Volume 5, Number 3     May/June 1997

  Welcome to Innovation

Telemedicine—NASA's Perspective

by Charles R. Doarn Program
Executive, Aerospace Medicine

ASA HAS BEEN PIONEERING the development and application of telemedicine since the Agency's beginnings. Challenged by the need to monitor the health status of astronauts in the remote and extreme environments of space, NASA adapted and further developed biotelemetery to obtain critical biomedical information. Telemedicine has long been a significant tool, linking astronauts on space platforms such as the Space Shuttle and Shuttle/Mir to medical personnel on the ground. Private medical conferences between individual astronauts and their crew surgeon are conducted on a scheduled basis during space missions. During select activities, such as extravehicular activities and biomedical research, physiological parameters, including heart rate, ECG, oxygen consumption and several environmental parameters, are monitored by a biomedical team at NASA's Johnson Space Center.

Delivering health care in remote locations such as space is challenging. The challenges include constraints on resources (for example, power, volume, and weight), resupply, training of the inflight crew medical officer (who may not be a physician), crew time on orbit for operations and maintenance, and technology adaptability to withstand the rigors of space flight. NASA astronauts represent the healthiest of humans; therefore, disease and illness are minimized. However, it is paramount that appropriate medical care systems are in place to address illness and injury should they occur.

As the dawn of the new millennium approaches, human exploration of space will be characterized by the operation of the International Space Station and human missions to Mars. A return to definitive medical care during these future missions will be delayed because of the significant distance from Earth. It may be impossible in some cases to return in time to affect change in health status. Men and women who participate in these exploration-class missions will become more autonomous than the current cadre of astronauts. Technologies in telecommunications and information systems, noninvasive medical technologies and new protocols and procedures must be developed to provide in-flight medical support during these types of missions. Thus, NASA has developed a strategic plan that guides the Agency's activities in telemedicine.

NASA's strategic plan serves as the foundation for developing collaborations and fostering adaptation and integration of telemedicine technologies into both space flight operations and terrestrial applications. Today, NASA is forming partnerships with academia, industry and other governmental entities to leverage technology and resources to support mission needs. Through the development of a commercial space center and partnerships with the Technology Transfer Centers, technology used to support in-flight medical care will serve to meet NASA's needs and capitalize on industry involvement to cross-fertilize ideas and concepts.

Telemedicine only recently has become a household word, although its notion has been around for many years. Approximately 10 programs existed in 1990. Several hundred programs today are conducted worldwide with millions of dollars spent. The technology used to support these activities varies from expensive, dedicated telemedicine studios to robust desktop or portable workstations.

NASA's achievements from its endeavors are about life on Earth. The challenges that we face as space explorers have resulted in technological breakthroughs that have enhanced the quality of life for all humanity. The evolution of medical care in space through the integration of telecommunications, information technologies and microelectronics, nanoelectronics and picoelectronics will revolutionize medical care throughout the world in the 21st century.

A special note of thanks to Shaik Mazharullah, M.D., and the National Technology Transfer Center for their contributions.