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During the last decade, teleoperated robotic systems have extended humans’ sensorimotor competence to digitally fly beyond the physical barrier of distance and scale and thus transmit sensorimotor skills of the human through direct communication. Telepresence capabilities have enabled tele-physical remote access at small scales thanks to telerobotic mediums. Although the concept was initially motivated by space applications, such technologies quickly have expanded into the medical domain and resulted in teleoperated medical robots, including telerobotic surgical systems (such as the da Vinci surgical system). Effective telepresence fundamentally depends on an agile, reliable, and secure communication medium that can transmit real-time information between the operator and a remote device. However, direct telepresence may not be achievable for long-duration exploration spaceflight missions. Thus, autonomous systems and local intelligence represent potential solutions to the aforementioned issues. One example solution employs demonstration systems which enable learning from the pre-captured inputs of a skilled human operator. These will be computationally modeled and later probabilistically replicated toward the completion of remote physical tasks when direct telepresence is not viable - such as under communication blackout conditions. In other words, trained autonomous systems (e.g., robots) can perform remote operations that mimic the physical performance of experts during remote operations/training. Beyond learning the physics of the task, autonomous agents can also be used to conduct algorithmic decision-making that mimics the higher-level cognition of the expert. Thus, using an autonomous system, pre-trained cognitive and manipulation-based skills can be leveraged (acquired during pre-mission events) to produce digital twins of an intelligent operator. Such systems can be used for the real-time conduction of intricate tasks in complex and unstructured environments. Such systems will operationalize “cognitive digital twins” and can expand the reach of human cognition and manipulation through the power of data-driven learning from demonstration algorithms. This system category will be discussed as a fully autonomous operation in this talk. In addition to the above, we will also propose and discuss the possibility of partial-automation using remote intelligence and remote sensing. In contrast to full automation, partial automation can close the loop through a local operator equipped with augmented sensory awareness through wearable systems. Such technologies will allow the local operator to conduct delicate tasks while being guided using sensory augmentation and being monitored to gauge her/his level of cognitive focus and performance. The difference with the previous category is that a remote human will conduct the task. Further, rather than making a digital twin of human cognition, we will augment the control inputs of the local human to match those of the skilled expert operator who is not accessible in real-time. Going beyond classic telepresence and thus approaching intelligent telepresence, our vision is that autonomous agents will eventually enable the safe, consistent and efficient delivery of complex, remote and smart medical care during space exploration across operators in an Earth-independent fashion. We will discuss our collective vision from NASA and MERIIT@NYU lab in this talk.