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Future Pathway: Overcoming the Sustained
Challenges in Digital Forensic Investigation Process.

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Joseph O. Esin
Professor
Department of Computer Science, University of Calabar, Nigeria
Lead Professor of Computer Information Systems/Cybersecurity
Jarvis Christian College, Hawkins, Texas USA

Preamble
Forensic investigation is an organic profession whose success depends
heavily on a continuous, vibrant, and deliberate effort to design new gadgets,
devices, and techniques of investigation. Criminals and law breakers are ready and
determined to circumvent the existing technologies in order to stay ahead of
detection and arrest in their self-generated craft. As a result, the proliferation and
use of electronic devices, encryption machines, protective tools, stationary and
mobile devices, and internet technologies is expanding at alarming rates. Today,
mobile devices, computers, and internet technologies are the nucleus of
communications, economic potentials, and continued human existence.
However, these devices are dynamic sources of grave concern against criminal
activities and cyber criminals who are out to disrupt, access, steal data and
information, and engage in unlawful activities that undermine personal, national,
and global security. Inter alia, the operative and active use of electronic devices
by digital forensic investigators is playing an important role in the prosecution of
criminals and the blocking of unauthorized access to data and information stored on
secured digital storage systems.

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The use of computers, mobile devices, email logs, and internet technologies
in forensics investigations is a self-motivated measure set forth to recover the
much-needed digital records from immobile and mobile devices within
organizations to produce irrefutable, convincing, and up-front evidence to the
public and in court. Naturally, when a regular crime occurs, digital forensic
investigators and law enforcement officers are invited to conduct, examine,
analyze, and produce comprehensive and conclusive evidence gathered on the
crime scene for presentation in court. Despite the attempts by forensic investigators
to dissect and present reliable evidence to the public and the court, law offenders,
code-named criminals, are urbane and equipped with available diplomacies to
circumvent new activities to evade being detected and/or arrested and detained.
Framework of Digital Forensic Investigation

Forensic investigators’ approach to gathering evidence on the crime scene,
arresting, and prosecuting criminals is not a panacea to digital crimes. Indeed, the
digital domain provides an opportunity, a haven, for killers, pornographers, and sex
officers to roam the streets and terrorize citizens of the peaceful community. The
zenith of forensic investigation is to recover data stored in victims’ and the
criminals’ wired and wireless systems, and email log activities which are
considered as integral parts of crime evidence in the court of law. As Shaaban
and Sapronov (2016) and Casey (2011) hinted, digital forensic investigation is an
enduring long-term investment and an unwavering measure to cripple criminals’
motives and intents to threaten the vulnerable innocent human community. These
investigators create innovative and projected measures to battle and eradicate
computer intruders and sex offenders’ intent to petrify innocent adults and
children. To overcome the impending challenges, the same combating procedures
must be stretched to apprehend, forestall crackers, and hackers who attempt to

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break into organizations’ web sites, launch DDoS attacks, secure access and
engage in cyber-stalking, cyberbullying, and child pornography schemes. As
Shaaban and Sapronov (2016) noted, forensic investigators often overlook the
standard evaluation criteria to identify security-related lapses on the crime scene
while searching for perpetrators, suspicious witnesses, and human intruders. The
society is highly in need of inclusive channels to champion the production and
collection of reliable, balanced, and dispassionate, decisive evidence to disengage
and discourage aggressive criminals, victims, witnesses, and attorneys from
lighthearted and off-balance dialogue in court.

By design, criminals do not want to be caught and exposed to the public, but
are willing to spend twenty-four hours, seven days per week on computers, wired
and wireless devices, and the internet to camouflage all-inclusive outlawed motives
and intents. Per Ashish (2015), criminals claim to understand the law, knows right
and wrong, and are inclined to make a quick reference to the violation of their
Fourth Amendment rights to distract forensic investigators from performing their
duties as they search for evidence. Modern forensic investigators face sustained
challenges in the areas of unlimited access to wired and wireless communication
devices and internet technologies by criminals, culprits, sex offenders, child
pornographers, and disgruntled personnel. Unfortunately, these challenges are
growing exponentially leading to the snarled and unceasing threat to the security of
vulnerable innocent citizens across the globe. Criminals are cultured and stylish in
their ability to remotely destroy evidence on computers, wired and wireless
devices, secured network systems, and the acceleration of uncompromising modus
operandi to outperform forensic investigators and law enforcement officers
(Hayes, 2015; Shaaban & Sapronov, 2016).
Measures to Mitigation Challenges to Digital Forensic Investigation

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Amid multiple and sophisticated challenges from the underworld of cyber
criminals, modern forensic investigators are actively using wireless electronic
devices to identify fraudulent activities and enforce compliance in the crime scene.
Unfortunately, these investigators continue to encounter almost insurmountable
handicaps among which are lapses in strategic planning and compliance measures
to monitor and protect digitally secured storage centers. These arrays of measures
to mitigate crime are undercut by the lack of stratagems of enforcement of
compliance against criminals who engage in an art of destabilization of innocent
communities.

To overcome the far-reaching challenges, modern forensic investigators
must step out of the narrow scope of operation and work diligently to decrease
mistakes and increase consistency and accuracy across the entire investigation
process. All-embracing attempts are a precondition to retain, store, and preserve
digital log files and records collected from the crime scene in a digitally encrypted
system, PDF, and on read-only media format (Hayes, 2015; Ashish, 2015; &
Casey, 2018).

