Extending e-health to rural areas
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Extending e-health to rural areas Tuxtla, 18-19 May, 2006 Alcatel Alenia Space broadband telemedicine solutions. Extending e-health to rural areas : geographical context. French initiative in South East of France, Department of les Alpes Maritimes 4 valleys whose access is very difficult

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Extending e-health to rural areas : geographical context

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Extending e health to rural areas geographical context

Extending e-health to rural areasTuxtla, 18-19 May, 2006Alcatel Alenia Space broadband telemedicine solutions


Extending e health to rural areas geographical context

Extending e-health to rural areas : geographical context

  • French initiative in South East of France, Department of les Alpes Maritimes

  • 4 valleys whose access is very difficult

  • Landslides, snow in winter are blocking roads

  • Aging population

  • Local medical staff isolation


Extending e health to rural areas geographical context

Extending e-health to rural areas : objectives

Professionals

  • Maintain general practitioners in mountainous/isolated areas

  • Maintain qualified staffs in local hospitals

  • Provide remote assistance / expertise to local staff to treat patients

    Patients

  • Accelerate recovery at home or in usual environment

  • Provide locally new services avoiding travelling to urban hospitals

  • Reduce hospitalization frequency, transfer and cost

  • Increase population’s confidence into local teams

  • Deal with medical but also social aspects

  • Maintain quality of life


Extending e health to rural areas geographical context

Extending e-health to rural areas : set up of a specific program

  • To achieve the objectives, setting up of a specific program including medical training, teleconsultation & tele-expertise with relevant partners

  • Strong partnership :

    • General Council Alpes Maritimes

      • telemedicine local development,

      • contractual matters and funding,

      • planning, communication

    • Nice Faculty of Medicine

      • provides medical expertise, specialists coordination,

      • referents in local hospitals,

      • training program

    • Alcatel Alenia Space leader for

      • satellite technology, telemedicine Workstation and e-health applications,

      • network installation / configuration / optimisation,

      • end-users support, technical training

      • supervision, maintenance


Extending e health to rural areas geographical context

Extending e-health to rural areas : Satellite network architecture

  • A9780 DVB-RCS based satellite network

  • Hub and applications platform hosted at Alcatel Alenia Space France premises and managed by AASF technical team

  • 12 sites : 8 local hospitals (isolated area) and 4 Hospitals in Nice (urban area)


Extending e health to rural areas geographical context

Extending e-health to rural areas : DVB-RCS technology

  • Two ways satellite broadband technology. Ground network independency (2W architecture) of the DVB-RCS satellite solution enables customers currently suffering of the lack of terrestrial broadband networks, to access value added services

  • DVB-RCS standard compliant : mature and fully operational technology implementing DVB-S norm (DVS-S2 ready) on the forward link & offering powerful capabilities (up to 2 Mbps return) on the return link to access and transmit over satellite from anywhere.

  • DVB-RCS system ensures interoperability with heterogeneous network like terrestrial, mobile, wireless and secures customer investments in infrastructure

  • It supports current and upcoming IP services , providing network functionality to support new generation of interactive and multimedia applications (high quality video based applications)


Extending e health to rural areas geographical context

Extending e-health to rural areas : SIT installation

  • Ease of installation of the DVB-RCS satellite terminal allows fast installation of a new site and its integration into the overall network.

    • Ground, wall, roof

    • Vehicle

    • Container


Extending e health to rural areas geographical context

Extending e-health to rural areas : DVB-RCS technology & telemedicine

requirements

  • 2W design & High Rate on return link (medical training, teleconsultation, tele-expertise/telediagnosis)

    • High quality video transmission from teacher/specialist side (H264)

    • Asymmetric/Symmetric traffic

    • Applications interactivity (videoconference, questions/answers)

    • Very high image quality transmission

  • QoS mechanisms (medical training, teleconsultation, tele-expertise /telediagnosis)

    • Robust audio communication

    • Guaranteed BW

  • Multicast (medical training)

    • Satellite is the best solution (coverage, terrestrial multicast nodes)

    • Point to multipoint architecture

    • Videostreaming

    • Push of contents


  • Extending e health to rural areas geographical context

    Extending e-health to rural areas : Medical training

    • Doctors, nurses, auxiliary nurses, pharmacists

    • 3 hours sessions (1-2 per months)

