Shuji Shimizu, MD Chairman, Medical WG, APAN, Director, Telemedicine Development Center of Asia, Kyushu University Hospital, Fukuoka, Japan

Jan 14, 2013 at TIPS2013, Hawaii

Telemedicine : Where Medical community meets Network community

Telemedicine Doctors to patients

Examination Tele-surgery

Doctors to doctors Consultation Education

But, was NOT popular in medical community

Why not?

Remote education

• New diagnoses and therapies one after another • Continuous education for young doctors/students.

• Save time & travel expenses • Scalability: Easy repeat & Large audience

HUGE demands in education!

<Economical & Effective!>

Int’l Teleconf/Live demo

Expensive!

Satellite ISDN/Narrow

Poor image!

1990s

Situations dramatically changed in 2002

We use BIG Internet!

QGPOP

Big Broadband Network: Bandwidth 2G

Japan

Korea Good team

Key technologies DVTS (Digital video transport system)

Academic network (Research and education network)

2000s

Start of practical telemedicine

Casual setting Endoscopy live demonstration

Kyushu Univ. Nagasaki Univ.

(2006.8.21)

• Easy • Cheap

Big formal meeting: Live surgery

2006.4.13

Seoul => Fukuoka International Convention Center

High Quality

Another technical breakthrough

MCU for DVTS

2005

China-Japan Early Gastric Cancer Teleconference

Tokyo/JP Fukuoka/JP

Fudan U, Zhongshan Hosp/CN 2011.11.15 PUMCH/CN

Mutli-site DVTS

Video

KR

China

Gastric cancer

Thailand

India

Vietnam

Malaysia

JP

Taiwan

Singapore

Central & Latin America

Recovery Less cost Back to work

Endosc

Early

Admission Recurrence Death

Ope

Advanced

Diagnosis and treatment

Education for early detection is very important.

Surgical revolution: Endoscopic surgery Open Endoscopic

Japan Singapore

Philippines

France

China

Australia

Korea

2007.8

First connection to Europe @ APAN-Xian

• Germany • Italy • Belgium • Czech • Spain • Norway • Lithuania

TEIN

First to Cape Town in South Africa Kyushu U, JP

Cho Ray, VN

U Cape Town, ZA

2011.9.21 2011.3 VIDEO

2004.7

Sapporo

2004.1

Beijing

2004.12

2005.1

Tokyo

Bangkok

Shanghai

Singapore

Kuala Lumper

NUS

2004.7

2004.1

Brisbane

Manila Philippine U

Bandung ITB 2005.11

2005.6

Iwate 2005.7

2005.11

Taichung 2005.11

New Dehli ERNET

2004.10

HaLong 2006.6

2006.7

2006.7

Taipei

Mumbai Tata MH

2003.2 Jilin

Jakarta, UI

Hanoi

Melbourne Sydney

Auckland

2007.3

Canberra ANU

Hawaii

Ho Chi Min Cho Rai Hosp

2007.1

2007.1

Before 2005

After 2008 2006 - 2007

2007.1 Adelaide

Flinder’s Hosp

2005.11

2007.3

California

2007.1 Stanford, UC Irvine Hong

Kong

Brazil

Fukuoka Yokohama

Cairnes

Egypt Cairo U

2007.8 ＜Asia Medical Project＞

32 countries 205 institutions 325 events

Seoul

Europe

South Africa

Decade of DVTS

DVTS challenge to Latin America

Brazil/-3

• Jan 15 (Wed), 2013

• 8:30-10:00

• Endoscopy case

conference

Hawaii /-10(+14)

Chile/-4

Mexico/-3

UY/-3

APAN-Hawaii

1. Better quality with smaller bandwidth - better compression system - bigger commercial network 2. Mobile technology - anytime, anywhere

New Technologies 2010s

Generalization! H.323/Vidyo/DVTS

Pros & Cons: Medical viewpoints • HD-H.323 is the easiest to use, but all the stations

have to purchase costly equipment. And the movie quality is not good at multiple connection. There are some incompatibility problems among companies.

• Vidyo can be used with PC and receiving image quality is good even with multiple connections. But to send a video clip, they need to purchase special equipment. And camera is only for a small group.

• DVTS requires 30Mbps, and IEEE1394 gets much less popular. But movie quality is good at all the stations both for sending and receiving at multiple settings. Equipment is cheap and common.

Conclusions 1. Global telemedicine is now in practice

both in quality and cost, but there are still lots of hospitals who want to join.

2. There is no single solution to meet all the medical requirements yet, and so further development is awaited.

3. We sincerely appreciate the continuous support of collaborating engineering people.