Per Ayers, Brothers & Jansen (2014), a balanced approach to overcoming
sustained challenges must include unbiased examination of records and the
adoption of equitable techniques to identify and extract data from the crime scene.
The slant also calls for a dispassionate approach to analyzing and using preceding
records and resources to produce nonpartizan evidence in the court. Traditional
forensic investigation of yesteryears was engrained with deficiencies, and non-
functional method of operation. According to Hayes (2015) and Ashish (2015),
the culture of modern forensic investigation will not escape similar challenges
without a comprehensive, independent, and unprejudiced process relative to
compiling, producing, reporting, and presenting reliable evidence in court.

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To abate the disturbing rate of challenges in forensic investigation, restore
trust and confidence in the society and in the court system, the future pathway must
involve the eradication of redundant indecorum and the sloppy method of
operation on the crime scene. The old-fashioned traditional or lay process must be
abolished in favor of the new methods and Best Practices that will redirect the
production of conclusive document pregnant with transparency and authenticity.
Forensic investigation is an organic profession; hence, its success depends squarely
on unremitting, vibrant, well-adjusted, and unbiased effort to design new methods
and techniques of operation. However, it is always in the interest of criminals to
persistently try to overpower and outsmart investigators by circumventing the
investigative system in order to stay ahead of being detected, captured, and brought
to justice.

As Ayers, Brothers & Jansen (2014), hinted the world of criminal
investigation must engage in a deliberate attempt to stay relevant and abreast
with the technicalities and logistics of communications devices. According to
these researchers, the National Institute of Standards and Technology (NIST),
Samsung,

smartphone, Nokia, Huawei, and Apple, the standard communication devices
today, must constantly be monitored and upgraded with modern technological
developments at a faster rate to withstand the challenges and rigors of digital
forensic investigations. These operations must be a step ahead of criminal
operations and be able to use the entrenched development to detect and apprehend
digital criminals. The National Institute of Standards and Technology (NIST)
operative must concentrate its energy on its ability to gather reliable and
dependable manual and digital records from wired and mobile devices in all major
operations (Zoltanszabodfw, 2018).

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Similarly, the NIST often uses mobile devices to provide a forum to gather
and compile data and information during forensic investigation. The system
strongly requires enduring professional and rigorous training for forensic
investigators to enhance effective operation that will produce authentic, reliable,
and acceptable conclusive evidence in court. Until recently, mobile devices, email
logs and files, and the internet were isolated objects and domains in all facets of
forensic investigation. Such a myopic approach often ignored digital evidence
often stored in the hard disk, flash drive, emails, and related locations and
resources. The modern-day forensic investigators must come up with proactive
methods for acquiring adequate knowledge, skills, and understanding of how to use
most operating systems (OS), network operating systems (NOS), Linus, Unix,
Apple OS, vertical and application software, and more (Hayes, 2015; Shaaban &
Sapronov, 2016).The thriving future pathway for forensic investigators is to
acquire knowledge and expertise, and to stay abreast with the evolutions in
network protocols including transport control protocol (TCP) and internet protocol
(IP). Furthermore, they should be experts in adopting these tools in order to
identify file server logs and monitor incoming and outgoing traffic on wired and
wireless secured networks systems to detect and deduce victims and criminal
activities.

According to Zoltanszabodfw (2018) and Shaaban and Sapronov (2016),
the norms of modern forensic investigations call for the acknowledgement and
adoption of these three phases of challenges: the combative, preemptive, and
proactive. The Combative phase involves previously committed crimes such as
murder, robbery, and burglary. This phase includes collecting evidence, locating,
and interviewing witnesses, and identifying and arresting the suspected. The
Preemptive phase is a response to projected criminal activity, pilfering,
misappropriation, corruption, and forestalling and apprehending agents of

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organized criminal activities, and the Proactive phase is a persistent phase which
calls for the investigators willingness to endure environmental pressure, being
observant, and monitoring would-be suspects’ attempt to escape from the crime
scene, paying attention to descriptions of offenders, color of the vehicles and
license plates of criminals attempting to escape from the crime scene, and notifying
the dispatcher for a backup unit to assist the crime scene.   

Forensic Investigation Professional Training

As indicated by Shaaban and Sapronov (2016) and Ayers, Brothers and
Jansen (2014), most organizations are forced to cut cost and reorganize the
workforce due to unforeseen financial and economic situations that necessitate the
implementation of the furlough policies. In the interim, most employees who have
been with organizations for a decade are unlikely and unwilling to accept such
reorganization policies even in the face of abrupt emergencies such as the COVID-
19 pandemic. As it is often expressed, capable disgruntled personnel who are
negatively affected by layoff and furlough policies, especially those who were first
in line to pledge loyalty to the organization, often switch their loyalty and nourish
negative intents and motives of revenge. The evidence of negative motives and
intent are discerned in data breach and exposing the organization to danger. The
projected imminent challenges ahead of forensic investigators reside in the areas of
cloud technology, metadata, anti-forensics, encryption, social networking, Internet
of things, and wired and wireless network systems that must not be overlooked
and/or underrated.

Disgruntled Personnel Parochial Culture.
Per Pazzaglia, Flynn, and Sonpar (2012), the amicable approach to mitigate
disgruntled personnel’s assault and incursion tactics must include the

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understanding, acceptance, and recognition of the two fundamental facts
adumbrated by two schools of thought. The first school of thought hinted that
“active personnel are the nucleus and life wire of a functional organization; hence,
it is a sad miscalculation, an unfortunate option to misjudge and ignore
personnel’s frame of mind.” The second school of thought whose emphasis is on
the mindset of the distrust, bred by a negative and toxic working atmosphere, urge
“chief executive officers, administrators, managers, and supervisors to refrain from
the culture of secrecy.” In response, to sponsor well-matched future pathways for
forensic investigators, organizations are admonished to be willing and ready to get
rid of the culture of extreme secrecy and lack of transparency. Organizations
should be open to the culture of embracing mission-driven judgment calls to
prevent mid-level managers and supervisors’ engagement in the process.
Electronic crimes using digital domains are increasing, while criminals using
computers, mobile devices, and internet technologies are creating enormous, and
unlimited challenges to circumvent and undercut detection. This is all at the
expense of unbiased attempts by forensic investigations, law enforcement officers
to keep organizations and community criminals off-the street.

