For transatlantic flights, two important "backups" are in Iceland and in the Azores. I wonder how often airplanes actually have to detour to these airports...
Airlines have contracts with companies who provide a sat phone link to doctors who have the flight information and medical facilities at possible diversion airfields. Eg MedAire.
The view coming in to Keflavik, with whales swimming in the ocean below, was pretty cool.