What to Throw Out When Downsizing Your Office

As we start a new year, we always reflect on the year before, what we accomplished and perhaps what we were not able to accomplish. This issue marks the beginning of the Journal’s 29th year. Yes, Telemedicine and e-Health has brought you nearly three decades worth of excellent material to guide all sorts of disciplines in the adoption and integration of telemedicine and telehealth into the health care field. Although the acceleration of telemedicine’s growth was brought about by the pandemic, the foundation of it was laid decades ago.

Recently I moved my academic office from one building to another. The office space went from large to a bit smaller, which meant I had to downsize. Beginning in 1990, I had collected way too much material on telemedicine, telehealth, space medicine, disaster medicine, and global/public health. Moving provided an excellent opportunity to cull my collection of materials. Although much of the material is now online, it is still rewarding to actually pick up an old book, feel it in your hands, and actually look something up the old-fashioned way. Much of what went into the recycling bin was information on the foundation already mentioned. Alas, do not fret, this material is obviously not the only copy!

As I was deciding what went into the recycling bin and what went into the moving boxes, the opportunity to leaf through the material provided an excellent opportunity of reflection on how things have (a) changed and (b) how they have not changed much. For example, in 1994, I was a faculty member at the International Space University’s summer course in Barcelona, Spain. The students developed a program called Global Access to Telehealth and Education Systems (GATES).¹ This report lays out a concept of global network for disaster response.

Jump ahead to 2012, NATO funds a project between Romania and Russia on a multinational telemedicine system, conceptually the same as 1994, just different technology. This involved U.S. subject matter experts. This project eventually was modified to terminate Russian participation and integrate Finland, Moldova, and Ukraine.² The NATO project also resulted in an IoS press publication by NATO.³ Although not specific to pandemics, these resources serve as a reminder of what has already been developed and applied. In fact, anyone pursuing a telemedicine or telehealth solution should look back and understand what others have already learned.

In addition, my filing cabinets and bookshelves were laden with materials of little use: reports, presentations, copies of books, and copies of journals containing a wide variety of useful and not so useful materials. The usefulness may indeed be a personal choice. But just reviewing it all before it hit the recycling bin provided a trip down memory lane! It is truly amazing what our telemedicine and telehealth community has accomplished in the past 50 years or so. Yes, I have a lot of historical materials from the 1960s and 1970s. Old reports and publications from that time period were concerned about bandwidth, reimbursement, cross-state licensing, regulations, etc. Same challenges today, right?

A number of years ago, I was at an informational hearing on Capitol Hill as the cochair of the Federal Telehealth (FedTel) Working Group. Since I was there as a NASA person, I was accompanied by a NASA legislative liaison. Along with the other FedTel chair (from the Department of Health and Human Services/Office of the Advancement of Telehealth) and her legislative liaison, we were discussing the development of a national definition for telehealth. I asked whether the assembled group of young staffers had looked back at the various reports and peer-reviewed literature from the 1990s. The response, although not blank stares, was striking. Most were unaware of what had been done, written about, and shared. This reinforced the point of the historical record. It has often been said “we must learn from our mistakes, lest we repeat them.”

Although not a direct quote, the basic tenant was espoused by many, including Sir Edmund Burke (ca 1760s), George Santayana (ca 1900’s), and Winston Churchill (ca 1930s). Speaking of Churchill, he quipped “The farther backward you can look, the farther forward you are likely to see!”⁴

Why is any of this important? First, much of what we know today happened yesterday. The tools we have at our disposal provide a unique perspective of the past and how it impacts the future. Bookshelves and filing cabinets may be overflowing with great stuff but the digital libraries of today and artificial intelligence that is rapidly becoming commonplace will provide great resources for us to look back and embolden us to change. So do not agonize when you clean out an office, your garage, or attic. Keep what is of intrinsic value to you and recycle the rest. I am pretty sure, you can find anything you want in the cloud.

What is in This Issue

First and foremost, I thank all of the reviewers and the editorial board who have helped shape this journal. Although the total submission has dropped slightly from the past 2 years of record growth, it is still a challenge to get peer review done in a timely manner. So, I appreciate all you have done in this regard.

Second, the issue is full of great materials on a wide variety of applications. This includes four excellent review articles; five articles on COVID-19; and a myriad of articles from Australia, Canada, Spain, the United Arab Emirates, the United Kingdom, and the United States.

Finally, as we all look forward to 2023, we are reminded of our past and of those who helped get us to where we are. The coming year will be full of anticipation as new technologies and processes emerge. I look forward to a productive and another meaningful year in our burgeoning field.