Telehealth: The Future is Here. From Cyber Threats to Aerospace Medicine

The pandemic era prompted the rapid growth and evolution of telehealth. This was preceded by the widespread implementation of electronic health records at medical practices across the United States in the last decade or two. With that infrastructure present at healthcare facilities, telemedicine can become part of regular healthcare. Additionally, advances in internet transmission and the increased capabilities and availability of mobile devices have made access possible. People can now receive medical services without leaving their homes.

Telehealth may increase access to specialists, improve patient compliance and reduce no-shows. Ease of scheduling is another advantage, depending on patient literacy.

This rapidly evolving healthcare delivery system may be innovative and convenient but involves many complexities. Some hurdles include regulation, evolving technology, reimbursement, limited access for low-income patients, and poor accessibility in remote areas. Also, telemedicine services are not for everyone. Many medical conditions still require in-person evaluations. However, some people with chronic long-term conditions may benefit from telehealth for in-between follow-ups.

The 2022 Florida Telehealth Forum took place on Sept. 23, 2022, at the NASA Kennedy Space Center. It gathered telehealth industry leaders who exposed on areas such as clinical practice, cybersecurity, and the legal perspective. They explained that cybersecurity attacks may pose threats to healthcare providers and patients alike.

Cyber threats may disrupt healthcare provision through loss of medical data, unauthorized disclosure of personal information, or software failures. The good news is that safeguards and security protocols are available so we can make the best use of this technology.

Information technology and computer systems have evolved to provide such safeguards. The provision of healthcare services has evolved over time in parallel. Noteworthily, space navigation has played a notable role. The fact that a telehealth forum took place at NASA facilities may have been a coincidence or not.

The origins of telemedicine are linked to our space and aeronautics history and to astronauts’ healthcare.

With more aerospace launches and upcoming missions, new medical advances could be expected and applied for general use.

Let’s go back in time. Since the 1960’s, NASA has been expanding its medical monitoring technology to determine human body function in space and the effects of spaceflight in the human body. Later, this translated into remote medical communications through “terrestrial analogs”. Remote American Indian communities in Arizona were the first to use NASA telemedicine technology. Similar projects followed in the 1980’s after natural disasters in Mexico and Armenia.

Nowadays, NASA continues to use telemedicine to monitor and diagnose astronauts. This has benefited the Apollo, Space Shuttle, and International Space Station programs, shaping the future of human space exploration.

Medical fields like cardiology have benefited from these initiatives. Tele-echocardiography is currently a reality. Specialized echocardiography technicians and paramedics can do this diagnostic test in remote areas. The information is sent to physicians in the bigger cities for interpretation and diagnosis. But this technology is further advanced in space. Microgravity may cause the astronauts’ hearts to atrophy. They may develop cardiac arrhythmias, heart blocks, and reduced exercise capacity.

The International Space Station has echocardiography machines operated by technicians on Earth through a robotic arm. The operator can be a healthcare provider that does not need to be an expert echocardiographer. The images can then be relayed to and analyzed by experts, who may interact with the operator during the procedure. This process simplifies cardiac evaluations without the need for specialists present in spacecrafts. Research efforts aim to further develop this system in space and on Earth.

Advanced understanding of both aeronautics and telehealth is ongoing.

The first International Conference in Aerospace Medicine took place in September 2022 in Paris, France, and included considerations about space medicine and cybersecurity and the potential use of artificial intelligence to provide care to remote communities on Earth and in space. It also featured a full presentation on the evolution of telemedicine in space, from the first space-to-Earth transmission via radio frequency in 1961 to the active provision of healthcare services to space crews at present times.

The recent Artemis I mission launch and the successful splashdown of the Orion spacecraft on December 11, 2022. opens the door for new advances as data analysis and preparations continue toward the launch of a crewed flight around the moon. It will be exciting to see how new missions in human space exploration further impact telehealth.

Telehealth continues to grow in unimaginable ways. Aerospace medicine has set the foundations and continues to innovate providing tools to the modern provision of telemedicine in Earth. However, telehealth providers must bear in mind that cyberthreats are a reality and should consider the need to implement policies to protect their data, and that of their patients, against attacks.

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Telehealth: The Future is Here. From Cyber Threats to Aerospace Medicine