Conclusion
Digital devices, including desktop and laptop computers, mobile phones,
tablets, gaming consoles, and smart phones, are indispensable cultural gadgets of
the modern society. The proliferation of these devices in everyday life is
entrenched with the tendency to amplify criminal activities such as fraud, drug
trafficking, homicide, hacking, forgery, pornography, and terrorism. The
propagation of criminals’ sustained use of electronic devices is almost a pandemic,
and the accelerating increase, and dexterity of usage are placing forensic
investigators, law enforcement officers, and citizens at a disadvantage. The modern
digital forensic operative is continuously faced with challenges, originating from

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the lack of standardization, and scheduled enduring professional education for
career forensic investigators. The National Institute of Standards and Technology
(NIST) has established and published guidelines for digital forensics investigation
professional training and certification programs to keep up with rapidly evolving
technologies in an attempt to outstep criminals who spend sleepless nights to
engage in circumventing detection and involvement in organized, sophisticated
criminal activities.

References
Ashish. (2015). Carving out the Difference between Computer Forensics and
E-Discovery. Retrieved from http://articles.forensicfocus.com/2015/02/27
difference-between-computer-forensics-and-e-discovery/

Ayers, R., Brothers. S., & Jansen, W. (2014). Guidelines on Mobile Device
Forensics. From
http://nvlpubs.nist.gov/nistpubs/SpecialPublication/NIST.
SP.800-101r1.pdf.

Casey, Eoghan. (2011) Digital Evidence and Computer Crime: Forensic Science,
Computers and The Internet. Elsevier Inc., Waltham: MA.

Hayes, Darren R. (2015). A Practical Guide to Computer
Forensics Investigations. Pearson, 800 East Street, Indianapolis: IN.

Shaaban, Ayman & Sapronov, Konstantin (2016). Practical Windows
Forensics. Packt Publishing Ltd, Birmingham: U.K.

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Zoltanszabodfw. (2018). “Digital Forensics is not just HOW but WHY.”
http://articles.forensicfocus.com/2012/07/03/digital-forensics-is-not-
just-how-but-why/

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July 8, 2022

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Artificial Intelligence Telemedicine

Mythology of Telemedicine Operations

Joseph O. Esin

Professor of Computer Science/Cybersecurity

University of Calabar, Nigeria

Synopsis

Telemedicine is clever way of attending to the medical health of all sorts of

patients; especially, those in remote areas and in critical conditions that require

experts and specialists who are physically far removed from healthcare consumers.

This innovation in healthcare service method will definitely replace; if not

supplement, the low-esteem and unpopular means of delivering and exchanging

healthcare services, clinical assessment, and communication between physicians

and patients. Today, the emergence of the modern telemedicine operations has

triggered comprehensive opportunities alongside with variety of success and

numerous benefits for patient care, flexibility, reliable healthcare assessment,

treatments, and recovering outcomes. It has equally increased collaboration

between healthcare professionals and the patients, the global communities, and

slowly in most military operations. Telemedicine is not in full operation in most

military arena because some military commanders maintain that the incorporation

of telemedicine in military theater will directly interfere during bumping into direct

gunfire, and shrapnel-pierced casualties in firefights, and will circumvent the

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activities of a military on-site physicians who are struggling to manage and care for

seriously wounded military personnel. On the contrary, current researchers such as

Timpel, and Harst, (2020), Ives, (2018), Esin, (2020), defended the situation by

affirming that due to the modern technological maneuvering, telemedicine services

are in no way capable of circumventing on-site military healthcare, activity-

physician; rather, such services will provide the much urgently needed experts and

specialists attention which are far removed from the war zone to provide the

needed critical service. So, these researchers call for collaboration for the interest

of our military service and the world community because telemedicine and

associated technologies have proven to be dependable and beneficial to medical

practitioners, patients, healthcare consumers, and the global community in multiple

ways.

Key Words: telemedicine, telesurgery, healthcare, e-health care, quarantine,

collaboration, circumvent, remote patient monitoring, COVID-19 pandemic,

remote patient monitoring.

Introduction

Telemedicine is an advanced modern communication healthcare technology

designed to deliver health care services using technology across considerable

physical distance to patients. The up-to-date telehealth care interactive

technologies are engrained with a variety of advanced, computerized equipment,

allowing physicians, nurses, and allied healthcare professionals to provide complex

clinical services thousands of miles away from the physician’s clinic and hospital

locations of service (Totten, Womack, Dana, Eden, Eden, Griffin, Grousing, and

Hersh, 2016). Vast areas of medical services have been progressively connected

and challenged using innovative, complex technological devices to support various

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healthcare delivery processes. Telemedicine approach has been enhanced by

reliable Internet-based medical sites to provide an enormous amount of

information about diseases, treatments, and pharmacy locations for patient to fill

and refill prescribed medications. Hailey, Roine, and Ohinmaa (2001) and Esin,

(2020) have all acknowledged and documented this fresh breakthrough in

telemedicine, using mobile technologies and e-health techniques which provides

medical services culminating in an invaluable line of resources that are accessible

by mobile computers, laptops, tablets, and smartphones in the same life-saving

process.

