A strategic vision for telemedicine and medical informatics in space flight

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Article Review: A Strategic Vision for Telemedicine and Medical Informatics in Space Flight David R. Williams, Rashid L. Bashshur, Sam L. Pool, Charles R. Doarn, Ronald C. Merrell, James S. Logan Telemedicine Journal and e-Health. December 2000, 6(4): 441-448.


Telemedicine and medical informatics have been integral parts of National Aeronautics and Space Administration (NASA) operations since the beginning of human space flights. NASA’s telemedicine program was developed for monitoring the well being of as well as management, support, and delivery of health care to humans in the extreme environment of space exploration. Although significant in importance, NASA’s telemedicine has not fully developed as rapidly as terrestrial medicine. This is largely due to two factors: (1) the astronaut population is relatively healthy; and (2) the absence of any life-threatening medical issues during space flights. However, previous space experiences such as the Mir space station program led to serious concerns regarding the medical care aspects of long duration missions. Environmental events such as fire or loss of pressure, and the effects of microgravity on bone loss and other physiological conditions complicate medical care in outer space especially in the absence of real-time communications. Therefore, the expeditions and long-duration missions will require a broad range of telemedicine and biomedical informatics technologies in the U.S. and other countries.


A workshop was organized by NASA to assist in the development and application of telemedicine and medical informatics.

Participants: A broad range of specialists in telemedicine, medical informatics, and space flight, both internal and external to the agency, that were divided into three working groups.

Study Design: Each group was asked to address four inquiries. (1) Develop a vision statement for NASA to consider in the development of telemedicine in support of human space flight. (2) Develop a set of requirements necessary to support the long-term needs of NASA in the area of telemedicine. (3) Outline specific approaches or methodologies that might be employed to address both the vision statements and requirements. (4) Offer recommendations pertinent to the question: “What does NASA need to develop with regard to telemedicine for long space flight?” (p. 443).


The participants developed the following:

Vision statements: Astronauts should be educated about and provided with highest quality health care through information technologies.

Requirements: Pre-flight preparations and in-flight operations should be improved.

Approaches for achieving vision and meeting requirements: Comprehensive needs assessment for developing an appropriate space-medicine program is necessary.

Final recommendations: Collaboration with other organizations in engineering and medical fields in the public and private sectors are necessary. Integration and interoperability between NASA’s technical systems and engineering, the human-machine interface, and medical hardware and all platforms are required.


NASA’s ultimate aim should be a sound telemedicine and medical informatics operational system to provide the best medical care for astronauts.


The authors have thoroughly summarized the NASA’s Strategic Planning Workshop convened in November of 2000. Even though NASA has canceled current missions to the Moon and to Mars, this article presents the importance of telemedicine and medical informatics technology in both terrestrial and space medicine, and for further research and operational studies.

Submitted by Leily Esteghlalian