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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 areasTuxtla, 18-19 May, 2006Alcatel Alenia Space broadband telemedicine solutions
slide2
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
slide3
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
slide4
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
slide5
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)
slide6
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)
slide7
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
slide8
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
slide9
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
slide10
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
slide11
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

slide12
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
slide13
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
slide14
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
slide15
SIP

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

DVB-RCS HUB

Management tools

Security

Applications & services

slide16
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
slide17
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
slide18
Contacts

Pascal LOCHELONGUE (technical manager)

[email protected]

Olivier AUTRAN (marketing manager)

[email protected]

Pierre LEON (local marketing manager)

[email protected]

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