What Do NASA and Telemedicine Have in Common?

There is a considerable buzz in the healthcare industry around telemedicine as if it were a new and innovative technology. But telehealth technology dates back to the 1960s when the race for space was still young and telemedicine was also just getting started.

Let’s explore how NASA launched what became today’s modern telehealth applications and what we’ve learned from their efforts to develop the technology over the past 50 years.

Virtual healthcare was a requisite for early space flight. The National Aeronautics and Space Administration (NASA) had hundreds of problems to solve in their contemplation of space exploration in the 50s and 60s and how to take care of the health of their astronauts was top on the list.

One of the problems was how humans physically would react to the low-gravity environment in space. The concerns centered on circulatory and respiratory health and whether space flight would actually harm the astronauts. To prepare, NASA sent a number of test animals into space and monitored their health with a telemetric link. Once it was determined that humans could indeed survive, NASA’S attention turned to early applications of telemedicine to monitor and care for its astronauts.

By 1964 NASA had developed the Integrated Medical and Behavioral Laboratories and Measurement Systems (IMBLMS). While funding cuts slowed the program in the late 1960s and early 1970s, IMBLMS was to be a:
Highly flexible, state-of-the-art system, capable of acquiring, displaying, analyzing, and recording a wide variety of medical, biochemical, microbiological, and behavioral, measurements and experiments designed to study in detail man’s well being and operational capability during long-duration space missions.

The goal of these early telehealth-monitoring systems was to create a way to support longer human space flights. NASA’s historic record of their work on telehealth applications points out that, “if a medical emergency arose, astronauts would have only their crew mates to accurately diagnose them.”

By the 1970s the U.S. economy was dragging, with NASA budget cuts as the inevitable end result. But an internal letter from the White House Domestic Policy Council suggested that existing government programs might be leveraged to stimulate struggling American financial health. The White House set their sights on the old IMBLMS program as a way to bring healthcare to rural communities, thus stimulating the economy and health of residents here at home. Thus the Space Technology Applied to Rural Papago Health Care (STARPAHC) was born.

The goal was to take the telemetric applications used for astronauts and use them in new ways to benefit rural Americans. STARPAHC partnered with external organizations such as the Indian Health Service and Lockheed to work on remote healthcare technologies.

STRPAHC worked primarily by using analog signals to link rural patients on reservations with Indian Health Service hospitals in Arizona. It was an early example of what was called “cooperative telemedicine,” that brought together a number of interested parties from government and industry to develop a beneficial product for Americans.

This work continued into 1977 and laid the groundwork for today’s telemedicine applications on the web.

Today, telemedicine is in active use as an important tool to monitor the health and well-being of the astronauts on the International Space Station. The Harvard Business Review chronicled the work that began with the Expedition One launch in 2001. By that time, elements of the old STARPAHC research had morphed into the Human Health and Performance Team, which used telehealth technology to monitor “effects on crew member’s bone and muscle, fluid distribution, and immune function.”

American astronauts on the International Space Station stay in space for six months to a year, performing routine operational and engineering tasks while their health is closely monitored. NASA suggests, “Telemedicine is a key component of medical care on ISS.”

The long-duration of these flights make access to healthcare imperative. Telehealth virtual visits allow remote clinicians to not only diagnose but also treat routine, preventative, and more serious illness in space. This continuity of care cannot be discounted both for the purposes of research on the effects on the health of long-term space travelers but also to simply provide these courageous people with good clinical care throughout their time of service.

Telemedicine in space has implications for the application of the virtual visit back on earth. A Health Tech Magazine article spells out the correlating benefit between telehealth in space versus here at home, “Much of what makes up a good telehealth program is the ability to deliver high-quality care advice to individuals from a distance.”

Interestingly, there are a number of implications for the deployment of telehealth in space that can be extrapolated for the use of virtual visits on the ground. The Harvard Business Review article spelled some of them out, including:

• Extensive planning for telehealth as a medical support tool is imperative for any telemedicine rollout. For NASA, planning encompasses biomedical engineers, nurses, psychologists, imaging specialists, and doctors.
  For a medical practice, clinical and operational teams must come together to plan around the workflow changes that come with any telemedicine launch.
• Population health is a factor in telemedicine. Astronauts receive extensive training in how to use a variety of medical tools that are on board the International Space Station. They also receive 40-hours or more of paramedic training and receive additional emergency response training. In the same way that astronauts learn preventive care and basic responses to common problems such as back pain, we can use telemedicine to teach our patients preventive care for the maintenance of chronic disease such as diabetes at home.
• Better communication and improved access to care are the hallmarks of any telemedicine application, whether in space or on the ground. We can use telehealth to teach our patients better communication skills about common medical problems in the same way that astronauts learn to address the best course of action for routine and urgent care issues that crop up in space.

Clearly, telehealth serves an important role in the medical treatment of remote populations. While NASA pioneered the technology, the Internet has helped democratize telehealth applications as close as our nearest smartphone. OrthoLive offers one of the most cutting-edge iterations of NASA technology in our orthopedic-inspired telehealth application. Contact us to find out more.