shuji shimizu
TRANSCRIPT
1Kyushu University UI project Kyudai Taro,2007
Shuji Shimizu, MD
Director,Telemedicine Development Center of Asia,
Kyushu University Hospital, Fukuoka, Japan
Shuji Shimizu, MD Director,Telemedicine Development Center of Asia,Kyushu University Hospital, Fukuoka, Japan
May 9, 2013, Cali, Columbia
Remote Medical Education in Asia-Pacific- Possible expansion to Columbia-
1000 km
500 km
Tokyo
Seoul
Beijing
Shanghai
Taipei
Busan
Fukuoka
1500 km
Sapporo
Osaka
JAPANJAPAN
CHINACHINA
KOREAKOREA
East Asia
The World’s 10 Hottest Cities
1. Las Vegas/USA2.2. Fukuoka/JapanFukuoka/Japan3. Munich/Germany4. London/England5. Toulouse/France6. Nanchang/China7. Moscow/Russia8. Ghaziabad/India9. Goyang/Korea10.Florianopolis/Brazil
1. Las Vegas/USA2.2. Fukuoka/JapanFukuoka/Japan3. Munich/Germany4. London/England5. Toulouse/France6. Nanchang/China7. Moscow/Russia8. Ghaziabad/India9. Goyang/Korea10.Florianopolis/Brazil
July 2006
Today’s menu
Background Activities
Korea-Japan Asia-Pacific
Challenges
Kyushu Univ., Fukuoka
Surgical revolution: One exampleSurgical revolution: One exampleOpen Endoscopic
Benefits of Endoscopic SurgeryBenefits of Endoscopic Surgery
Small wound
Open Endoscopic
1 week after surgery
Pain Walking Recovery
But, NOT popular in medical community yet
Why not?Why not?
Remote education
• New knowledge and procedures keep coming.• Young doctors do not have enough chances.
• Save time & travel expenses• Scalability: Daily use & Large audience
HUGE demands in education!
<Economical & Effective!>
Int’l Teleconf/Live demo
Expensive!
SatelliteSatelliteISDN/NarrowISDN/Narrow
Poor image!
?
1990s
FIFA World Cup 2002FIFA World Cup 2002
Situations dramatically changed in 2002Situations dramatically changed in 2002Situations dramatically changed in 2002Situations dramatically changed in 2002
We use BIG Internet!We use BIG Internet!
Korea- Japan was connected with Big
Broadband Network (2G).
Korea- Japan was connected with Big
Broadband Network (2G).
JapanJapan
KoreaKorea Hub in Kyushu
Univ.
Key technologies Key technologies
DVTS (Digital video transport system)
Academic network (Research and education network)
2000s
Actual bandwidth in each network
0.4
30
0
5
10
15
20
25
30
ISDN DVTS
Mbps
Compressed, degraded
Original quality
D: DigitalV: Video T: Transport S: System
Point 1: Big Broadband Network
Digital Video
Internet
Moving images
DVTS: Cheap and Simple
DV Camcoder DVTS PC
Microphone
UTP(Ethernet)
Audio
Internet
• DVTS: free but powerful software• No special teleconferencing equipments
>30Mbps>30Mbps
Commercial network does not work!Commercial network does not work!
Surgical instrument
IEEE1394
Point 2: Academic Network for Research and Education
Columbia: RENATA
Science 1986, “Computer Networking for Scientists”
High-speed Network for R&E in Japan
Ministry of Education
• Government-funded • No commercial use• All national universities are connected• No additional cost if connected• Big Internet is ready to use anytime
• Government-funded • No commercial use• All national universities are connected• No additional cost if connected• Big Internet is ready to use anytime
Practical Telemedicine has started.
Today’s menu
Background Activities
Korea-Japan Asia-Pacific
Challenges
Kyushu Univ., Fukuoka
OR Surgical movie
NCC, KoreaKyushu Univ., Japan
Needs! Laparosc. Surg.
Security software used
Aug 1, 2003
The first live demonstration of surgery
TV news reportsAug 22, 2003
TNC in the evening news
RKB
KBC
NHK
KBC
Routine Int’l Case Teleconference
Seoul Univ., KoreaKyushu Univ., Japan
2005.2.17
Tele-lecture: From Japan to Korea
2006.9.22
Equipment
Kyushu U
Seoul NU
DVTS package
Live Surgery from Korea to Japan2006.4.13
Seoul => Fukuoka International Convention Center
Live Surgery for Medical Students
2008.5
Seoul/KR
Fukuoka/JP Video
• Endosc Surg• Telemed• English
Today’s menu
Background Activities
Korea-Japan Asia-Pacific
Challenges
Kyushu Univ., Fukuoka
International academic network (APAN)
All connection fee is free!
Asia-Pacific Advanced Network
Kyushu Univ. as secretariat
Taipei Beijing
Fukuoka Seoul
2005.3.18
The first multi-station teleconference by DVTSThe first multi-station teleconference by DVTS
Pancreatic Transplantation MeetingPancreatic Transplantation Meeting New technical breakthrough
KRKR
ChinaChina
Gastric cancer
IndonesiaIndonesia
ThailandThailand
IndiaIndia
VietnamVietnam
MalaysiaMalaysia
JPJP
TaiwanTaiwan
SingaporeSingapore
PhilippinesPhilippines
Recovery
Less cost
Back to work
Endosc
Early
Admission
Recurrence
Death
Ope
Advanced
Diagnosis and treatment
Early detection is very important!
