According to the recent “Telemedicine Market Shares, Strategies, and Forecasts, Worldwide, 2010 to 2016” report, presented on March 25th, 2010 by Aarkstore Enterprise Worldwide, telemedicine markets at $7 billion in 2009 are expected to reach $24 billion by 2016. Total healthcare spending worldwide will reach $8.4 trillion. In this context Cybertherapy-the provision of healthcare services using advanced technologies-has the promise of delivering care more adequately to rich and poor people.

As U.S. President Barack Obama underlined in his speech to the American Medical Association, “We are spending over $2 trillion a year on healthcare-almost 50 percent more per person than the next most costly nation. And yet, as I think many of you are aware, for all of this spending, more of our citizens are uninsured, the quality of our care is often lower, and we aren't any healthier. In fact, citizens in some countries that spend substantially less than we do are actually living longer than people in other countries.”

What Obama's statement didn't address is that some portions of the population are healthier. To say that not everyone is treated is not the same as saying that the system does not treat many people very well. Cybertherapy is poised to increase the quality of healthcare delivery and spread its superior healthcare delivery system to a greater portion of the population.

Healthcare delivery systems are moving towards a quantum shift in care delivery. Technology provides new ways to sense and monitor heart disease, inflammation, infection, cancer, diabetic condition, and chronic condition status using technology. This represents a quantum shift in care diagnosis. The old methodologies of patients' verbal descriptions and in-person visual inspections are becoming less important. Monitoring technologies and blood work are being used in combination with imaging and telemetrics to provide a real time, continuous evaluation of patients' conditions.

Moreover, cybertherapy supplements information available from a physical examination by making healthcare delivery more readily available. Cybertherapy is able to supplement traditional care. Cybertherapy is extending monitoring capabilities through the concept of “Interreality” which creates a bridge between the physical and virtual worlds. Using Interreality, cybertherapy is bridging virtual experiences with real experiences using advanced technologies (virtual worlds, advanced sensors and PDA/mobile phones). Therefore, the ability to visualize patient conditions through monitors, sensors, imaging, and biometrics and by adapting their experience through the use of these capabilities changes everything.

Despite the potential of cybertherapy, its benefits and the technical maturity of the applications, the use of cybertherapy services is still limited, and the market remains highly fragmented. Although many countries-including the U.S., Europe, Korea and Japan-have expressed their commitment to wider deployment of cybertherapy, most cybertherapy initiatives are no more than one-off, small-scale projects that are not integrated into healthcare systems.

It has been recognized that integrating these new types of services into existing healthcare systems is a challenging task. The aim of this volume is to support and encourage all interested countries in this endeavor by identifying and helping to address the main barriers hindering the wider use of cybertherapy and by providing evidence to build trust and acceptance of these practices.

Because of the complexity of this goal, we have put a great deal of effort into the definition of the structure of the volume and in the sequence of the contributions, so that those in search of a specific reading path will be rewarded. To this end we have divided the different chapters in four main Sections:

1. Critical Reviews: These chapters summarize and evaluate emerging cybertherapy topics, including technology-enhanced rehabilitation, Interreality, and Intersubjectivity.

2. Evaluation Studies: These chapters are generally undertaken to solve some specific practical problems and yield decisions about the value of cybertherapy interventions;

3. Original Research: These chapters research studies addressing new cybertherapy methods or approaches;

4. Clinical Observations: These chapters include case studies or research protocols with a long-term potential.

For both health professionals and patients, the selected contents will play an important role in ensuring that the necessary skills and familiarity with the tools available, as well as a fair understanding of the context of interaction in which they are operated.

In conclusion, this volume underlines how cybertherapy has made initial progress in treating a variety of disorders. However, there is more work to be done in a number of areas including the development of easy-to-use and more affordable hardware and software, the development of objective measurement tools, the need to address potential side effects, and the implementation of more controlled studies to evaluate the strength of cybertherapy in comparison to traditional therapies.

We sincerely hope that you will find this year's volume to be a fascinating and intellectually stimulating read. We continue to believe that together we can change the face of healthcare.

Brenda K. Wiederhold,

Giuseppe Riva,

Sun I. Kim