Telemedicine is an organized technological mechanism designed to bridge

the gap between the availability healthcare professionals and allied healthcare

professionals, and proximity to patients’ locations and financial constraint. Per

Breen & Matusitz (2010) and Hailey, Roine, & Ohinmaa (2001), modern

telemedicine technologies are equipped with smart alarms to communicate vital

information such as transpiring clinical emergency, medication refills, increasing

and decreasing dosages, discontinuing medications between physician, healthcare

professionals, local pharmacies, patients, patient relatives and caretakers.

Clinical Reward of Telemedicine

Hospital industries, patients, and human communities are fully rewarded

from the dynamic operative nature of telemedicine and remote patient monitoring

(RPM) systems. It is an acuity that RPM is playing a key role in the advancement

and improvement of the global community healthcare services. The present-day

expansion of telemedicine and associated technologies is culminating in reducing

the inclusive cost of hospital visits, healthcare professionals and patient expenses.

The reward that comes from telemedicine service to humanity is invaluable and

has encouraged and precipitated the promulgation of wide-ranging sophisticated

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technologies designed to engage physicians, allied healthcare professionals,

patients, and hospitals systems in a massive life-saving process.

According to Esin (2019), the unexpected emergence of COVID-19

pandemic inflicted almost irreparable healthcare setups and establishments across

the global community, extending its tentacles and challenges to the vicissitudes in

transportation of patients and their safety, along with conveyance of physicians and

allied healthcare professionals to the hospitals and respective clinics. Today,

telemedicine activities are supporting and solving problems that were encountered

in the former medical delivery methods. Today, tele-medical processes have

gained popularity by highlighting the essential reward of RPM such as enduring

improvement decision-making regarding physicians and patients’ schedules and

office visits. Per Ives (2018), Jin, Kim, Miller, Behar & Correa (2020), and Timpel

& Harst, (2020), modern telemedicine is a practical foundation of medical

treatment engraved with multitude of devices. According to the assessment of

these researchers, telemedicine is a veritable, rewarding apparatus to diagnosis

terminal and life-threatening illnesses, playing a vital role in diagnoses, treatment,

and cure of most stages of HIV/AIDS, and other disease infections. Regardless of

the severity of the disease and magnitude of stigma, modern telemedicine is

helping to support, increase patient levels of communication with physicians and

allied healthcare professionals, and to decrease the risk of infection process

(Totten, Womack, Dana, Eden, Eden, Griffin, Grousing, & Hersh, 2016).

Hailey, Roine, & Ohinmaa (2001), Esin (2020), and Ohannessian & Duong

(2020), in their studies on the importance of telemedicine during the sudden

outbreak of coronavirus disease (COVID-19) pandemic that affected citizens of

approximately over 203 countries, asserted that the initial and timely response

strategy was facilitated by entrenched knowledge of patient diagnosis, isolation,

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symptomatic monitoring of contacts with suspected and confirmed cases, and

public health quarantine. In the process telemedicine framework, mainly video

consultations, were promoted and scaled up to reduce the risk of transmission the

deadly COVID-19 through physical contact in many countries. The result of the

studies validated and confirmed an updated framework for telemedicine in the

COVID-19 pandemic highlighting the unquestionable relevance, dependability,

and services of the telemedicine structure during the world deadly pandemic;

therefore, the evidenced-based telemedicine should be applied at a large scale to

improve the national and global health predicament.

Framework to Value the Undervalued Clinical Process.

There is an ongoing outcry calling upon the healthcare industry, hospital

system, physicians, allied healthcare professionals, patients, and the affected and

none-affected communities to form a united front to appreciate the value of

telemedicine, and to acknowledge improved modern telemedicine technologies as

active operative medium for healthcare service delivery operations. The

undisputable value of and contribution of telemedicine to the healthcare services

lie in its proactive culture in all phases encircling healthcare delivery, and the

physicians’ and allied healthcare professionals’ life-saving clinical judgment based

on patient condition, consideration of patient treatment plan, and proximity to the

hospitals and treatment clinics which must also be documented and remain

standardized. (Totten, Womack, Dana, Eden, Eden, Griffin, Grousing, and Hersh,

2016 & Ives, 2018).

In one accord, the present-day studies on telemedicine by Hailey, Roine, &

Ohinmaa (2001), Timpel &Harst (2020), and Esin (2020), concluded that

telemedicine technologies provide healthcare providers and consumers condition-

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specific and user-friendly options to manage life-threatening health conditions such

as post-surgical rehabilitation in various patient populations, single and multiple

chronic morbidities, maternal, and childcare malignant neoplasms. Their up-to-date

and comfortable devices help in improving the health condition, maximize

associated costs of patient in-person visits to hospitals and physician clinics. It is

my contention that the acceptance and recognition of the eminent value in

telemedicine will definitely help to avoid the inconvenient expenses of travelling,

babysitting expenses, car parking expenses, and the taking of time off work,

thereby constituting an added-value and major breakthrough in healthcare history.

Telemedicine is a dynamic, effective, and successful means of positively

delivering, and exchanging healthcare services, sharing clinical assessment data

with patients, and using highly sophisticated technologies to engage physicians,

allied healthcare professionals, patients, patients’ family members, and relatives in

aggressive life-saving process

Indeed, it has been established that telemedicine operative is a life-saving

healthcare service which differs from traditional medical practices because of its

modern digital equipment and technologies. Telemedicine operative is currently

used to expand healthcare services to patients by creating the fertile ground for the

growth and advancement of clinical services. Furthermore, this new operative

supports often provides changes from the expensive route to affordable and

accessible use of modern techniques to serve the deserving patient populations. To

make this great innovation more useful and serviceable to patience, our

practitioners should research and identify the culture of deficiencies, where

changes are required, and come up with best practice guidelines available to

patients, trajectories of care, greater degrees of built-in flexibility, and proximity to

patient residents.

