’u. The ASDOH is responsible for preventive and outreach services to the community. It is also responsible for infectious and chronic disease surveillance and prevention, community nursing services, environmental health, immunization, Public Health emergency preparedness, comprehensive cancer control, HIV/STD screening, early intervention, newborn hearing, and MCH services that includes the Maternal Created Infant Early Childhood Home‐visiting (MIECHV) Program.
Mixed public + private
In 2019 American Samoa invested $30M in the Hawaiki Submarine Cable that connects American Samoa with 200+ gbps off-island bandwidth capacity. The Hawaiki Cable is a 15,000 kilometer (9,320 miles) high-capacity underwater cable connecting Australia and New Zealand to the mainland United States, American Samoa, and Hawaiʻi. With the Hawaiki Fiber Optic Cable, American Samoa can expand telehealth services to continue to improve access to care, increased availability of services both on- and off-island, have access to healthcare professionals not locally available, reduce costs of services by reducing unnecessary travel and referral costs, and provide online educational opportunities for health care professionals. American Samoa is now well positioned with connectivity to further benefit from telehealth services.
In 2020, the American Samoa Department of Commerce (ASDOC) partnered with the University of Hawaiʻi Telecommunications and Social Informatics (UH TASI) Research Program and SH3 Resource Development, LLC to launch the American Samoa Territorial Broadband Strategy (ASTBS). The plan identifies nine key priorities and dozens of strategies for improving the day-to-day lives of all territorial residents through broadband-connected technology including telehealth. Read more at: Telehealth Transforming Healthcare in American Samoa.
Specific to telehealth, the plan identified these as the top three priority action items:
The potential value of telehealth in American Samoa is clear in terms of improved access, quality of care, lowered cost, and increased patient satisfaction. The local healthcare system, while stressed with many challenges such as liability, lack of medical professionals, credentialing/licensure, reimbursement, workflow integration, care coordination, continues to progress in various ways with innovative technology driven solutions to meet the healthcare needs of the people of American Samoa to the best of its ability and limited resources.
A few existing and ongoing telehealth programs in American Samoa:
The relationship between Lyndon B. Johnson Tropical Medical Center and Shriners Hospitals for Children has been ongoing for many years with the use of telehealth. This image from 2003 is of LBJ Hospital conducting a tele-rehab with physical therapists at the National Rehab Center; and the bottom left image shows Dr. Tuato’o (LBJ Hospital) using a Polycom and an elmo camera to show x-rays to Dr. Ono (Shriners) in Honolulu.
These telehealth sessions were delivered via a 384kbs dedicated link for health, education, disaster management donated by American Samoa Telecommunications Authority. Almost 20 years later, the relationship remains strong and now with the capacity to expand services, especially with American Samoa’s increased capacity and investment in Hawaiki Cable. Mahalo and Faafetai to all for the partnership over the years.
The Pacific Basin Telehealth Resource Center (PBTRC) is an affiliation of the 14 Telehealth Resource Centers funded individually through cooperative agreements from the Health Resources & Services Administration, Office for the Advancement of Telehealth. This website was made possible by grant GA5RH37468 and 1 U1UTH42529‐01‐00 from the Office for the Advancement of Telehealth/Health Resources and Services Administration/HRSA.