China-Japan Early Gastric Cancer Teleconference
Tokyo/JPFukuoka/JP
Shanghai/CN2011.11.15
Beijing/CN
Regular meeting
Video
Continuous Medical Education in Asia
Fukuoka, JP Cho Ray HospitalHo Chi Minh, VN
Cancer InstituteTokyo, JPShanghai, CN
2009.6.26
Bariatric Surgery from Australia
Adelaide
Fukuoka
Singapore
2005.11.16
Learn from others easily
Endoscopic Demonstration with Europe
Bangkok, TH
Kyoto, JP
Hamburg, GR Kuala Lumpur, MY Taipei, TW
Xian, CN
Fukuoka, JP
Seoul, KR
2007.8
• France• Italy• Belgium• Czech• Spain• Norway
Video
Expansion of Network
to South Africa
2010
First to Cape Town in South AfricaKyushu U, JP
Cho Ray, VN
U Cape Town, ZA
2011.9.21 2011.3
14,000km
Video
1. Smaller bandwidth for better quality- better compression system- high-definition image
2. Mobile technology- anytime, anywhere
New Technologies 2010s
Generalization!Generalization!
HD-H.323/Vidyo
Global endoscopic conference with Vidyo
2012.8.28
IN
LKTW KR
GEIN KRSG
HK
Video
Post-graduate course across border
2012.10.23
KR 1
KR 2
KR 3
JP
VN
TH
Seoul Univ.Prof Kim HH
Select a system depending on a program/conditions
Telemedicine Development Center of Asia (TEMDEC) 2008.4
http://www.temdec.med.kyushu-u.ac.jp/eg/index.html
Organize all programs with doctors and engineers
2004.7
SapporoSapporo
2004.1
BeijingBeijing
2004.12
2005.1
TokyoTokyo
BangkokBangkok
ShanghaiShanghai
SingaporeSingapore
Kuala LumperKuala Lumper
NUSNUS
2004.7
2004.1
BrisbaneBrisbane
ManilaManilaPhilippine UPhilippine U
BandungBandungITBITB2005.11
2005.6
IwateIwate 2005.7
2005.11
TaichungTaichung2005.11
New DehliNew DehliERNETERNET
2004.10
HaLongHaLong2006.6
2006.7
2006.7
TaipeiTaipei
MumbaiMumbaiTata MHTata MH
2003.2JilinJilin
Jakarta, UIJakarta, UI
HanoiHanoi
MelbourneMelbourneSydneySydney
AucklandAuckland
2007.3
CanberraCanberraANUANU
HawaiiHawaii
Ho Chi MinHo Chi MinCho Rai HospCho Rai Hosp
2007.1
2007.1
Before 2005
After 2008
2006 - 2007
2007.1AdelaideAdelaide
Flinder’s HospFlinder’s Hosp
2005.11
2007.3
CaliforniaCalifornia
2007.1Stanford, UC IrvineStanford, UC IrvineHongHong
KongKong
BrazilBrazil
FukuokaFukuokaYokohamaYokohama
CairnesCairnes
EgyptEgyptCairo UCairo U
2007.8<< Asia Medical ProjectAsia Medical Project >>
34 countries221 institutions360 events
SeoulSeoul
EuropeEurope
South AfricaSouth Africa
Today’s menu
Background Activities
Korea-Japan Asia-Pacific
Challenges
Kyushu Univ., Fukuoka
Network in Latin America
First DVTS trials with Latin America
MX
TX BR
SeattleCL
Not so good…
U San Paolo, BR
2009
Dr Miguel/BO
Dr Pablo/ARDr Nicolas/CO
Dr Mauricio/MX
Dr Franco/CLDr Carlos/BZ
Dr Alberto/UYDr Gabriel/CR
Dr Carlos/BR
Visiting Latin America with engineers Alemana Hosp/CL
USP/BR
Univ. of La Plata/ARINNSZ/MX
Endoscopy teleconf. with Central/Latin America
2013.1
Hawaii
Mexico
Brazil
Chile
APAN venue
Dr Yao
Dr Uedo
UNAM
Dr Tanimoto
UERJ
Dr Fatima
REUNA
Dr Ignacio
RENATA is expanding network RENATA is expanding network in Columbiain Columbia
Good timing to start the project!
You need…•Engineers (network & system)
- who make it possible•Doctors (programs)
- who make it meaningful
Engineers: Network to the very endEngineers: Network to the very end1) International network
2) Domestic (NREN)
•APAN•RedClara
RENATA/CORNP/BRInternet2/US
NetworkPoint
Big academic network
Connected to hospital?
NetworkPoint
3) Hospital
NetworkPoint
Support of engineers
Big enough and stable network at all steps
Firewall
Doctors: Make attractive programs• Surgery/Endoscopy
• Cardiac intervention
• Rehabilitation
• Dental
• Bird flu, SARS, HIV
• Basic Science
• Nursing
• Medical students, etc.
A lot more needs…
Cardiac Intervention: live demonstration2012.2.16APAN-Chiang Mai
Taiwan Univ.
Osaka Univ./JPSingapore Univ.
Thai main venue
Int’l Endoscopic Nurse Teleconference
Kyushu U
U Malaya
Singapore
Brisbane
Thailand
Team buildingTeam building
National RENEngineers
Local Engineer(Network &
Audio-visual)
The success depends on how good team you can make.
Medical Doctors
Medical Doctors
Local Engineer(Network &
Audio-visual)
National RENEngineers
Conclusions
1. Quality preservation of moving image transmission is essential in telemedicine.
2. R&E network has made the clear and smooth medical streaming possible with low cost.
3. Good time to foster continuous remote medical education programs in Columbia.
Let us start working together!