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As group of telemedicine researchers, Hailey, Roine, & Ohinmaa (2001),

Breen & Matusitz (2010), and Esin (2020) posited, most physicians and allied

healthcare professionals are challenged with conflicting priorities such as whether

to accept or reject this never method of medical services. Hence, telemedicine

operations must include patient-education orientation, self-management support,

exchange of data and information amongst each patient’s physician and with allied

healthcare health care providers. The process should also cuddle the transfer of

images and medical data, expedition of contacts with health professionals, and

uninterrupted support regarding the distance to patients with chronic diseases. Of

special significance, is the crucial needs of patients with type-2 diabetes,

hypertension, heart attacks and strokes where time and distance to medical help are

very essential. Telemedicine gives them opportunities to meet up the appointment

for regular annual check-ups with a primary care physician, dental visits, follow-up

appointments, especially when further healthcare treatment is often and almost

impossible with physically challenged and psycho-socially challenged individuals.

Patients who live in remote rural areas often encounter snags in attempt to locate

healthcare providers practicing in the same vicinities. It is inevitable that the

consumers are required to travel millions of miles overseas and long distances for

medical treatment, and follow-up services. And Telemedicine is a likely panacea

for these handicaps and challenges

Most patients are physically, mentally, and financially challenged with the

burden and ability to travel to physician clinics and healthcare facilities due to

limited mobility and restricted access to public transportation stations.

Telemedicine services is recognized as one of the most effective and efficient

opportunity to provide healthcare to individuals, families, and communities, who

would, otherwise have no access to healthcare providers on a regular basis

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including psychiatry, radiology, dermatology, remote surgery known as

telesurgery. Telemedicine often presents a valuable, remarkable, flexibility,

unrestricted, modern mobile technological and operative corridor to provide

quality care for the needed population. Telemedicine services are increasingly

popular, flexible, and available, and the current trends indicating these services are

readily available to consumers over time. Advancements and progress in related

telemedicine technologies are urged to adapt the existing, efficient, and higher

quality care to civilian and military populations (Ives, 2018; Esin, 2020).

Challenges and Solutions on the use of Telemedicine in Military Arena

Telemedicine is not a functional operation in most military combat situations. Most

military commanders often decline telemedicine services in military arena to avoid

treating direct gunfire personnel, and shrapnel-pierced casualties. The idea has

been to avoid circumventing the activities of on-site physicians, while managing

and caring for serious military wounded personnel. On the contrary, Timpel and

Harst (2020), defended the situation by stating that technologically maneuvering,

telemedicine services are in no way capable of circumventing activities of on-site

military physicians and that the incorporation of telemedicine is a vital service in

military theater that should be strongly encouraged. As Ives (2018), Esin (2020),

and Timpel and Harst (2020) conceived, telemedicine and joined modern

technologies have proven to be dependable and beneficial to civilian and military

medical practitioners, patients, and healthcare consumers in multiple ways. These

innovations make available experts and specialists, who may be physically

removed from a wounded person or an emergency situation, to attend to the

patients.

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Lesson Learned

The COVID-19 pandemic ranged each nation’s alarm doorbell. World

leaders were charged with the traditional responsibility of doing what could be

done to curb the devastating effects of the pandemic for their countries, that is, to

become effective, efficient, dependable, defensive, and offensive commanding

officers who place their priority on a substantive increase in the budgets for health

care. Then, the only unchallenged and all-inclusive concerns were the global

health-care security of vulnerable private citizens. The entire education enterprises

all over the world were shut down and the learning process obstructed and

modified virtual learning in countries where computers and the internet were

accessible. I must admit, physician and allied health-care professionals and other

frontline responders stood firm for the challenges during the COVID-19 pandemic.

Equally, telemedicine is entrenched with the ability to cuddle the transfer of

images, medical data, and information progress with physicians and to provide

uninterrupted support regardless of the distance to patients with chronic diseases,

and to provide opportunities to meet up the appointment for regular annual check-

ups with primary care physicians, dental visits, and follow-up appointments, and

further healthcare treatment. Most appointments with physically challenged

patients had always almost been impossible; but today, appointments with

physically challenged and none-physically challenged patients are available

through telemedicine’s operations. Patients who live in remote rural areas often

encounter snags in attempt to locate healthcare providers practicing in the same

vicinities, and it is now predictable that telemedicine has closed the gap requiring

patients regardless of the physical condition to travel millions of miles for medical

treatment to obtain medical visits and treatment and follow-up services from home.

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References

Breen, Gerald-Mark and Matusitz, Jonathan. (2010). “Evolutionary Examination of

Telemedicine: A Health and Computer-Mediated Communication

Perspective.” Journal of National Library of Medicine. Bethesda, MD.

Esin, Joseph O. (2020) “Impulsive Time Ahead of Healthcare Operation in Event

of the Next Global COVID-19 Pandemic.”

https://www.washingtoncybercenter.com/publications-projects

Hailey, David, Roine, Risto, and Ohinmaa Arto. (2001). “Systematic review of

evidence for the benefits of telemedicine.” Journal of National Library of

Medicine. Bethesda, MD.

