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International Telemedicine
Experiment between Japan and
Thailand
Nippon Telegraph and Telephone Corp.
Research and Development Planning Dep!.
and
Service Integration Labs.
Yuichi Fujino
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Outline
! Background! Broadband Network in Japan
! Next Generation Network
! A Telemedicine experiment between Japanand Thailand! Asia Broadband Network Experiment
! Proposed Annotation function concept
! Telementoring experiment using VR simulator andreal tissue with annotation function
! Telesurgery experiment
! Summary
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Broadband access users in Japan
Ministry of Internal Affairs and Communications
Mill
ion lin
es
9.6
27.0
FTTH users are 9.6 million
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Comparison of Network Charge (per 100kbps)
"#$%"&'()&('%*(+,)'-%.//01"&'()&('%#23&4-%5(+6%.//0
US$Network Charge (per 100kbps)
Japan
US
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Issues for Network Operators
Reductions in investment and operation costs and a revenue
shift from POTS to broadband are needed.
"Promotion of Broadband UbiquitousService -> Revenue Shift from POTS
New RevenueSources
POTS*Revenue
Cost "Migration to IP-based Networks ->Reduction of CapEx/OpEx
"Achievement of FMC and Triple Play-> Gain and Keep Market Share"New Business Development ->Market Expansion
*: Plain old Telephone Servicetime
cost
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A Telemedicine Experimentbetween Japan and Thailand
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Asia Broadband Experimental Network
45Mbps International connectivity
ThaiREN(ThaiSARN or
UniNET)
Kyushu Univ.
Asia BB NW
ChulalongkornUniv.
*JGN7%<Japan Gigabit Network 78Open test-bed network for research anddevelopment, sponsored by NICThttp//www.jgn.nict.go.jp/e/index.html
JGN7
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Proposed New technologiesfor telemedicine
! We have proposed! A secure network storage and distribution system using
iSCSI
! Tele-annotation system
! We have tested! MPEG4 scalable video CODEC in order to watch ROI
part
! Low latency MPEG2 video CODEC
! Low latency H.264 video CODEC
! In this session, I will show you a detailed tele-annotation system.
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Local Annotation System Configuration
Custom Keyboard
Tablet
Display
Microphone
9:
Video Mixer
Matrix Switch
Endoscope1 Endoscop2 Endoscope3
Custom Keyboard
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Annotation PC
Drawing
Application
Matrix Switch
Control Application
Down
Scan
4x4
Matrix
Switch
Video
Mixer
Tablet
Display
Up
Scan
Custom
keyboard
Small
Display
Endoscope1
Display1
Speaker1
Endoscope2
Display2
Speaker2
Endoscope3
Display3
Speaker3
Splitter
Splitter
Splitter
USB
Microphone
USB
NTSCAudioVGA
RS-232C
Small
Display
Small
Display
“Local” Annotation System Configuration
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JGNII
CODECCODEC
MIXER
AP Sharing(master)
DATA transmit
MIXER
AP Sharing(Slave)
DATA receiveTablet Display
Endoscopiccamera
Thailand sideJapan side
Tele-annotation System Concept
; Easy to use
; Draw simultaneously
; Simple control box
12Annotation PC (Master) Annotation PC (Slave)
application sharing application sharing
Drawing
Application
Drawing
Application
Transmitter Receiver
Matrix Switch Matrix Switch
JGNII
CODEC
CODEC
Down
Scan
Storage
Server
Endoscope1
Endoscope2
Matrix Switch
Video
Mixer
Display2
CODEC
CODEC
Down
Scan
Client2
Matrix Switch
Video
Mixer
Display3
(with Tablet)
Up
Scan
Custom
keyboard
Small
Display
Small
Display
Small
Display
Down
Scan
Down
Scan
Down
ScanClient1
Down
Scan
Controller
Network
NTSC/PALVGA
USB/RS-232C
Secure Storage and Distribution System
Display1
Tele-annotation and Secure Storage Distribution System Configuration
Thailand sideJapan side
Storage
Encoder2
Storage
Encoder1
Annotation System
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Telementoring using VR Simulator
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Result of Telementoring usingEndoscopic VR Simulator
NSP < 0.05 P < 0.05
Telementoring with virtual-reality-based training can be effective
for the development of laparoscopic suturing skills.
Start - keep a needleKeep a needle - insert a needleInsert a needle - make a first tieMake a first tie - make a second tieSuccess rate
Start - keep a needle Keep a needle - insert a needle Insert a needle - make a first tie
Conclusion
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A Scene of Tele-mentoringusing a training box
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A Scene of Tele-mentoring with real tissue
Chulalongkorn University side
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A Scene of Tele-mentoring(Japan side)
Tablet displayStylus penCustom keyboardDisplaying an operating
room at Thailand side
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A Scene of Tele-mentoring (Video)
19Video Phone Video Phone
ROBOTROBOT
(Master)(Master)ROBOTROBOT
(Slave)(Slave)
Camera
(reserved)
MPEG4
Decoder
Circumstances image of
Chulaloncorn University
Operator
Endoscopic
Camera
Endoscopic
image
(For Doctor)Endoscopic
image
(For Residents)
MPEG2
Encoder
MPEG4
Encoder
Back up<single channel=
alternative
Doctor’s hands image
at Chulaloncorn University)
Camera
(On doctor>- hands)
Endoscopic
image
(reserved)
MPEG2
Decoder
MPEG2
Decoder
Assistants
Camera
Circumstances Image
of Kyushu University
(For Doctor)SwitcherMPEG2 LL
Encoder
Circumstances of
Kyushu University
(For Residents)
MPEG2 LL
Decoder
MPEG2
Encoder
MPEG4
Enc/Dec
Chulalongkorn University Kyushu University
<For Stuff Communication=
Asia BB NW and JGN!
ThaiREN
(ThaiSARN
or
UniNET)
6Mbps
MPEG4 Scalable
(3 - 10Mbps)
6Mbps
6 - 4Mbps
?@A?BKbps
0.5 - 1Mbps
Telesurgery System Configuration
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Telesurgery Experimentbetween Japan and Thailand
Thailand Side
Japan Side
Animal Center in Medical Center of Kyushu University
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A Scene of Telesurgery
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Summary
! The telemedicine system enables a more effective medical andhealthcare treatment over broadband network.
! We have developed the tele-annotation and secure storage systemand also have tested some video CODECs.
! From the results of our subjective evaluation test, we have confirmedthe most suitable video CODEC is H.264 and it’s bandwidth is about3Mbps.
! We are carrying out an international experiment in telemedicinebetween Kyushu University in Japan and Chulalongkorn University inThailand, and we have verified some functions.
! Our annotation system is effective not onlly in a telemedicine field butalso in a tele-education field.
! We believe that ICT and NGN will contribute to the development andexpansion telemedicine, tele-healthcare treatment.