The astronauts currently on the International Space Station rely on telemedicine for everything from coughs to bruises. But as Dr. Shannan Moynihan, deputy chief of space and occupational medicine at the NASA Johnson Space Center, said in a presentation at HIMSS18, telemedicine has its limits for caring for astronauts.

“As we get further away from our home here on earth, we’re talking about an increased delay in the communications we already have,” she said at the time. “... For example, if we’re talking about Mars, it’s 18 to 20 minutes one way for an audio signal to get there. That really takes telemedicine for an acute issue out of commission. We need to start thinking outside the box and thinking differently. We need our crews to be more autonomous. There needs to be more capability onboard, both technology and training."

Now NASA has taken the first steps toward tackling that issue as the Translational Research Institute for Space Health (TRISH) at Baylor College of Medicine, which contracts with NASA, has awarded digital health startup VisualDx a grant to work on creating a diagnostic tool for astronauts on deep space missions.

"A lot of people think VisualDx is all about rashes or eye problems [where you can diagnose from] a photo, but VisualDx covers any symptom or differential diagnosis across medicine," Dr. Art Papier, VisualDx's cofounder and CEO, told MobiHealthNews. "And that’s why NASA was looking at it. They weren’t just looking for rashes in space, they were looking at diagnoses across medicine."

VisualDx offers doctor-facing clinical decision support tools and treatment guidance tools for patients, both through Skinsight, a website, and Aysa, a soon-to-launch app. Papier said that it's the combination of deep knowledge — VisualDx has been in the space for 18 years — and that consumer-facing capability that attracted TRISH.

"These astronauts have PhDs and they’re really smart people, but they’re not physicians," he said. "So we have to come up with the questionnaires and search capability that will fit a non-physician. But we have that capability because we work on tools for patients as well."

Papier thinks the tool as-is can diagnose 89 percent of the conditions it will need to be able to deal with. The one year grant will support the company as it removes unecessary data and adds new protocols unique to spaceflight.

"There’s quite a bit of customization that needs to happen," Papier said. "We cover diseases in children, so we don’t need to cover diseases in children for astronauts. Or we have rare diseases that you’re exposed to by a fly or a mosquito in Africa. If there’s no chance of an astronaut getting that disease, we have to modify the software. .... [In addition,] we don’t have those diagnoses that have to do with being weightless for a year, so they’re going to have to help guide us on what they want added to meet the needs of spaceflight."