extending e-health to rural areas : geographical context

Extending e-health to rural areasTuxtla, 18-19 May, 2006

Alcatel Alenia Space broadband telemedicine solutions

Broadband satellite telemedicine - 2 All rights reserved © 2006, Alcatel Alenia Space

Extending e-health to rural areas : geographical context

French initiative in South East of France, Department of les Alpes Maritimes4 valleys whose access is very difficultLandslides, snow in winter are blocking roadsAging populationLocal medical staff isolation


Extending e-health to rural areas : objectives

Professionals Maintain general practitioners in mountainous/isolated areasMaintain qualified staffs in local hospitals Provide remote assistance / expertise to local staff to treat patients

PatientsAccelerate recovery at home or in usual environmentProvide locally new services avoiding travelling to urban hospitalsReduce 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 : set up of a specific program

To achieve the objectives, setting up of a specific program including medical training, teleconsultation & tele-expertise with relevant partnersStrong 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 : Satellite network architecture

A9780 DVB-RCS based satellite networkHub and applications platform hosted at Alcatel Alenia Space France premises and managed by AASF technical team12 sites : 8 local hospitals (isolated area) and 4 Hospitals in Nice (urban area)


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 servicesDVB-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 : 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, roofVehicleContainer


Extending e-health to rural areas : DVB-RCS technology & telemedicine requirements2W 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 : Medical training

Doctors, nurses, auxiliary nurses, pharmacists3 hours sessions (1-2 per months)

Management of end-of-life care : physical, psychological, social, spiritual, and practical needs of patients and caregiversEmergency : introduction to the use of a Semi-automatic

defibrillatorGeriatrics : disorders of sphincter / swallowing risks and eliminationGastroenterology : repercussion of non-steroidian anti-inflammatory

(NSAI) drugs usageProctology : acute pain identification and treatmentPsychiatry, Gynaecology, Endocrinology, Dermatology


DVB-RCS HUB Management toolsSecurityApplications & services

DVB-RCSRemote

SITEnd user WS

Extending e-health to rural areas : Medical training

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

ContentsPresentation

Return : 256kbps remote participants/512kbps teacher


Extending e-health to rural areas : examples

Unlimited number of participants

Meeting room with several participantsand video-projector and wall screen

Remote pointer

session recording for further use


Extending e-health to rural areas : teleconsultation

Nurses, doctors, specialistsRegular 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 : teleconsultation

Telemedicine WS

Each participant connects to the same core application


Patient transfer, local hospital recovery ?

Return : 256-512kbps


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

Specialists½ hour point to point sessionsSpecific tele-expertise application with advanced image processing capabilitiesInterconnecting 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




SIP



DICOM compliantAcquisition from DICOM modalitiesImage manipulation (any manipulation is remotely reproduced)

zoom contrast, brightness black & white magnifying glass measurements, annotation window levelling scrolling

Tele-cursor

Return : 1024 kbps

Echography

Return : 512 kbps

Diabetic eye disease examination


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


Contacts

Pascal LOCHELONGUE (technical manager)[email protected]

Olivier AUTRAN (marketing manager)[email protected]

Pierre LEON (local marketing manager)[email protected]

extending e-health to rural areas : geographical context

Documents

satellite technology

satellite networkhub

ehealth applications

dvbrcs satellite solution

telemedicine workstation

local staff

local teams

medical training