A Quarter Century On—A Look Back

As we close out the first quarter of the 21st century, we must look back over the past 25 years. From an innovation perspective, there has been a plethora of new and perhaps enhanced technologies in all facets of life. There have also been a wide variety of events that have shaped this quadricentennial or silver jubilee. If I use the song “I’ve Been Everywhere” written by Geoff Mack and the U.S. version sung by Johnny Cash, I am reminded of all the places telemedicine and telehealth have been. In the song, the writer states, “I’ve been everywhere” … then city after city with versions in multiple countries.

In the case of our work in telemedicine, we can start with the Y2K software problem as time and the calendar moved from 1999 to 2000. It was believed that computer systems would not work.^1,2 Thankfully, this problem was addressed, and it was a seamless transition. However, this does not mean computers are seamless adjuncts to our daily lives. The information technology of our global economy is currently addressing the “epochalypse” or Y2038, which affects 32-bit processors. ³ By the third decade of the 21st century, everything will be digital, so it will be critical to address that issue!

Since 2000, we have seen an acceleration in information technology, the development and integration of artificial intelligence, robotics, and access to an enormous amount of data at our fingertips. There were mobile phones, personal digital assistants, and large telemedicine systems in the 2000s. That all changed in 2007. As Thomas Friedman pointed out in his 2016 book, “Thanks for Being Late,” 2007 ushered in the iPhone, Watson and IBM became a thing, and online services like Facebook, Twitter, Airbnb, and so forth became part of our daily lives! ⁴ This rapid transformation, that has made the world smaller, has benefited humanity in stark and sometimes contrasting ways.

Technology and innovative thinking for decades were driven by the catalyst of federal funding and entrepreneurship, often brought about by needs or events. The Moon Shot was the focus of the 1960s. The aftermath of the 9/11 attacks and the war on terror, and then, of course, there was a global pandemic, and the financial crisis. Peppered in these key events was the building of the International Space Station, commercial flight programs like SpaceX, AI-generated individuals, and a change in leadership in the United States at 4-year intervals, which often change the nation’s course. Nevertheless, we as consumers have an insatiable desire for the next cool technology.

A recent CBS Sunday Morning story in October, “These United States: Bright Ideas.” ⁵ In this segment, correspondent, David Pogue, highlights the origins of the following inventions by U.S. scientists: the light bulb, the phonograph, the airplane, the personal computer, the microwave oven, transducers, the personnel computer, the internet, the World Wide Web, air conditioning, the zipper, lasers, GPS, the smart phone, well you get my point. In this piece, Pogue presents on Ohio native, Thomas A. Edison and his systems approach to the components and systems that support and utilize the light bulb. Edison was often quoted as saying, “I have not failed, I’ve just found 10,000 ways that don’t work.” He also said, “Many of life’s failures are people who did not realize how close they were to success when they gave up.” ⁶

In our field of telemedicine, we understand there is a sense of pessimism among some, while others are more optimistic. A quote by Friedman illustrates this poignantly. “Pessimists are usually right and optimists are usually wrong but all the great changes have been accomplished by optimists.” ⁴

In all the aforementioned material, it is abundantly clear that there must be a vision and a much higher ceiling with which to challenge the status quo! We must be willing to fail and get up and try again.

These past 25 years have seen tremendous and boundless change worldwide. Through technology and entrepreneurship, society has seen significant improvements in education, access, health care, public health, governance, literacy, and so forth. That is not to say there are not still barriers and challenges to overcome. That remains a work in progress. If the next 25 years see the same acceleration we have lived through, perhaps the world will be a better place.