The View Is Based on Perspective

On Friday, April 10, 2026, the international crew of Artemis II landed safely in the Pacific Ocean after traveling farther into space than anyone in all of human history. This 695,000-mile, 10-day mission provided a unique opportunity to evaluate the systems, including medical capabilities (supported via telemedicine), to support long-duration missions to the moon; and it provided an opportunity to view the Earth from beyond the moon—the so-called dark side. Similar to the photo taken by the Apollo 8 astronauts on Christmas Eve of 1968, the photos taken with very different cameras showcase the fragility of Earth in the dark void of space.

These two photos, juxtaposed to one another, highlight the beauty of Earth. The blues of the atmosphere and the water, the various hues of white clouds, and the greens and browns of the land mass. To put this in perspective, the four astronauts were totally alone on the dark side of the moon for approximately 50 min and at times could not see the Earth. This means they were fully alone and autonomous, albeit for a short period of time.

During the mission, telemedicine was supported through near-real-time video calls from the Orion spacecraft “Integrity” and Mission Control in Houston, Texas. If a medical issue arose, the flight surgeons and other expertise on the ground were available via the deep space communications network. NASA has been using telemedicine since the early 1960s at the dawn of human spaceflight. Observing the view of Earth from a far distance, like the moon, makes one think of home from a different perspective. You can see landmarks and continents, but you cannot see people or what they are engaged in—regular life, struggles, or the challenges we all face.

As telemedicine has evolved terrestrially, several pioneering individuals have postulated or flat out said “when does telemedicine become the practice of medicine.” Similarly to viewing the Earth, it is all about perspective. From space, the Earth looks pretty much the same; it is the camera technology that has improved significantly. The same with health care. While the integration of telemedicine has had its ups and downs, the pandemic caused all of us to look at health care from a different perspective. Nevertheless, there remain concerns from patient and provider perspectives. Davenport et al. explored the advantages and disadvantages of using telemedicine, although they demonstrated similar patient experience. ¹ Berry et al. reviewed patients’ perspectives on telemedicine and behavioral care during the pandemic. They found that while most respondents would return to face-to-face, they were supportive of telemedicine because of its utility. ² A recent study by Durdova et al. reviewed the perspectives of tele-emergency physicians in Germany regarding artificial intelligence (AI) in prehospital settings. ³ They posited that while there are concerns and perhaps fear of AI technology in prehospital emergency medicine, the physicians were overall positive about the technology. While much has been written about perspectives in telemedicine over the past several decades, it is the constant change in technology and its impact on every aspect of our lives and certainly the health care construct that has been the catalyst for change.

As I mentioned earlier, the innovation in camera technology from 1968 to the present time has allowed us to look at both the Earth and the moon with more clarity, remembering the whole time it is the same Earth and moon! When we explore how telemedicine began in the past, we know it has become much more capable simply because of innovation. So, if telemedicine, regardless of what you are doing with it, has become a stanchion of health care, then it is simply health care. What is your perspective? Has it changed over your career or your use of telemedicine? It certainly has reinforced my perspective.

We also know that individuals look at things from a different viewpoint. The idiomatic expressions “the glass is half full (optimism)” versus “the glass is half empty (pessimism)” are in contrast to one another. Some see telemedicine and all its attributes as a necessary tool for improving health care, and there are those who see it as a tool but still have reservations on its utility and effectiveness. Which are you?