“It’s 2017, we should have a lunar base by now,” noted Elon Musk when he revealed his grandiose plans about going to Mars in at least five years. “What the hell is going on?”, he asked clearly not being satisfied with the current state of astronautics. However, I say, we should not only concentrate on the development of space technologies but devote more focus to advancing technologies to keep people well and alive on the Red Planet. Digital health opens amazing horizons there. That’s what I detailed in my paper in New Space.

We’ll colonize Mars

There are plans for human missions to Mars by the United States, China, and Russia by the 2030s, the 2040–2060, and the 2040–2045 timeframes, respectively. Private companies such as SpaceX also plan to bring people to Mars and eventually colonize it. Elon Musk repeatedly said he wants to build a spaceship able to bring humans to the Red Planet (the latest is called the Big F*king Rocket), and launch the first two vehicles by 2022. These would be cargo missions to the surface of Mars, to find water for future missions. Two years later, he already wants to launch four rockets, two with crews.

According to Musk’s incredible vision, the BFR will transport one hundred people at a time to the surface of Mars. The huge rocket would have 40 cabins inside its payload area, enough to take one hundred people per flight to Mars. Passengers would be protected from incoming radiation in a solar storm shelter, while restaurants, zero-gravity games, and other entertainment areas would ensure they enjoy the five months long journey. Imagine that you ask the waiter in the restaurant addressed to the end of the universe to bring some more milk for your coffee and when exactly landing on the Mars Colony is scheduled.

As one of the biggest fans of the idea to colonize Mars, I was more than surprised that Elon Musk concentrated on the space technological and financial side of getting to the Red Planet in his article entitled Making Humans a Multi-Planetary Species, but he did not mention the medical challenges of space travel at all. Not one word about how we bring healthy people to Mars and keep them healthy there or on their way back to Earth.

It seems like space agencies want to solve engineering challenges but take health for granted. I decided to explain why they shouldn’t in the same journal Elon Musk chose to publish in. Here is my paper “Digital Health Technologies to Support Human Missions to Mars” (you can download it for free from here) that describes why digital health is inevitable for a Mars mission and proposes exactly which technologies will be needed to create a base like the one below.

Traveling to Mars will have serious health consequences

The human factor means a bigger burden than the technological one. It is well documented that spaceflights pose health risks, as well as lead to short- and long-term health consequences to astronauts. Short-term effects on health include space orientation syndrome, injuries, limited access to medical facilities and emergency care services, and a possible failure of life support systems. Long-term effects and risks are certain types of cancer due to exposure to radiation, weightlessness-induced muscular and vertebral changes, psychological effects from fatigue to sleep deprivation, bone and calcium loss, renal stone risk, effects of isolation, social effects due to cultural differences, cardiovascular risks, the change in the circadian shifts.

How do we ensure that those people who are able to afford traveling to Mars and willing to undertake the journey arrive at the destination healthily?

There are several problems which could be solved by using digital health.

  1. As astronauts cannot bring every medical resource with them and cannot cover every medical specialty, they need devices which are small, smart and comprehensive.
  2. Since the time delay between the spaceship and mission control could reach between 4 and 24 minutes – the amount of time needed for radio signals to reach the vehicle in space from Earth and vice versa -, telemedicine and giving medical advice remotely is limited. Especially, if astronauts have to deal with emergencies. Thus, they need efficient instruments for decision-making on board.
  3. Besides medical challenges, astronauts are also required to keep up with their tight schedule and an extremely healthy lifestyle. Digital health technologies would allow astronauts to access data about their vital signs and health status, predict whether any major medical conditions are imminent, and participate in the shared decision-making process about their care. It could support the prevention, diagnoses, interventions, and monitoring of health conditions and injuries of the crew to avoid unnecessary risks and minimize others. It could involve them in their care.

Thus, astronauts themselves need to become the point-of-care.

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ESA astronaut Samantha Cristoforetti exercises on the International Space Station

Why do space agencies miss out digital health?

I got really curious how much time and effort space agencies and SpaceX dedicate to keeping astronauts (and potential passengers) healthy in space. I found that NASA’s ground medical team of physicians, biomedical engineers, nurses, imaging specialists, and psychologists evaluates medical care needs, means of prevention, and potential risks for every mission. The European Space Agency’s (ESA) Space Medicine Office carries out similar tasks, and their Russian and Chinese counterparts also dedicate resources to medical issues.

In the case of NASA, the ground medical team periodically evaluates NASA’s procedures and medical kits to make them up-to-date with recent best practices and studies in both terrestrial and space medicine. Astronauts undergo extensive medical examinations and also training to use medical kits on board. NASA’s Exploration Medical Capabilities research program has launched investigations into developing a flexible ultrasound imaging system and track medical equipment with RFID chips among others.

Space agencies are clearly aware of the medical challenges of long missions; however, it seems astronauts are not fully engaged in their care. In my view, a lot more effort should be done for developing space medicine in order to successfully bring people to Mars. Moreover, companies advancing digital health technologies have experience with huge patient cohorts and present amazing innovation that could further augment the efforts of agencies. However, I haven’t met any digital health venture being involved in the mid- or long-term plans of space agencies or SpaceX for that matter.

Digital health technologies could and should support astronautics

That’s why I decided to draw attention to the subject and examined the issue in an article in New Space. I argue that digital health technologies could help reduce the health risks and potential medical consequences related to human spaceflights to Mars by making astronauts the point-of-care.

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Digital health offers a vast network of technologies that could support human mission to Mars. Certain companies developing such technologies even have experience and more importantly data of millions of patients. It also introduces the concept that involving the end users of these technologies is a crucial component in maintaining their motivation of living a rigorously healthy lifestyle. The transition from astronauts’ regular lifestyle to a data-based lifestyle should start before the mission to ensure the necessary habits are built on time, resulting in active use of the necessary technologies and leading to seamless collaboration between the crew and mission control.

I truly believe a higher synergy between developers and researchers in digital health and space technologies would help avoid astronauts facing unnecessary risks in hostile environments. Furthermore, more detailed studies are needed to test whether specialized digital health technologies need to be developed to work effectively in high-radiation environments and in microgravity, and to fully exploit their potential in supporting human missions to Mars and beyond.

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