Abstract
To quote Bob Dylan “These Times are a Changin” and the late David Bowie in his famous 1971 song, “Changes”, “Time may change me but I can't trace time,” we reflect on change. More importantly the relevancy of change in our society, in our lives, and in our healthcare system, pick your own field of change. Change can be measured by looking at its impact on what is changing, such as attitudes, behaviors, demographics, quality, or opinions. Change can be seen as both good and bad. What is considered good for one is not necessarily good for another. We know, as we see it daily, innovation and technology are at the forefront of change. The fabric of society has benefited from change, locally, nationally, and internationally. But a digital divide remains. Instant communication, although very important and vital for modern society, also has its drawbacks.
The word change has been used extensively in the political realm all too often in the last several election cycles. In the U.S. election, some people in the electorate are even changing parties. Attitudes, behaviors, desires, and even innovation can drive change as well as be changed. Leaders can command respect or earn it based on how they choose to use change. In healthcare, innovation and change are paramount to enabling a stronger and more robust system. That may in fact mean changing the entire paradigm. That may be seen as scary change to some! If the healthcare administrators or senior management maintains a myopic view of the future for the sake of profitability, then change may be hard to fathom for some. Others may challenge the status quo and actually achieve change and demonstrate new growth opportunities.
The application of information technology, imaging, smart systems, sensors, and decision support systems can cause a significant change in how health is delivered and managed. These subjects have been amply addressed and reported in this Journal and other disciplines, specifically scientific journals, and it has actually empowered better medical care. Without the almost continuous deployment and integration of technology, our healthcare system would not be competitive or capable of addressing our patient's needs. Nor would our educational efforts keep up with our growing needs.
Change often happens faster than we expect and can come as a surprise. There is an old axiom in Texas, “If you don't like the weather, wait a minute.” The weather literally can change in a very short period of time. Change in tele-communications took more than 100 years to go from the telegraph to cellular phones. Within the past several years, we have gone from cell phones to amazingly capable smart phones. In surgery, an “open” operation used to be the norm. Today, tele-manipulation systems or “robotic surgical systems” are employed across the world. Although these two examples did not occur over a “minute”, they nevertheless occurred in a very short time span when compared with those technologies that took centuries or millennia to become commonplace. Often the changes that have been observed are not the most productive or cost effective. Furthermore, some changes can leave segments of the population behind or in some way neglected.
In the United States, this fall we will elect a new president. Although this process is arduous and frustrating, we will definitely see change. Some change will be brought about by new people with new ideas and new attitudes. Some change will come naturally due to the continuous refinement in technology. Even events may drive change. If our environment continues to change, we will adapt and develop technology to address disease. If we continue to strive for the discovery of new treatments of the Zika virus, our health and our healthcare system will change. Always keeping in mind that with new technology come challenges. Change is good and change is not so good. You be the judge. If you have a minute!
What Is in This Issue?
Over the past several issues, we have begun to trim down the materials we bring to through a rigourous selection process and extensive peer review. Our goal is 10–11 articles per issue and this means we will continue to push our rejection rate more than 60%. What this means is we will only accept the best of the best and that of course is a very challenging task to determine what is considered the best of the best. This is accomplished through our extensive peer reviewer network that is worldwide.
In this issue we bring to you a wide array of original research, including gaming in rehabilitation exercise, optimizing surgical management using an app in Italy, novel fall detection in older adults, m-health, and diabetes, use of telehealth in language disorders for Spanish toddlers, smartphone apps, and HIV, and smartphones and tele-dermatology. In addition, there are two reviews on how e-health is incorporated in attention-deficit disorder and Electronic Health Records and diabetes. Finally, a case report on m-health and self-control of diabetes.
Each of these articles provides potential solutions for change. They provide you the reader with additional measureable proof in a growing evidence base that telemedicine and telehealth are agents of change! These times are a changin!