cognitive information to provide a diagnostic and treatment plan for the patient, as communication with medical specialists on Earth may or may not be possible or effective when needed. It is estimated that communication with Earth or satellite stations will be available only 50 percent of the time and that there will be up to a 40-minute round-trip communication delay, depending on the spacecraft’s proximity to Mars.
These estimates reinforce the necessity not only for independent action but also for a full spectrum of resources on the spacecraft. Diagnostic and therapeutic resources should be available, including computerized teaching resources and computerized references. A comprehensive drug database would be helpful. The crew should also be able to repair, maintain, and if necessary, fabricate equipment to perform diagnostic and therapeutic tasks adequately. Medical supplies that can be reused, reconstituted, or somehow replenished in the spacecraft environment should also be part of this future.
During the space mission, routine surveillance of health measures should be conducted and all episodes of illness and injury should be recorded. Systematic record keeping with a computerized database will be necessary so that data can be accessed periodically and also used for identification of diagnostic and therapeutic errors and continued health care planning. Sex and cultural differences should be identified as part of surveillance of health measures. A centralized catalogue for all peer-reviewed manuscripts, abstracts, reports, handouts, mission log summaries, and monographs related to space biomedical research, health care, and relevant studies in analog environments (Lugg and Shepanek, 1999) should be developed. Access should be maintained through a centralized database with contemporary medical information on personnel and equipment. All material should contain the date and the responsible author(s). This is important, because resources could well be available but not used because they are not accessible and because promising information regarding countermeasures or important biomedical associations could be missed because the material is unknown or unavailable. The databases on board the spacecraft could be continuously updated as newer scientific information becomes available.
The Australian National Antarctic Research Expeditions Health Register is one model for such a database (Sullivan et al., 1991; Sullivan and Gormley, 1999). The database system should include descriptions of the