Ives, Aysha. (2018). “The Benefits of Telehealth for the Modern Healthcare

Consumer.” Journal of National Library of Medicine. Bethesda, MD.

Jin, Micheal X., Sun, Young Kim, Miller, Lauren J., Behari, Gauri, and Correa,

Ricardo. (2020). “Telemedicine: Current Impact on the Future.” Journal of

National Library of Medicine. Bethesda, MD.

Ohannessian, Robin and Duong, Tu Anh. (2020). “Global Telemedicine

Implementation and Integration within Health Systems to Fight the COVID-

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19 Pandemic: A Call to Action.” JMIR Public Health and Surveillance.

Paris: France.

Timpel, Patrick. And Harst, Lorenz. (2020). “Research Implications for Future

Telemedicine Studies and Innovations in Diabetes and Hypertension.”

Journal of National Library of Medicine. Bethesda, MD.

Totten, Annette M, Womack, Dana M., Eden, Karen, Eden B., Griffin, Jessica G.,

Grousing, and Hersh, William. R. (2016). “Telehealth: Mapping the

Evidence for Patient Outcomes from Systematic Reviews Internet.” Agency for

Healthcare Research Quality, Rockville: MD.

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August 20, 2020

Impulsive Time Ahead of Healthcare Operation in Event

of the Next Global COVID-19 Pandemic

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Dr. Joseph O. Esin
Visiting Professor of Research
University of Calabar, Nigeria
Professor, CIS/Cybersecurity
Jarvis Christian College, Hawkins, Texas USA

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Prelude
Time and again, aggressive, and venomous viruses such as 2020 COVID-19
pandemic emerge, killing millions, and pushing the world back several donkey years, and
yet the world community never enrolls and even comes close to graduating from any
institution in preparation to battle the past, present and future looming threats of
pandemic attacks. The 2020 COVID-19 pandemic is not a legend or myth; it is a deadly
pandemic and a ruinous virus with ability to changing lethargic components, mutate and
facilitate the transfer of deadly venom to all people from the youngest, middle-ages to the
elderly citizens speedily. In our generation, the riposte of September 11, 2001, twenty-
seven (27) days after terrorists crashed airliners into the Twin Towers, the Pentagon and a
field in Pennsylvania, President George W. Bush signed an executive order to establish
the Department of Homeland Security, on October 8, 2001 paving the way for the biggest
reorganization of the federal government since the years immediately after World War II
in 1944, when Congress established the Defense Department, the Central Intelligence
Agency (CIA) and the National Security Council (Bradbury-Jones & Isham, 2020). A
year later, the Department of Homeland Security was created, absorbing twenty-two (22)
agencies, organizations and becoming the third-largest federal bureaucracy in the United
Sates (Andreas, Kuckertz, Anja, Carlos, Reyes, Alicia, Elisabeth & Berger, 2020).
Across the government, national budgets were increased for counterterrorism operations.
Congress enacted laws granting powerful investigative authorities to law enforcement
units.

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Notably, the intelligent and security departments and most organizations that were
created did not foresee the advent of the Coronavirus of 2020 (COVID-19) pandemic
which has effected the most devasting attacks on humanity more than any other tragedies
the world have ever experienced. The stealthy advent of the 2020 COVID‐19 pandemic
presents a rinsing aura of virulent diseases that is presently ripping the global community
and spearheading the expansion of healthcare professionals’ hours of operations. These
healthcare professionals are constantly put at risk of attending to patients infected with
the deadly virus. This irritable, newly arrived pandemic is engrained with unintended,
negative consequences such as mental anguish, physical and psychological health risks,
isolation, and loneliness and closures of the educational systems.

Per Gibson, (2020) and Esin, (2020), in recent months, the global population have been
shut down due to the abrupt and unprecedented advent of the 2020 COVID-19 pandemic,
resulting in an histrionic adjustment of individuals, public and private organizations’ schedules,
and modus operandi of all business and academic establishments and people-oriented businesses.
This unfortunate turn of events revealed central truths about the fragile balance between the
natural environment and citizens, scientists and the legislators, physicians, allied healthcare
professionals and patients, relative to the navigation of the landscape for strength and recovery. It
must be underscored that the unexpected arrival of the pandemic has immersed global operations
in a sea of confusion and unreadiness and have called for immediate active plans of action to
remedy the expected post-pandemic episodes. This call is in preparedness which finds is greatest
advocate in the fundamental upsurge in the state and national healthcare budget to eradicate
global healthcare and economic predicament.

The abrupt eruption of the 2020 COVID-19 pandemic emerged as a colossal shockwave
to physicians, allied healthcare professionals, public and private organizations, and higher
education systems and exposed the fragility of the global community which has been thrown into
unexpected health and economy jeopardy (Esin, 2020 & Bradbury‐Jones, and Louise, 2020).

3

. Measurable Outcome of National Pandemic Healthcare Security
in Event of the Next Global COVID-19 Pandemic

President John F. Kennedy once admonished Americans and the world at large to “think of
what you can do for your country, not what your country can do for you” making it incumbent
and morally obligatory for humanity to be proactive in serving each other and always thinking
about what to do to make the work a better place to live and work in. Today, as the 2020
COVID-19 pandemic is drumming each nation’s doorbell, world leaders are charged with
aphoristic questions of what can you for your country? How can they become effective, and
efficient, dependable, defensive, and offensive commanding officers in the fight to this gigantic
challenge? The answer lies in the direction of empowering the health professionals by providing
them with substantive annual state and federal government increase in healthcare budgets and
establishment of active pandemic centers across the nation and each state capitals. I must admit,
during the current unexpected epidemic, entire healthcare professionals, code-named, “health-
provider front-line responders” were unquestionably struggling to defend, protect, and save lives
with limited medical and personal protective equipment (PPE) and supplies amid the abrupt
arrival and ongoing life-threatening crisis. ((Andreas, Kuckertz, Anja, Carlos, Reyes, Alicia,
Elisabeth & Berger, 2020); Naja and Hamadeh, 2020 & Esin, 2020).

