Health and mobility: Current status and future paradigms

The movement of telemedicine to the wireless and mobile Internetable applications is imminent in the next few years. This migration from the desktop platforms to the wireless and mobile configurations will have significant impact on the future health care delivery system and their globalisation. The recent telecommunications and biomedical computing advances will significantly enhance the current methodologies of telemedicine and telecare systems. This editorial will present some of the evolutionary issues and important aspects that have to be considered in the developing technologies for the next generation of Internet and Third Generation of Mobile Systems (3G), geared for future telemedical applications. These will provide new dimensions to existing medical services and areas of outreach, that are not possible in the current generation and will have tremendous impact on how the health care delivery will be shaped for the 21 Century

Open-Source Telemedicine Platform for Wireless Medical Video Communication

An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings

Using handheld pocket computers in a wireless telemedicine system

Objectives: To see if senior emergency nurse practitioners can provide support to inexperienced ones in a Minor Injuries Unit by using a wireless LAN system of telemedicine transmitting images to a PDA when they were on duty. In addition, whether such a system could be sufficiently accurate to make clinical diagnoses with a high level of diagnostic confidence. This would permit an overall lower grade of nurse to be employed to manage most of the cases as they arrive with a proportionate lowering of costs. Methods: The wireless LAN equipment could roam in the Minor Injuries Unit and the experienced emergency Nurse practitioners could be at home, shopping or even at a considerable distance from the centre. Thirty pictorial images of patients who had been sent to the Review Clinic were transmitted to a PDA various distances of one to sixteen miles from the centre. Two senior emergency nurse practitioners viewed the images and opined on the diagnosis, their degree of confidence in the diagnosis and their opinion of the quality of the image. Results: the images of patients were sharp, clear, and of diagnostic quality. The image quality was only uncertain, as was the level of confidence of the diagnosis if the patient was very dark skinned. Conclusions: The wireless LAN system works with a remote PDA in this clinical situation. However there are question marks over the availability of enough experienced emergency nurse practitioners to staff a service that provides senior cover for longer parts of the day and at weekends

Performance of a wireless telemedicine system in a hospital accident and emergency department

The article version is the pre-edited accepted version of the paper which is entitled: Performance of a wireless telemedicine system: MedLANThis paper validates a medical videoconferencing system previously developed, called MedLAN. Besides the positive comments that medical consultants might have regarding a wireless videoconferencing system designed for use inside the A&E wards, a methodically and exhaustive clinical testing of such a system must take place before adopting such technology in a wider scale. Clinical testing using a wide number of patients, modalities and a number of medical consultants proved that the suggested system could operate effectively under most conditions and it would be beneficiary to the patients. After this clinical evaluation, a number of hospitals showed interest on installing such a system in their A&E wards

Emergency TeleOrthoPaedics m-health system for wireless communication links

For the first time, a complete wireless and mobile emergency TeleOrthoPaedics system with field trials and expert opinion is presented. The system enables doctors in a remote area to obtain a second opinion from doctors in the hospital using secured wireless telecommunication networks. Doctors can exchange securely medical images and video as well as other important data, and thus perform remote consultations, fast and accurately using a user friendly interface, via a reliable and secure telemedicine system of low cost. The quality of the transmitted compressed (JPEG2000) images was measured using different metrics and doctors opinions. The results have shown that all metrics were within acceptable limits. The performance of the system was evaluated successfully under different wireless communication links based on real data

Impact of Mobile and Wireless Technology on Healthcare Delivery services

Modern healthcare delivery services embrace the use of leading edge technologies and new scientific discoveries to enable better cures for diseases and better means to enable early detection of most life-threatening diseases. The healthcare industry is finding itself in a state of turbulence and flux. The major innovations lie with the use of information technologies and particularly, the adoption of mobile and wireless applications in healthcare delivery [1]. Wireless devices are becoming increasingly popular across the healthcare field, enabling caregivers to review patient records and test results, enter diagnosis information during patient visits and consult drug formularies, all without the need for a wired network connection [2]. A pioneering medical-grade, wireless infrastructure supports complete mobility throughout the full continuum of healthcare delivery. It facilitates the accurate collection and the immediate dissemination of patient information to physicians and other healthcare care professionals at the time of clinical decision-making, thereby ensuring timely, safe, and effective patient care. This paper investigates the wireless technologies that can be used for medical applications, and the effectiveness of such wireless solutions in a healthcare environment. It discusses challenges encountered; and concludes by providing recommendations on policies and standards for the use of such technologies within hospitals