    • Management of end-of-life care : physical, psychological, social, spiritual, and practical needs of patients and caregivers

    • Emergency : introduction to the use of a Semi-automatic defibrillator

    • Geriatrics : disorders of sphincter / swallowing risks and elimination

    • Gastroenterology : repercussion of non-steroidian anti-inflammatory (NSAI) drugs usage

    • Proctology : acute pain identification and treatment

    • Psychiatry, Gynaecology, Endocrinology, Dermatology


    Extending e health to rural areas geographical context

    Extending e-health to rural areas : Medical training

    DVB-RCS HUB

    Management tools

    Security

    Applications & services

    Contents

    Presentation

    DVB-RCS

    Remote

    SIT

    End user WS

    • Each participant connects to the Alcatel Alenia Space broadband medical training application

    • Return : 256kbps remote participants/512kbps teacher


    Extending e health to rural areas geographical context

    Unlimited number of participants

    Meeting room with several participants

    and video-projector and wall screen

    Remote pointer

    session recording for further use

    Extending e-health to rural areas : examples


    Extending e health to rural areas geographical context

    Extending e-health to rural areas : teleconsultation

    • Nurses, doctors, specialists

    • Regular ½ hour point to point sessions

    • Psychiatry : patient with personality or mental disorders, mortality / morbidity related disorders (suicide, injuries from accidents, substance abuse)

    • Elderly

      • Nutritional disorders

      • Kinesytherapy: evaluation, diagnosis, rehabilitation in locomotion

      • Cognitive disturbances

      • Orthoepy: speech and swallowing troubles

      • Dermatological or rheumatologic disorders

  • Gerontology : Care of scabs, podology and chiropody


  • Extending e health to rural areas geographical context

    Extending e-health to rural areas : teleconsultation

    DVB-RCS HUB

    Management tools

    Security

    Applications & services

    Telemedicine WS

    • Each participant connects to the same core application

    • Patient transfer, local hospital recovery ?

    • Return : 256-512kbps


    Extending e health to rural areas geographical context

    Extending e-health to rural areas : tele-expertise / telediagnosis

    • Specialists

    • ½ hour point to point sessions

    • Specific tele-expertise application with advanced image processing capabilities

    • Interconnecting with DICOM compliant modality

    • Radiology (fractures, angiogram, mammography, ..)

    • Dermatology (melanoma or dermatitis or pictures/MRI examination, tissue microscopic examination)

    • Cardiology (prevention, investigation and treatment of diseases involving the cardiovascular system)

    • Anatomo-pathology


    Extending e health to rural areas geographical context

    SIP

    Extending e-health to rural areas : tele-expertise / telediagnosis

    DVB-RCS HUB

    Management tools

    Security

    Applications & services


    Extending e health to rural areas geographical context

    Extending e-health to rural areas : tele-expertise / telediagnosis

    • DICOM compliant

    • Acquisition from DICOM modalities

    • Image manipulation (any manipulation is remotely reproduced)

      • zoom

      • contrast, brightness

      • black & white

      • magnifying glass

      • measurements, annotation

      • window levelling

      • scrolling

    • Tele-cursor

    • Diabetic eye disease examination

    • Return : 512 kbps

    • Echography

    • Return : 1024 kbps


    Extending e health to rural areas geographical context

    Conclusion

    • Leading position in telemedicine using satcoms

      • System and solutions integrator, not only a supplier

      • Take advantage of Alcatel Group competencies for network architecture definition (terrestrial, mobile, satellite, wireless) and integration of end users applications for medical uses

      • Build robust partnerships for industrial solutions (cost sharing, roadmap) and commercial deployments success (user acceptance)

      • Design and provide end-to-end solutions for e-Health vertical market (unique interlocutor)

      • Have got a unique experience in Europe of deploying and exploiting an operational medical training and teleconsultation network

      • Is the coordinator of the Healthware European project (Aeronautics & Space program – European Commission 2005-08), which is the reference in Europe regarding telemedicine by satellite and the driver for the development and the deployment of DVB-RCS based telemedicine applications : http://healthware.alcasat.net


    Extending e health to rural areas geographical context

    Contacts

    Pascal LOCHELONGUE (technical manager)

    [email protected]

    Olivier AUTRAN (marketing manager)

    [email protected]

    Pierre LEON (local marketing manager)

    [email protected]


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