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

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

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

Adjusting DICOM specifications when using wireless LANs: The MedLAN example

Wireless networks will become increasingly useful in point-of-care areas such as hospitals, because of their ease of use and their flexibility. A system called MedLAN has been developed by the Central Middlesex Hospital and Brunei University to take advantage of the above desirable properties of WLANs for use in accident & emergency departments to broadcast live, high quality video images and sound over a LAN or the Internet. However, in many cases, the limited available throughput of such a WLAN system makes the use of high demanding specifications, such as DICOM, problematic especially when using no compression during transmission. In this paper we will present some practical results when combining low compression with wireless LANs. We will conclude with the assessment of images and sounds by several doctors showing that the system we have devised is very useful in this setting

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

Mobile consultant: Combining total mobility with constant access

Minimizing the time required for a medical consultant to offer his/her expert opinion, can be viewed as a life-saving procedure. We have designed and tested an integrated system that will allow a medical consultant to freely move either within, or outside the hospital, while still maintaining constant contact with the patients via videoconferencing and high-resolution imaging. The above system is explained in this paper, along with its advantages and its potential limitations. Conclusively, we demonstrate that such a system further increases the mobility of the medical consultant, while improving the healthcare service

Using HSPA to improve the telemedical links on a moving ambulance

As the demand for faster and more effective health care increases, there is a growing need to establish mobile, high-speed communications between a moving ambulance and a consultation point (usually a hospital). The recent addition of HSPA (HSDPA and HSUPA) into the UMTS suite provides higher bandwidth and reduced delays, making this choice ideal for real-time telemedical applications. In this paper, we will describe a set of scenarios that took place in a typical large city area, along with their equivalent results: a moving ambulance was linked with a consultation station using HSPA and several videoconferencing sessions were initiated. Best-case, worst-case and average scenarios were recorded. Furthermore, in areas where the UMTS reception was marginal, a repeater was placed on top of the vehicle to boost up the signal power and thus maintain the higher bandwidth. Finally, treating doctors were asked to evaluate the effectiveness of this system’s outputs, based on a variety of objective and subjective criteria

Mobile consultant: Evaluation of additional services

As the need for mobility in the medical world increases, newer systems and applications came to light; many of them based on wireless and mobile networks. PDA based systems were presented in the past, capable of videoconferencing and transmitting high quality images between a roaming consultant and a fixed point in the hospital. These systems not only had desirable characteristics but also incorporated additional services that were found of value: paging, Voice over IP calling, Internet, email, intranet, patient record update, etc. This paper presents an engineering and clinical evaluation of those additional services based on both objective and subjective criteria. It concludes that such complementary services can be desirable as they increase personnel mobility, utilize the hospital resources more efficiently while at the same time increase productivity and decrease the cost of hardware and communications

Mobile consultant: Combining total mobility with constant access

Minimizing the time required for a medical consultant to offer his/her expert opinion, can be viewed as a life-saving procedure. We have designed and tested an integrated system that will allow a medical consultant to freely move either within, or outside the hospital, while still maintaining constant contact with the patients via videoconferencing and high-resolution imaging. The above system is explained in this paper, along with its advantages and its potential limitations. Conclusively, we demonstrate that such a system further increases the mobility of the medical consultant, while improving the healthcare service

Use of 3G mobile phone links for teleconsultation between a moving ambulance and a hospital base station

The importance of this paper lays in its suggestion: minimise the time for the initial treatment of a patient. As soon as an ambulance receives a patient, a videoconferencing session can be initiated between the moving vehicle and a base station in a hospital where a medical consultant resides. The communication link is implemented using 3G networks. Effectively, the use of such a system can decrease fatality on patients being transferred to A&E, as expert opinion can be obtained straight away. This paper was repeatedly cited in IEEE papers and formed the basis for an EPSRC proposal that was recently submitted