Space,The Final Frontier: Impact on Telemedicine

When I started to write this editorial on October 13, actor William Shatner (aka Captain James T. Kirk) and three other individuals went into space for the first time on Blue Origin's second flight. While only in space for 10 min or so, they passed the Kármán line (330,000 feet or 100 kilometers) into space and at age 90 Shatner became the oldest person to accomplish this feat. Since mid-July of this year, three companies have taken individuals to space or near space—Space X, Virgin Galactic, and Blue Origin. This of course is amazing as the growth in the commercial space industry has been on a fast track. For millennia, humans have looked to the heavens in wonderment, intrigue, and apprehension. Is the realm of space travel really the “final frontier”? Much has come out of humanity's quest to conquer space travel.

Shatner played Captain Kirk on the 1960's science fiction television program Star Trek. In this television series there were many devices used that, while make believe props then, are now actually in use worldwide. Telemedicine and telehealth, although their origins are not specifically from the space programs of space-faring nations, their growth is representative of the need to provide access to health care in challenging environs. As we have seen in previous writings and in our observance of change, it is measured in very short spurts of time now. Technology and change—what took centuries, decades, or years to be developed and accepted, now takes months. The mRNA vaccines come to mind!

Yet science continues be challenged on many different fronts. We know that facts are facts and they are viewed in different ways by different people. If we set our minds on something with the idea of bettering society, is it not our charge to do so? It may be the glorification of some but it is the gratification for most of us to do so. The push in any new technology leads to paradigm shifts and changes to the status quo. Commercial spaceflight, although compelling to watch today as important events, will lead to significant changes in many fields. Certainly, the travel and leisure field is one. But I am more interested in how technology in the delivery of and access to health care services will continue to evolve and change significantly. Perhaps even beyond our current comprehension or belief in what is acceptable. In the 1950s and 1960s, science fiction was just that, fiction. Today, science fiction is actually becoming science fact with increasing vigor and enthusiasm.

So if we accept the tenent that change is good—the devices have a proven life cycle and utility, why then do we question the utility of telemedicine and telehealth? The pandemic pushed aside all concerns and was rapidly adopted and integrated, yet there is now a decrease in utilization as providers and payers yearn for the aged, tried, and true approach. We have seen throughout the Anthropocene period (Holocene epoch approximately 11,700 years since the last ice age) that we as humans have made a significant impact on this planet. ¹ Does this paradigm impact health care? ² Whitmee et al. discuss how human health can be safeguarded in the Anthropocene epoch. ³ Chevance et al. posit the idea the information and communications technology are causing a rapid rise in energy consumption and there are downstream impacts on health as well, mostly from mining precious metals and e-waste. ⁴

As consumers we seek (perhaps demand) constant renewal of our devices. This renewal has positive and negative implications. Nevertheless, we have an insatiable desire to have the next best thing. We trust these devices. We store secrets with these devices. Yet, we remain cautious of vaccines, climate change, what those individuals who are highly educated have to say, and put our faith in pundits who appear to know more than we do!

Science fiction becoming science fact is a core pillar of the 21st century. We will continue marching forward to fulfill our desires and seek new opportunities. To use the words of Captain Kirk in 1966, “to boldly go where no man has gone before.” Telemedicine and telehealth and the technologies that support its growth and very existence will drive change.