International Telemedicine Experiment between Japan and ... · Encoder MPEG4 Encoder Back up

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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

y.fujino@hco.ntt.co.jp

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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.