Debbie Passey for The Conversation

Melbourne: In 1874, a surgeon in South Australia transmitted wound care instructions to a patient 2,000 kilometers away. A few years later, in 1879, a letter in the medical journal The Lancet suggested that doctors should use the telephone to avoid unnecessary patient visits.

With the proliferation of the telephone and telegraph, the idea of ​​telemedicine – literally “healing from a distance” – inspired science fiction writers to imagine new ways to treat patients over long distances.

Since then, real-world technology has evolved in parallel with science fiction speculation. Today, certain forms of telemedicine have become commonplace, while other futuristic tools are in development.

The Radio Doctor and the Teledactyl

In his short story from 1909 The machine stopsEnglish novelist EM Forster described a telemedicine device that descended from the ceiling on a telegraph signal to provide care to patients in the comfort of their own homes. His story is also the first description of instant messaging and a form of the Internet – both important elements for real-life telemedicine.

In 1924 Radio News The magazine printed a cover story featuring the future “radio doctor.” The cover shows a doctor examining a patient through a screen. Although the magazine story itself was a bizarre work of fiction that had little to do with a radio doctor, the images are striking.

In a 1925 cover story in Science and Invention, American author Hugo Gernsback describes a device called the “Teledactyl” (from tele, meaning far away, and dactyl, meaning finger). The device uses radio transmitters and television screens to allow a doctor to communicate with a patient. The special feature: The doctor touches the patient using a remote-controlled mechanical hand that is placed in the patient’s home.

Gernsback was a futurist and pioneer of radio and electrical engineering. Nicknamed Father of science fiction, Gernsback used fictional stories to educate readers about science and technology, often including extensive scientific detail in his writings. He helped establish science fiction as a literary genre, and the annual Hugo Awards are named after him.

From sailors to astronauts

Radio was important to early telemedicine. In the 1920s, doctors around the world began using radio to examine, diagnose, treat, and provide medical advice to sick or injured sailors and passengers. Radio is still used to provide medical advice to ships at sea.

In 1955, Gernsback revived the idea of ​​telemedicine with “The Teledoctor.” This imaginary device uses the telephone and a video surveillance circuit with mechanical arms controlled by the doctor to provide care to patients remotely. Gernsback said that the doctor of the future would be able to “do almost everything through telemedicine that he can do in person.”

In 1959, psychiatrists in Nebraska began using bidirectional surveillance cameras to conduct psychiatric consultations between two locations, considered one of the first examples of modern telemedicine. Earlier telemedicine networks were expensive to develop and maintain, limiting wider use.

In the 1960s, NASA began incorporating telemedicine into every manned space program. By 1971, a telemedicine system was ready for testing on Earth as part of the Space Technology Applied to Rural Papago Advanced Healthcare (STARPAHC) program. Using a two-way television and radio link and remote telemetry, the program connected the Tohono O’odham (then called Papago) people with nurses and doctors hundreds of miles away.

The Internet and a pandemic

It was not until 1970 that the term telemedicine was officially coined by the American doctor Thomas Bird. Bird and his colleagues set up an audiovisual connection between Massachusetts General Hospital and Logan Airport to provide airport employees with medical advice.

From the 1970s onwards, telemedicine became increasingly important. The Internet, which was officially born in 1983, brought new possibilities for connection between patients and doctors.

Satellites could connect doctors and patients over longer distances without the need for two-way surveillance cameras. The cost of developing and maintaining a telemedicine network dropped in the 1980s, opening the door to wider use.

In his 1999 science fiction novel Starfish, Canadian author Peter Watts describes a device called the Medical Mantis, which allows a doctor to remotely examine and treat patients deep beneath the ocean’s surface. In the early 2000s, NASA’s Extreme Environment Mission Operations began testing remotely operated surgical robots in underwater environments.

The development of telemedicine has kept pace with advances in information and communication technology. Nevertheless, telemedicine was hardly used in the 1990s and early 2000s.

It was the global COVID pandemic that made telemedicine an integral part of modern healthcare. Most of these consultations are done via video call – not far from what Gernsback envisioned a century ago, but so far without robotic hands.

What’s next? One factor that will likely bring real-world telemedicine closer to science fiction dreams is developments in human spaceflight.

As humanity advances in space exploration, the future of telemedicine may look more like science fiction. Monitoring the health of astronauts from Earth will require technological breakthroughs to keep up with them as they venture deeper into space.

(Debbie Passey is a Digital Health Research Fellow at the University of Melbourne)