Download - Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson
![Page 1: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/1.jpg)
Computing and the Developing World
CSEP 590B, Spring 2008
Lecture 3 - Telemedicine
Richard Anderson
![Page 2: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/2.jpg)
Administration
• Reading assignment
• Supplementary Readings
• Authentication– User: csep590b– Password: student
![Page 3: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/3.jpg)
Today’s class
• Kiosk Summary• High Bandwidth, High Latency Internet
– Data Muling
• Telemedicine• Wireless Long Distance Internet
![Page 4: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/4.jpg)
Highlights from Lecture 2
• Internet connectivity
• Kiosk Applications– Financial Contribution– Social Impact
• Case studies
• Viability of Kiosks– Income generation too low
![Page 5: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/5.jpg)
Kiosk Summary
• Holy Grail of ICTD
• Two fundamentally different cases– Build down from economic viability
• Akshaya
– Build up from nothing• LinkNet
![Page 6: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/6.jpg)
Remote Internet Access
• Technology Questions– Method of Connection– Level of service
• Bandwidth, Latency, Reliability
– Cost
• What are the connectivity demands of different applications
![Page 7: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/7.jpg)
Can the internet create rural business opportunities?
![Page 8: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/8.jpg)
Traditional Crafts Marketing
• Is a “direct from the village” internet based traditional craft business viable? Why or why not.
LUMSUWMS
![Page 9: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/9.jpg)
Technology Case Studies
![Page 10: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/10.jpg)
Sneaker Net
• What is the bandwidth of a single DVD carried between Africa and the US?
LUMSUWMS
![Page 11: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/11.jpg)
DakNet
• MIT Media Lab, First Mile Solutions, United Villages
• Ideas– High latency connectivity sufficient for many
applications– Vehicle based transport
• Rely on regularly scheduled transport
– Automatic wireless data transfer
![Page 12: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/12.jpg)
System model
• Vehicle has “Mobile Access Point”
• Kiosk has wireless access
• When vehicle in range of kiosk, data is exchanged
• Cost and power are low
• Leverage existing transportation routes
![Page 13: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/13.jpg)
Orissa Pilot, Busses
• Advantages of public busses
• Disadvantages of public busses
![Page 14: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/14.jpg)
Cambodia Pilot
• Internet connectivity for AAfc/JRF schools– 250 schools with computers– Pilot for 15 schools
• Motor scooters used to carry MAPs
• Costs– 15 schools with VSAT: USD 260,376– DakNet to share 1 VSAT: USD 39,979
![Page 15: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/15.jpg)
KioskNet
• S. Keshav, University of Waterloo• Minimum cost kiosk• Target: $100 PC (aka recycled PC)• Address
– Low cost– Low power– Recycled PCs– Minimum maintenance– Connectivity
![Page 16: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/16.jpg)
Full system deployment
• Kiosks– Low cost computers with Kiosk Controller
• Ferries– Mechanical Backhaul
• Gateway
• Proxy
• Legacy Server
![Page 17: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/17.jpg)
Technical Challenges
• Implementation of Delay Tolerant Networks (DTN), Integration with services
• Security model, Public Key Infrastructure
• Support boot from Kiosk Controller
• Maintenance– Secure software update integrated with data
ferry
![Page 18: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/18.jpg)
Kiosk SummaryOpen issues
• If you could fund a Kiosk Research Project what is the problem you would have the project investigate?
LUMSUWMS
![Page 19: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/19.jpg)
The Challenge of Telemedicine
![Page 20: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/20.jpg)
Tiered Health Care
• Teaching Hospitals
• Regional Hospitals
• District Hospitals
• Health Centers
• Health Post
![Page 21: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/21.jpg)
From the readings, what are the three most important problems addressable by ICT?
1.
2.
3.
Other problems
LUMSUWMS
![Page 22: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/22.jpg)
Important problems(summary)
1.
2.
3.
4.
5.
6.
