Abstract
On the radio the other day, I heard a song by Miranda Lambert—“Automatic” 1 —and it got me thinking of how life used to be and how it is now, a bit nostalgic and a bit about slowing down, using things and doing things we no longer do—pocket watches, payphones, writing letters, and the like.
I recently observed renovation in one of the buildings on the university campus where I work, a hallway full of payphones stacked 5 high and 20 feet long! Innovation and technology have surely changed the way we do things and interact with one another. The landscape is surely different. In the first two decades of the 21st century, we have seen a huge paradigm shift in everything we do. This has been further exacerbated by the pandemic and the technologies have not been evenly distributed across the world.
This brings to mind the digital divide, both within a nation's borders and across the world. We all know the rich get richer and the poor get poorer. Although there are a wide variety of government and nongovernmental efforts to distribute technologies, including vaccines, the void remains and it is widening. Disproportionately marginalized sectors of society suffer from lack of immunizations, the impact of infectious diseases such as COVID-19, maternal health services, and so on. In Bisht et al.'s article in 2020, the authors address this paradigm in India, especially regarding COVID. 2
We also see shifts in the development and application artificial intelligence and imaging. Saboury et al. address this in their 2021 publication. 3 This might include automation and enhancements in infrastructure that might lead to our dependency on smart machines—much more than we do now. The modern hospital embraces advanced technology. Precision medicine and personalized medicine are the rage. 4,5 Mobile health (m-health) or digital health is now a key component of our collective work. Cao et al. conducted a bibliometric analysis of 12,593 m-health-related articles published between 2000 and 2020. 6 This analysis showed an exponential increase for those past two decades, with the United States, the United Kingdom, Canada, and Australia leading the way.
The pandemic itself has had a significant impact on the workforce as well. Technology both eliminates jobs and creates new one. A recent news report from several sources indicated a 67% increase in robot orders in the second quarter of 2021 for the same period in 2020. Each of these reports quote the Association for Advancing Automation, much of which is outside of the automotive industry and includes food, consumer goods, and life sciences companies. This coupled with the Bureau of Labor Statistics' reporting of 4.4 million Americans quit their jobs in September 2021. Automation will continue to push on job elimination and this paradigm shift has many challenges for humanity. Stapels and Eyssel address ambivalence toward robots in their 2021 publication. 7 They posit that ambivalence toward robots might influence behavior of humans toward these devices. Pharmacists also express concerns of losing professional status and even employment itself. 8
As we continue to recover from this pandemic and the resultant changes it has brought about, we must reflect on the idea of “automatic.” Although the future remains unwritten, what we do today will influence tomorrow and the landscape will change in health care!
What Is In This Issue?
This issue has wonderful and informative mix of reviews, opinions, original research, and brief communications. Articles from Australia, India, Saudi Arabia, Turkey, and the United States provide outcomes of research on variety of applications of telemedicine and telehealth. The four on COVID further the knowledge base on our ability to respond effectively to our patient's needs. The opinion piece by Nadkarni and Mittal on professional equity for women in medicine is especially poignant with regard to physician burnout and how telehealth can be a helpful tool to ameliorate this critical issue. The U.S. military has been a developer and adopter of telemedicine for more than three decades; the Madsen et al. article provides a significant summary of how telehealth has been utilized in the Military Health System.
The Upcoming Year
This issue wraps another banner year for the journal. It continues to be at the forefront of telemedicine and telehealth research. It is highly ranked among health-related peer-reviewed journals and it remains highly relevant to this growing field. The coming year will continue to bring change and response to COVID. The transformation of health care will continue with new technologies, new approaches, and of course new challenges. The landscape is changing and we remain aware of the challenges we all face.