Abstract
As the Great War was winding down in 1918, there was a much deadlier menace killing people worldwide—influenza. Often called the Spanish Flu, it affected ∼25% of all humanity, killing millions. Highly contagious, the H1N1 virus caused havoc in everything and every walk of life.
Life appeared to come to a standstill. People avoided large gatherings; attending one was at one's own risk. We have often heard the phrase “we left the window open an in-fluenza.” This comes from a children's ditty or rhyme that was sung while they were jumping rope “I had a little bird, And its name was Enza, I opened the window, And in-flu-enza.” 1 Even more challenging was the isolation of entire communities with little to do, except jump rope, read the newspaper, or just sit and listen to the radio.
Although the medical and scientific community was advancing in the early 20th century, the winds of change were not quite where they would be in a few more decades. Although the war wound down and troops came home, there were parades and parties, and life began to return to normal, then the second wave in the fall came and mortality rose again. And yet the etiology of the virus remained elusive. 2,3 It was >100 years ago and although some things may be the same today—people's attitudes and beliefs—health care and access to advanced science are not the same.
As we begin the sixth month of 2020, the world is a lot different than it was at the beginning of the year. Telemedicine and telehealth have seen an exponential increase in utilization worldwide. We have seen a perfect storm and it has moved swiftly across the landscape of health care worldwide. Telemedicine and telehealth have been fully embraced and are now being utilized by millions. Although I can only imagine how there is some trepidation by a few naysayers of integrating it, it is not going to go away or somehow be put back in the box. It will no longer be stifled. It will continue to grow in utility and applicability.
Many of us including our colleagues worldwide have studied the many facets of telemedicine and telehealth. The intricacies of clinical operations, legal machinations, innovation, technology, and business processes are understood. Although these have all come front and center in every health care center, sector, or system in the world, further studies must be conducted. Processes and lessons learned will provide us all the necessary information to make improvements to enable even better care moving forward. This perfect storm may have very well begun in March 2020, but it will have a lasting effect on not only patient and provider safety, but also on the long-term business of health care and medical education.
As a leading peer-reviewed journal on telemedicine worldwide, Telemedicine and e-Health has seen a flurry of activity since COVID-19 and the pandemic began. Since April 1 (6 weeks ago), the Journal has received 70 submissions, many of which are “opinion,” “perspectives,” “brief communications,” “original research,” “letters to the editor,” and “guest editorials.” Most of these are on COVID-19 and come from China, Denmark, India, Iran, Israel, Italy, Poland, Spain, United Kingdom, and the United States. Many submissions will not pass peer review. Those that do will be published online as soon as possible, and in-print in a timely manner. It is very important to convey how telemedicine has been working around the world. We continually learn from our own mistakes and perhaps those of others.
There will certainly be a continued up-tick in submissions. For example, at this time of the year, the Journal normally sees ∼90–100 submissions through early May. As of this writing, there have been 158 submissions. That is a significant increase. During these unprecedented times, submissions will range from outstanding and publish-able to that has already been said and published and, therefore, rejected. That does not mean you should shy away from sharing your work and experiences. I suspect that in the coming years, we will look back on this pandemic as telemedicine's watershed moment.
This editorial is also the first one written without my compatriot and colleague, Dr. Ronald Merrell. Dr. Merrell stepped down effective April 1, 2020.
Dr. Merrell and I took on the responsibility of editors-in-chief in 2005 from Dr. Rashid Bashshur. Since that time, Dr. Merrell and I have written 194 editorials and articles together. I have him on speed dial should I need any advice. He has now moved to emeritus status, where his sage advice and more than 30 years of telemedicine experience can be tapped along with Dr. Bashshur's and Dr. Mark Goldberg's. These two individuals, along with others, started this journal more than 26 years ago. I have always appreciated our working relationship and how we built your Journal to what it is today. Thank you Ron, for you perseverance, compassion, and commitment.
We have much to learn from our pasts and from those who remain steadfast in their belief that telemedicine and telehealth will serve the health care community worldwide as we continue to develop, deploy, and fully integrate telemedicine. 4 The events of the past several months will no doubt change everything we do moving forward. We are indeed living with winds of change.
A quick shout out all those frontline health workers and first responders, thank you for all you do. Stay safe and one day soon we will all hug each other and shake hands—at least we can hope for that! In the meantime, know that science matters and this Journal will do its very best to bring you facts and currency of information.