![Page 23: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/23.jpg)
Telemedicine
• “Telemedicine is the ability to provide interactive healthcare utilizing modern technology and telecommunications”
• Specialist referral– You have a bad sore throat– Primary care physician arranges remote consultation with
ENT specialist– Audio video conference with medical records available to
the specialist– Special equipment – nasalpharyngoscope for real time
imaging sent to specialist– Facilitate scheduling and travel– Primary care physician participates
![Page 24: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/24.jpg)
Usage models
• Real-time– In or outpatient specialty consultation– Physician supervision of non-MD Clinician
• Store and Forward– Teleradiology– Images scanned, direct capture, digital camera– Dermatology, Ophthalmology, Pathology
• Home Health Telemedicine– Disease management– Assisted Living
![Page 25: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/25.jpg)
Telemedicine in the developing world
• Generally considering a broader problem– How can ICT improve care in remote regions
• Spanning greater divides– Travel time– Economic differentials– Expertise differences
• Constraints– Network connectivity– Electricity and other infrastructure– Financial
![Page 26: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/26.jpg)
Notable projects
• Aravind Eye Hospital– Remote exams through mobile van– Image based detection of diabetic retinopathy
• Black Lion Hospital, Addis Ababa, Ethiopia and Care Group Hospitals, Hyderabad, India– Expert consultation– Medical education– Fiber optic and satellite communication
![Page 27: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/27.jpg)
Telemedicine Summary
• Key questions: – Communication– Off the shelf applications?
![Page 28: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/28.jpg)
Upcoming Health Topics
• Medical Records
• Support for health care delivery
• Data Collection
![Page 29: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/29.jpg)
Network connectivity (again)
• High bandwidth, synchronous
• Low bandwidth, synchronous
• High bandwidth, asynchronous
• Low bandwidth, asynchronous
![Page 30: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/30.jpg)
WiFi-based Long Distance Networks
• Goal: inexpensive, high bandwidth connection
• Off the shelf, 802.11 b
• Directional Antennas– Modification of MAC layer protocol
• Example projects– Digital Gangetic Plains, IIT Kanpur– Aravind Eye Hospital, TIER Group, Berkeley
![Page 31: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/31.jpg)
Why 802.11?
• Commodity hardware– Inexpensive broadcast
• Wimax / Cellular– Expensive infrastructure amortized over large
user base
• Unlicensed spectrum
![Page 32: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/32.jpg)
Line of Sight
• Range of 10s of KM– Longest range ~ 300 KM
• Towers are a big issue– Use existing buildings– Avoid trees!
Height 10 15 21 24 27 30 35
Cost 100 150 800 950 1100 1850 5000
Costs from IITK, Height in Meters, Cost in USD
![Page 33: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/33.jpg)
Technical Issues
• Directional antennas
• Modify to support long distance– Change acknowledgement protocol
• Error detection / correction important issues
• Interference– Does not work well around other access
points
![Page 34: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/34.jpg)
Deployment Issues
• Maintaining antennas and relays– Antenna configuration– Remote equipment
• Development challenges while hacking commodity hardware
• Relying on the network while debugging the network– Back channels and recovery mechanisms
![Page 35: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/35.jpg)
Overall evaluation
• Aravind project demonstrates sustained bandwidth
• Utility in a production environment• Cost effective
– because alternatives are $$$
• Link throughput 5-7Mbps at 2% loss– 256 kbps (each way) for video conferencing
• Other deployments 500 kbps because of lack of clear line of sight
![Page 36: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/36.jpg)
Discussion
• What role do you expect long distance wireless to play in this field?
LUMSUWMS
![Page 37: Computing and the Developing World CSEP 590B, Spring 2008 Lecture 3 - Telemedicine Richard Anderson](https://reader036.vdocuments.us/reader036/viewer/2022062409/5697c0201a28abf838cd2216/html5/thumbnails/37.jpg)
Next Week
• Umar Saif– Rural Networking
• SMS Based Applications– Warana Unwired
• Homework Assignment– Design Exploration: SMS-based application