These Times Are a-Changing | Telemedicine and e-Health

In his 1964 hit “The Times They Are a-Changin’,” Bob Dylan writes of change in the early 1960s in the aftermath of an assassination, the early Civil Rights movement, and a change in attitudes in the populations of post-World War II America and the world.¹ A second anthem, the “Eve of Destruction,” sung by Barry McGuire in 1965, presents a world on the brink, with challenges in Vietnam and the Middle East and even Selma, Alabama.² He stresses the “button” being pushed and how some are attempting to change and some remain embedded in their ways and opinions and are not willing to change.

We face even more challenging times today. As I write this there are politicians with legal problems, a worldwide recovery from COVID-19, weird weather patterns, and nations invading other nations, all the while challenging the status quo.

You might think these are harsh analogues to our efforts in health care, specifically the proliferation of telemedicine and telehealth worldwide in the aftermath of the pandemic and the public health emergency. But there are many who ignore the challenges in the hope they will go away and there are those who want to affect change.

Each of you, as a researcher, clinician, policy maker, innovator, or patient, must not only remain vigilant but also informed. One way is to seek out data and review it yourself. The pages of this journal are a great resource. Akin to our students in academia, we encourage and appreciate queries into why. Do not just take someone’s opinion, explore the known and unknown. This is how we affect change. This is how and why we innovate. The times are a-changin’ indeed.

I recently returned from a trip to both the NASA Johnson Space Center and the NASA Kennedy Space Center, where colleagues are exploring the unknown. Engineers and researchers are pushing the envelope to get back to the Moon and eventually on to Mars. This requires thinking outside the box and how best to provide health care for those who dare to dream of exploration. Although NASA may very well have been instrumental in using telemedicine and telehealth more than 60 years ago, it is the lifeline of support in proximity to Earth. Once crews leave the Earth and head toward Mars, they will have to have autonomous systems for health care. This is simply because of limited communications. These systems are being thought of and designed for use in the coming decades.

As indicated previously, there are many challenges we face as a society; if each are left unchecked, they could have detrimental effects. Not responding to global warming—whatever the cause, not adequately understanding and addressing the pandemic, or even disparities in health—these can alter the face of humanity and our environment.

The songwriters of the 1960s wrote about the challenges human society faced in that time period. Some 60 years on we face similar issues. The button may not be pushed but the times are a-changin’!

What Is In This Issue

This issue has three excellent reviewers on how telehealth has been used by cancer survivors, in HIV testing, and for wearable devices for cardiovascular patients and their physical activity. In addition, although not insignificant in numbers, there are two articles on COVID-19, and the countries represented include Brazil, France, Germany, Spain, South Korea, and the United States. These articles continue to showcase the importance, efficacy, and utility of telemedicine and telehealth in managing health.