The state and federal government’s priority is to upsurge healthcare budget, create active
National Pandemic Healthcare Security (NPHS), similar to the Office of Homeland Security,
absorbing fifty (50) pandemic centers across the nation, and to appoint skilled NPHS leaders to
oversee the operations. I am sure, such operations hold the key to restoring hope, assurance, and
safeguard for vulnerable innocent citizens in the event of the next pandemics. Notably, the

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United States citizens and the world community knows the importance, prominence and
substance of the Department of Homeland Security (DHS); hence, the creation of the National
Pandemic Healthcare Security NPHS) unit will definitely restore the highest degree of hope,
confidence, promise, and assurance that adults, teenagers and children will all be protected in
the event of the next pandemic. Analogous to the Department of Homeland Security (DHS), the
National Pandemic Healthcare Security (NPHS) will restore hope, confidence and measures
allowing physicians, and allied healthcare professionals, often designated as healthcare
front‐line fighters, the opportunity to be equipped with healthcare armory, such as hospital
equipment and personal protective equipment (PPPE) supplies, and the likelihood to meet
patients’ needs regardless of ages, race, and nationality. The abrupt culture of the outbreak of
the pandemic provides clear evidence for substantive change in our thinking about our health and
life. It calls for a proactive approach to healthcare by increasing the annual and semi-annual
states and national healthcare budgets to support, protect and assist health professional’s ability
to provide effective services to individuals living with chronic illness and those in desperate
need of acute care.

During the 2020 COVID‐19 pandemic, physicians, nurses, and allied
healthcare professionals were at the forefront, willing and ready to respond to patients in critical
needs. Unfortunately, they continue to be handicapped in their response by the limited
fundamental resources and the shortage of supplies and personal protective equipment. They are
falling short of restoring hope to distressed relatives, family members and affected victims.
Once again, our eyes have seen the life-threatening unrestricted confrontation in the
domain of healthcare, beckoning on state, federal, counties, local government representatives,
private and public organizations to step forward and join the united front in providing support
and assistance, such as helpline, volunteers and pastoral care services alongside the healthcare

professionals. The provision of assistance must avoid deferments of defensive and offensive
measures against the renaissance of subsequent epidemics. It is adorable to see physicians and
allied healthcare professionals who, in spite of the equipment scarcity, are eternally organized,
prepared, agreeable and willing to support individuals, populaces and ceaselessly pressing
forward to serve the victims and families of this Coronavirus Pandemic. The lessons we should
take from the current healthcare challenge is to push for active and comprehensive healthcare
measures and procedures to be adequately trained and prepared in the event of the next COVID-
pandemic.

In our generation, the 2020 COVID-19 is my first encounter with a global pandemic.
Physicians and allied health professionals are overly concerned about their own lives. As the
document labeled “Fallen Coronavirus Heroes” by Michael C. Gibson, a professor at the Harvard
University School of Medicine on March 31, 2020, asserted, more than sixty (60) doctors who
provided care to Italian COVID-19 patients contracted the virus and died in the line of duty
(Gibson, 2020). In the wake of the Ebola epidemic, nations, state governors, and legislators
placed emphasis on public healthcare system. Furthermore, they showed limited or no interest in
expanding the national and state healthcare budgets, communication and trust in physicians and
allied healthcare professionals and working with the law of nature. Per Bradbury‐Jones, and
Louise (2020), approximately six years later after the Ebola eruption, the global community,
states and nations are still swimming in the pool of reluctance to provide adequate funding for
pandemic preparedness; and the delay in adopting preventive measures.  Failure to develop surge

capacity in healthcare systems, laboratories, and supply chain logistics; and reduced infectious
disease expertise is without doubt a major setback to the current and future generation in the
event of the next COVID-19 pandemic. Medical scientists and vaccine developers are primed

and progressing at gargantuan pace to produce COVID-19 serum and most candidates are
undergoing clinical testing in alarming velocity trying with challenging and unprecedented
energy to provide scientific cure of the 2020 COVID-19 pandemic. Today and tomorrow, the
country needs a well-thought-out and systematic plan with scheduled and completed period for
the delivery of healthcare equipment, supplies infrastructure and healthcare education to battle
against the next COVID-19 pandemic.

Preeminence of NPHS as Global Citizens’ Sturdy Shelter in the event of the next COVID-19 pandemic.
The National Pandemic Healthcare Security (NPHS) demographic factors required in the
formulation of global solutions in the event of the next COVID-19 must include, but not be
limited to this well-organized, methodical, and professional processes.

i. Professional healthcare education of the mind, body and soul for state and national
representatives, physicians, allied healthcare professionals, healthcare administrators
and the public to battle existing swiftly growing and future threat of the next
pandemic on vulnerable innocent citizens.

ii. National and state leaders, private and public organization executives, especially, in
most developing countries, to stop travelling to advanced nations for medical
treatment, while their countries are in distressed and desperate need of functional
healthcare equipment, supplies and adequate medicinal facilities for vulnerable
citizens in the event of the next COVID-19.

iii. All countries on earth are functional components of the global community, and amid
the sudden outbreak of 2020 COVID-19 pandemic, states and national borders are
closed, local and international flights are indefinitely suspended, entire educational
systems shutdown and global economy are on the brink of extinction due to lack of
understanding of the importance of effective healthcare plan.

iv. In the center of all global, national, and state restrictions, mandatory wearing of mask,
social distancing, healthcare facilities, hospitals, and clinics are opened twenty-four
hours and seven days a week. Physician and allied healthcare professionals are
habitually ready and willing to restore hope to distressed and affected patients.
Citizens of the global communities have total confidence in physicians and allied
healthcare professional in the event of the next COVID-19.

v. Twenty-seven (27) days after terrorists crashed airliners into the Twin Towers, the
Pentagon, and a field in Pennsylvania, the United Sates Congress approved a major
reorganization of the federal government, creating the Department of Homeland
Security to absorb twenty-two (22) agencies, with the largest increase in annual
national budgets to battle counterterrorism operations.