Applications of medical wireless LAN systems (MedLAN)

This is a post-peer-review, pre-copyedit version of an article published in Journal of Medical Marketing. The definitive publisher-authenticated version "Konstantinos A. Banitsas, R.S.H. Istepanian, Sapal Tachakra. Applications of medical Wireless LAN systems (MedLAN). Journal of Medical Marketing, Volume 2, Number 2, 1 January 2002 , pp. 136-142(7)" is available online at: http://www.ingentaconnect.com/content/pal/jomm/2002/00000002/00000002/art00008.In this paper the Wireless LAN (WLAN) networking principals are presented along with some of the implementation scenarios dedicated for Accidents and Emergencies wards. Preliminary simulation results of the MedLAN concept are also presented together with ongoing and future work in this area

Wireless Medical Sensor Networks: Design Requirements and Enabling Technologies

This article analyzes wireless communication protocols that could be used in healthcare environments (e.g., hospitals and small clinics) to transfer real-time medical information obtained from noninvasive sensors. For this purpose the features of the three currently most widely used protocols—namely, Bluetooth® (IEEE 802.15.1), ZigBee (IEEE 802.15.4), and Wi-Fi (IEEE 802.11)—are evaluated and compared. The important features under consideration include data bandwidth, frequency band, maximum transmission distance, encryption and authentication methods, power consumption, and current applications. In addition, an overview of network requirements with respect to medical sensor features, patient safety and patient data privacy, quality of service, and interoperability between other sensors is briefly presented. Sensor power consumption is also discussed because it is considered one of the main obstacles for wider adoption of wireless networks in medical applications. The outcome of this assessment will be a useful tool in the hands of biomedical engineering researchers. It will provide parameters to select the most effective combination of protocols to implement a specific wireless network of noninvasive medical sensors to monitor patients remotely in the hospital or at home

Using digital watermarking to enhance security in wireless medical image transmission

This is the published version of the article. Copyright 2010 Mary Ann Liebert Inc.During the last few years, wireless networks have been increasingly used both inside hospitals and in patients’ homes to transmit medical information. In general, wireless networks suffer from decreased security. However, digital watermarking can be used to secure medical information. In this study, we focused on combining wireless transmission and digital watermarking technologies to better secure the transmission of medical images within and outside the hospital. Methods: We utilized an integrated system comprising the wireless network and the digital watermarking module to conduct a series of tests. Results: The test results were evaluated by medical consultants. They concluded that the images suffered no visible quality degradation and maintained their diagnostic integrity. Discussion: The proposed integrated system presented reasonable stability, and its performance was comparable to that of a fixed network. This system can enhance security during the transmission of medical images through a wireless channel.The General Secretariat for Research and Technology of the Hellenic Ministry of Development and the British Council

CAMMD: Context Aware Mobile Medical Devices

Telemedicine applications on a medical practitioners mobile device should be context-aware. This can vastly improve the effectiveness of mobile applications and is a step towards realising the vision of a ubiquitous telemedicine environment. The nomadic nature of a medical practitioner emphasises location, activity and time as key context-aware elements. An intelligent middleware is needed to effectively interpret and exploit these contextual elements. This paper proposes an agent-based architectural solution called Context-Aware Mobile Medical Devices (CAMMD). This framework can proactively communicate patient records to a portable device based upon the active context of its medical practitioner. An expert system is utilised to cross-reference the context-aware data of location and time against a practitioners work schedule. This proactive distribution of medical data enhances the usability and portability of mobile medical devices. The proposed methodology alleviates constraints on memory storage and enhances user interaction with the handheld device. The framework also improves utilisation of network bandwidth resources. An experimental prototype is presented highlighting the potential of this approach