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

With the spread of the telephone and the telegraph, the idea arose Telemedicine – literally “healing from a distance” – inspired Science fiction Writers who invent new ways to treat patients across 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 1909 short story “The Machine Stands Still,” English writer EM Forster described a telemedicine device that descended from the ceiling in response to 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 of real-life telemedicine.

In 1924, Radio News magazine printed a cover story introducing 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 for Science and Invention, American writer Hugo Gernsback describes a device called the “teledactyl” (from tele, meaning far away, and dactylus, meaning finger). The device uses radio transmitters and television screens to allow a doctor to interact with a patient. The added twist: The doctor touches the patient using a remote-controlled mechanical hand placed in the patient’s home.

Gernsback was a futurist and pioneer of radio and electrical engineering. Nicknamed the “Father of Science Fiction,” Gernsback used fictional stories to educate readers about science and technology, often including extensive scientific detail in his writings.

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. Telemedicine networks were expensive to develop and maintain, which limited wider use.

In the 1960s, NASA began to integrate 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 known as Papago) with nurses and doctors hundreds of miles away.

Internet and a global 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 connecting 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 decreased in the 1980s, leading to wider use.

In his 1999 science fiction novel “Starfish” Peter Watts describes a device called the “Medical Mantis.” This device 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 only the pandemic that made telemedicine an integral part of modern healthcare. Most of these consultations take place via video call – not far from what Gernsback envisioned a century ago, but so far without robotic hands.

What comes next? One likely factor that will make telemedicine the stuff of science fiction dreams will be developments in human spaceflight. While humans are making progress in Space researchthe future of telemedicine may look more like science fiction. Monitoring the health of astronauts from Earth will require technological breakthroughs to keep pace with them as they venture deeper into space.

(By Debbie Passey, University of Melbourne, The Conversation)