Telemedicine has played a major role in the care of our astronauts at the International Space Station (ISS) since 2001, but the first pioneering telemedicine initiatives relating to space travel actually occurred in the 60s and 70s with the Mercury missions. The technology existed even back then to communicate an astronaut’s medical status, X-rays, and ECGs to a crew of professionals at the home base, ensuring that their health could be checked and monitored remotely.

2001 saw the first lengthy stay on the ISS and, since then, a new team of astronauts and cosmonauts has been dispatched to the Station four times a year. The duration of their stay can be anything from six months to a year, during which time they are required to perform engineering tasks, maintenance and upgrades, and so on. Access to medical care would be important for any group of people not within easy reach of physicians and specialists, but with astronauts in space, it’s even more vital that they are monitored regularly. The weightlessness that a lack of gravity causes can have demobilizing effects on the astronauts’ bodies – affecting in particular their immune system, fluid distribution, and the condition of their bones and muscles. The advancement of telemedicine technology means that the crew can be monitored and cared for throughout their stay. To help maximize the resources, a degree of training for medical emergencies and simple procedures is undergone by one or more of the astronauts during their pre-launch instruction period.

Divan Medical - International Space Station

Advances in telemedicine mean that astronauts hundreds of miles into space can receive medical monitoring and treatment.

One thing that the Mission Control staff have learned over the years is that good communication is crucial during situations involving telemedicine. All professionals involved in ISS expeditions – medical personnel, the astronauts, and Mission Control staff – undergo training in order to acquire excellent communication skills. In an emergency situation, the astronaut needs to convey clear and precise information on what is taking place, and the medical professional needs to be able to give definitive and speedy instructions on how to proceed.

There’s a story relating to an astronaut who had a history of a knee injury prior to his launch to the ISS. He’d been symptom-free throughout the training period before the launch, but, during his time at the station, his knee started to present with some problems. Spacecrafts are equipped with ultrasound imaging – a form of technology which is radiation-free, cost-effective, and reliable, and which requires less expertise from the operator than some other forms of technology. Perfect for use in space! An ultrasound NASA specialist on the ground guided the nominated crew member through the procedure of taking some X-rays of the offending knee. They were joined by a remotely located radiologist who was able to view the images and diagnose the problem. Treatment was prescribed and the astronaut went on to continue his stint in space without a further hitch. A perfect example of telemedicine working to its full potential.

It’s been proven that a lot of planning and training is required prior to any NASA launch and also, as previously mentioned, that good communication – along with the ability to learn essentials quickly – is vital in the use of telemedicine. This has had a positive impact on the potential for telemedicine’s role in care and treatment in other remote or extreme environments. And some of those remote and extreme environments exist on terra firma! It’s possible to be connected quickly and cheaply with health care providers without the need for travel. You save time and money – as does the health service, as they are able to treat more patients – and you’re in the hands of someone who not only has the necessary medical expertise but also appropriate communication skills. Just one more example of how you could benefit from telemedicine.

Divan Medical - knee X-ray

X-ray images can be taken on-board the International Space Station and transferred to Earth for examination.

Another clear result that has come from the NASA ventures is that shared knowledge and shared input work well in the diagnosing and treatment of conditions. Videoconferencing is used between an astronaut and a physician, either for a specific problem or for the general monitoring of health, and often a specialist will be called in to join the conference when further expertise is required. This communal meeting is beneficial to all concerned as it brings the top brains together simultaneously, thus saving time and money and giving the best odds for a positive outcome. It’s easy to see how this translates into everyday telemedicine, which can benefit us all.

A further vital point learned from NASA’s use of telemedicine is that a strong and secure communication link is essential. You wouldn’t want to lose connectivity in the middle of a consultation or the briefing of a minor procedure. The provision of better broadband facilities in rural areas is currently under discussion, thanks to a representation that has been made to the House Energy and Commerce Committee on behalf of a coalition of health care providers, schools, libraries, and health centers.

Ultrasound, as detailed above in the example of the astronaut’s knee problem, is currently still the most used and the most developed telemedicine procedure, but other “guidable” procedures – minor surgery being one of them – are in the process of being developed. Imagine how this will not only help people in remote areas, but will also reduce waiting times for minor operations anywhere in the States, thereby cutting down on time taken off work and the use of pain relief while waiting for the procedure. Health costs will be slashed and so too will insurance premiums. Ultimately, we will all be beneficiaries of the continued advancement and development of telemedicine, and NASA is playing an important role in showcasing exactly what can be achieved via telemedicine.