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The practice of space medicine is fraught by several unique challenges, including limitations in spacecraft resources and limited medical training opportunities. The great distance separating the astronauts from their doctors on Earth further confounds managing their health. NASA uses computer and telecommunication technology to bridge this distance and practice telemedicine. Since the beginning of the U.S. space program, NASA flight surgeons have relied on two-way radio communication and limited biomedical telemetry to remotely assist the crew in managing crew health matters. More recently, the capability for bi-directional video transmission was added, to enable the crew to speak virtually face-to-face with their doctors. However, for the International Space Station (ISS), additional capabilities must be provided. This paper presents a vision for delivering telemedicine in the ISS era.

Human missions to Mars will represent not only a departure from the relative protection and proximity of low Earth orbit but also the way space missions are currently conducted. Traveling at 180,000 miles per second, radiofrequency communication will require up to 20 minutes to reach Mars from Earth. Extended periods of communication blackout may leave the Mars-nauts without Earth contact for weeks. Crews will be on their own to recover from mission complications, including serious crew member illness or injury. These conditions dictate unique applications of telemedicine.