T@HIS is a telemedical network connecting physicians and hospitals over a new-generation satellite network based on the recently launched AmerHis payload on the AMAZONAS satellite.
Within the project three remote clinics in Amazonas, Para states in Brazil have been connected to a referral hospital in Belém, the capital city of Pará. The dominant type of images transferred over the system is ultrasound images, acquired from portable or stationary ultrasound devices. The medical applications include general examinations as well as obstetric and gynecology. However the applied platform handles any imaging modality and particularly DICOM formatted data.
The state of Pará presents the rate of general mortality of 3,65 deaths in 1.000 inhabitants. The main reasons are the blood circulation diseases and birth associated diseases. The aim of the current medical implementation was to improve the access to medical resources, available only to rural cities from the isolated areas in Amazon in Para prefecture.
- Demonstrate the advantages of using Telemedicine applications to improve the health assistance provided to underserved regions,
- Demonstrate the advantages and feasibility of regenerative Satellite systems to provide and fulfil the interconnection needs of such telemedicine applications,
- Demonstrate the sustainability of the Telemedicine applications over satellite in regions with low telecom infrastructures.
The medical network in Pará has joined the T@LEMED medical network, in which two referral hospitals in Espiritos Santos (Mid Brazil) and Rio Grade do Sul (Southern Brazil) offer medical services over terrestrial and radio connection using the aforementioned medical platform.
The main benefits of the project are related to improving the health care offered in the remote locations of the Pará State. As compared to previously existing networks, which were using PSTN modem connections, T@His increases the transmission capacity of the network. This permits establishing videoconferences to facilitate teleconsult with the remote expert, increasing the number of consults and reducing the time needed to download the images. In addition, reliability of the network is also improved. If the project proves to be successful the experience can be extended to other hospitals in this or other areas under the Amerhis coverage.
The medical platform that will be deployed is based on TeleInViVo, a research project funded by the European commission. TeleInViVo encompasses a portable ultrasound device and a mobile laptop computer and provides various communication links for medical data exchange. Presently the application is enriched with a teleconference tool providing physicians with a real-time face-to-face communication. The software on the mobile computer is capable of acquiring medical ultrasound images from the ultrasound device and storing them in the local medical database.
The application offers DICOM viewer and communication functionality over TCP/IP networks. Within the project ultrasound images are the main application addition, however there is no restriction to use it with any other digital image or file transfer.
Connectivity between sites will be provided by means of AmerHis system, the first regenerative DVB-RCS satellite platform. It was designed as a response to cover the growing demand in multimedia broadband services and the adaptation of real-time services to the satellite world. AmerHis permits direct meshed communication between four coverage areas (Europe, South America, North America and Brazil), and also broadcast and multicast transmission, for example from one to all beams, thanks to its on-board packet replication capacity.
AmerHis DVB-RCS user terminals can transmit up to 4 Mbps and receive up to 8 Mbps allowing the deployment of any IP application (for example Internet/Intranet Access and Virtual Private Networks between terminals) and is interoperable with the terrestrial networks. The architecture of the system is based on different dynamic QoS classes to differentiate the traffic and to be able to offer different SLAs to customers.
The planning of the project has four phases:
- T@LEMED requirements definition to prepare the integration within the AmerHis system for the first month,
- In Factory tests of the medical equipment in a test bed in AAS-E premises for the duration of one month,
- First Deployment in a site and In Orbit tests with the real Amazonas satellite for a period of one month (after a successful previous phase),
- And finally the network will be extended to the rest of the cities providing service up to the sixth month of the project.
The installations of the RCS terminals were finalised in the four sites in October 2007:
Reference Hospital in Santa Casa
Remote sites: Breves, Portel, Gurupá.
Connectivity at Gurupá was lost and there are open actions to restore it. A spare ODU has been sent to the site, and an IDU is also on its way to Gurupá.
The Santa Casa MD's explained some fundaments of the telemedicine project to the two remote towns and the medical team discussed the type and volume of the exams to be transmitted to Santa Casa on a daily/weekly basis. The sites have agreed with the following schedule (Breves site to confirm preferences):
|Day of Week||Morning Shift||Afternoon Shift|
|Tuesday||(available to Breves)||(available to Breves)|
|Wednesday||(available to Breves)||Portel|
|Thursday||(available to Breves)||(available to Breves)|
Pilot operations will run until the end of April 2008.