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vi. The same spirit must be extended to the 2020 COVID-19 with a corresponding
creation of National Pandemic Healthcare Security (NPHS) a unit with a large budget
to assuage the financial hardships the current health and CDC departments are facing.

In concurrence with the creation of the Department of Homeland Security, this research on
impulsive time ahead of healthcare operation in event of the next global COVID-19 pandemic is
a direct demand for a fundamental escalation of healthcare budgets to enthrall the creation of the
office of National Pandemic Healthcare Security NPHS) enters in the fifty (50) continental
United States. The office of the NPHS with headquarters in the national capital and active
branches in every state will serve as a solution to this chaotic approach to the OVID-19 and
purge physician and allied healthcare professionals’ trepidation relative to resources, supplies
and equipment. It will further restore hope, good judgment of security and confidence on
vulnerable citizens, and provide vigilant measures in the event of the next COVID-19 pandemic.
Global Matching Algorithm in the event of the next COVID-19 pandemic.

The world citizens’ privacy, medical doctors, allied healthcare professionals, national
leaders, state governors, mayors and local government representatives emerged as the most,
effective, and efficient, dependable, defensive, and offensive commanding officers in the battle
against the shattering episode of world pandemic. This unexpected outbreak took control and
positioned entire global communities in challenging, unbalancing, and uncertain disorders. The
intriguing and astonishing alarm is how super-powers, middle-powers, lower-powers and zero-
powers; first-world, second-world, third-world, fourth-world and zero-world nations continue to
undyingly and undeniably remain humble, unassuming, and untiringly acknowledge the nature of
God’s creation (Ngwang, 2016 & Gibson, 2020 & Esin, 2020).

The 2020 COVID-19 pandemic is drumming the doorbells of the global communities. It
is operating on an exclusive agenda that cannot be changed, and re-scheduled in aberration of
world leaders’ commanding authority, and finally demanding total obedience and submission to
God’s pronouncement across the globe. Surprisingly, Leaders with nuclear weapons are
reluctant to allow physicians and allied healthcare professionals access to the podium, to study

the combinations, push the nuclear weapons buttons and bring down the most egotistical and
bigheaded 2020 COVID-19 pandemic. In submission to the bullish and overconfident culture of
2020 pandemic, entire global communities, including villages, cities, counties, local regions,
states and national organizations must assume equal responsibilities in the re-organization and
re-structuring of functional rehabilitation by approving matching budgets that are desperately
needed to combat this pandemic monster. It must begin first by the creation of the office of
National Pandemic Healthcare Security NPHS) with active pandemic centers in the fifty (50)
continental United States, with nation, state, and local headquarters. The global creation NPHS
must be supported with a well-suited pandemic hospital and healthcare facilities, compatible
medical equipment, supplies to rescue and sustain the world community in the event of the next
pandemic (Esin, 2020).

Conclusion: Homecoming in the event of the next COVID-19 pandemic
All countries on earth are functional components of the global community. Amid the
sudden outbreak of 2020 COVID-19 pandemic, states and national borders are closed, local and
international flights are indecisively interrupted, entire educational systems shutdown and global
economy is pushed to the brink of extinction due to lack of understanding of the importance of
homecoming. Most leaders, legislators, and affluence citizens are cautiously refusing to
acknowledge the aphorism that home is forever a balanced study and permanent household.
Today, the world will be a better place if all citizens come home and engage in a mounting
support, peaceful home-based town hall sessions, collaborative alliances with state and federal
legislators to step forward in the creation of the National Pandemic Healthcare Security (NPHS)
in the national headquarters with branches in state and local capitals. Unquestionably, the
creation and establishment of NPHS will produce eternal, considerable, positive, rewarding steps
and a show of determination to subdue and conquer the next COVID-19 pandemics.

This initiative will be tantamount to investing in the self, for any investments outside of the home-
country, states, and yourself will repeatedly remain the worst and a life-time liability.
African leaders, legislators, and citizens with affluence and financially stable
opportunities, who are confronted with this indefinite lockdown in business and mobility must
avoid the worst life-time liability by supporting the creation of global, national, and state NPHS.
The culture of NPHS will be a well-structured algorithm to restore hope, and confidence that will
go a long way to allow or give physicians, and allied healthcare professionals, designated
healthcare front‐line fighters the opportunity to be equipped with healthcare armory, such as
hospital equipment, supplies, personal protective equipment. Ultimately, such a initiative in the
medical field will meet patients’ needs regardless of ages, race, and nationalities, and will
provide effective services to individuals living with chronic illness and those in desperate need of
acute care.

​

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No Ethical Obligation to Treat COVID-19 Patients.” Journal of Medical Ethics (JME).
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framework for action”. European Journal of Clinical Nutrition, Vol. 10, S-41430.
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