Abstract
Every new technology that comes out adds value in what we do in our daily lives. The introduction of the telegraph, the telephone, the train, the automobile, the computer, the VCR, the cell phone…well, you get the point! Each of these early inventions and then commercial products that resulted were fairly easy to use and made life simpler, although the VCR did flash 12:00 for a number of years before the guy at the video store explained how to change it. Today's technology is amazing but it is not simple, and in some cases, it has gone way overboard; it is too complicated, too expensive, and perhaps unnecessary.
Recent purchases have yielded great benefits but also some startling frustration. Although a new car smells great and gets great gas mileage, it is not clear why we need all kinds of gadgets on the dashboard that might distract even an experienced driver. Some dashboards are more complicated, giving the driver the feel of driving a space ship or small airplane (just kidding). The point is, “shouldn't it be simpler than that?” Although some technology is mandatory, some are not. Sensors that tell us that there is a car in our blind spot or there is an animal on the road in front of us should be a mandatory feature in all cars and trucks. They are often an expensive add-on feature. You may find yourself trying to activate the “voice” command or the navigation system, which may result in your need to use the “medical button” on your car to call for an emergency!
The new smartphones are not much different. The new Android and iPhone models are sleek, packed full of applications (apps), powerful, and not necessarily easy-to-use devices. There are all sorts of fees to get you started—the activation fee, the $25–50 plastic cover (a very thin sheet in a fancy package) to keep the cover from getting scratched, and then there is a drop-proof/water-proof case. Furthermore, it will most likely only last 18–24 months. Technology in previous generations lasted a long time. Many of us are still using this “old” technology.
It's like the AT&T commercial with an actor asking four rather delightful children questions about turtles or how fast something is or isn't, and then while we wait in anticipation for his response—“it's not complicated!"—we gain an appreciation of what is and what is not complicated. For technology to really become a significant element of our daily lives, where we grow dependent upon it—our smartphone, for instance—it must be simple to operate and unobtrusive. Have these enhancements in old technology—the car and the phone—really made life simpler? Perhaps not, but it is clear that we would not want to be without them.
The same must hold for telemedicine technologies. It must be simple and easy to use. When it becomes a challenge to interact with it, it may be shelved, ignored, and not used. The proliferation of the smartphone and its ever-growing capability will surely be the most important device we use moving into the future. Whether for simple communications, for finding information on products or services, or for monitoring our health, these devices are outpacing any innovation ever developed, marketed, and sold. Just keep it simple.
Not all telemedicine has incorporated the smartphone. There are several technologies used in telemedicine, and there are challenges in using them. These may be subtle, but it is not as easy as point and shoot or turning it on and using it. Technology's place in healthcare is firmly established. Telemedicine's integration into healthcare is becoming more ubiquitous, and unless it is undermined in some way, it will see rapid growth and high utility. The various devices that are on the market today, including smartphones, should be developed so that there is ease of use and high utility. Features that make the patient and practitioner's experience worthwhile and beneficial should be sought out and incorporated. They must be simple to use. Otherwise, they may not be used as intended. If the smartphone does become a tool that we can use to participate in the management of our individual healthcare, it must be designed using materials that are rugged and safe. They must be kept simple!
This issue presents to you a wide variety of original research and communications, a case study, and an update on the American Telemedicine Association (ATA) policy formulation. Each article provides a summary of what has been demonstrated and evaluated around the globe in cancer, trauma, chronic obstructive pulmonary disease, dermatology, autism, and the integration of e-health using communications technology.
The “ATA Practice Guidelines for Video-Based Online Mental Health Service” are published here
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and on the ATA Web site (