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Wireless telemedicine (technology trends) May 5, 2004 ©2004 Gerhard Fasol www.eurotechnology.com 1 by Gerhard Fasol PhD Eurotechnology Japan K. K. www.eurotechnology.com Zurich, May 5, 2004 ©2004 Eurotechnology Japan K. K. All Rights Reserved Wireless TeleMedicine Technology Trends

Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

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Wireless technology revolutionizes the delivery of medical services. Japan is an early and intense adopter of wireless technologies and internet medical services. This presentation describes the impact of wireless technology development on tele-medicine from the Japan viewpoint. Presentation given at an investors event at the Zurich Stock Exchange.

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Page 1: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1

byGerhard Fasol PhD

Eurotechnology Japan K. K.www.eurotechnology.com

Zurich, May 5, 2004©2004 Eurotechnology Japan K. K. All Rights Reserved

Wireless TeleMedicineTechnology Trends

Page 2: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2

Executive SummaryBroadband wireless communications (3G and beyond) are in rapid development andpromise great opportunities to improve health care. Integration of internet access, JAVAprograms, 3Mbyte cameras with autofocus and lighting, GPS (satellite global positioningsystem), multi-application smartcards enable a great variety of innovative healthcareapplications. Generally mobile communications in Japan are 3-5 years in advance ofdevelopments in Europe. Studying mobile communications in Japan today give a goodindication for which developments to expect in Europe about 3-5 years from now.◆ Video telephony will allow delivery of generalist or specialist consultation at a distance, for

example at the location of an accident, in disaster area, in emergencies. A general practitioner canconduct an emergency video conversation with an emergency patient arriving at his/her practiceroom while he/she is out on a patient visit.

◆ Mobile phones with 3Mbyte cameras with autofocus and flashlight generate high quality images,which can be transmitted from the scene of an accident to a waiting operating team, orconsultation of distant experts.

◆ Many mobile phones in Japan have integrated GPS (satellite position determination) services.Integration of GPS into mobile phone handsets allow to monitor aged people and have manyapplications in nursing care and emergency care.

◆ Internet access to remote data bases, and integration of JAVA programs, multi-applicationsmartcards and sensors, enable mobile phones to be key component of innovative illnessmanagement programs, e.g. for diabetes, where a patient uses specialized mobile phones tomanage his/her illness continuously.

◆ Telemedicine applications are not only “high-end”, telemedicine also has important applications ineconomically challenged situations, e.g. in developing countries.

Page 3: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com3

IssuesTechnology state-of-the-art and trends◆ Radio layer: 3G state-of-the-art and WiFi integration

◆ Imaging and video◆ GPS integration

◆ Multi-application smart card integration◆ Optical diagnostics, bio-chips

Imaging and video:◆ projecting vision and expertise

Ubiquitous care and health management:◆ ubiquitous care

◆ positioning systems

Telepresence◆ Dr. Tachikawa: “what is the impact of SARS on telecommunications?”

◆ Deliver healthcare and consultations at a distance

Page 4: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com4

Technology:State-of-the-Art and Trends

Page 5: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com5

3G State of the Art & Trends (Japan)while 3G (UMTS) is in the introduction phase in Europe, 3G in Japan is alreadymainstream and in the second or third stage of upgrades towards 4G

200,00012 million3G/FOMA: 3 million (2004)(total subscr. 40 million)

Subscribers

384kbpsCDMA 20001x: 144 kbps

CDMA 2000 1xEV-DO: 2.4Mbps384kbps

HSDPA from 2005:handsets: 3.6 Mbpsnetwork: 14 Mbps

Data rates(downlink)

64 kbpsCDMA 20001x: 64 kbpsCDMA 2000 1xEV-DO: 144 kbps

64 kbpsData rates(uplink)

tests: June 2002commercial: Dec 20,2002

wCDMA

Vodafone

April 1, 2002

CDMA 2000-1x

from 28 Nov 2003:CDMA2000 1xEV-DO

KDDI/AU

tests: May 2001commercial: Oct 2001

start date

wCDMA3G Network

NTT DoCoMo

Page 6: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com6

DoCoMo’s 3G FOMA900i series (2004)

CCD + AUTOFOCUScamera 2.02 Mpixelrecord: 2.0 Mpixel

262,144 colors2.4 inch240 x 320

13,000 dpi

300hrs120minsTV:80mins

130gSH900i

CCD + AUTOFOCUS

camera 1.28 Mpixelrecord: 1.23 Mpixel

65,536 colors

2.4 inch

300hrs

140minsTV:90mins

130gP900i

Super Honeycombcamera 1.0 Mpixelrecord: 2.0 Mpixel

65,536 colors2.2 inch

300hrs140minsTV:90mins

115gN900i

camera 1.28 Mpixelrecord: 1.23 Mpixel

(fingerprint recognition)

Super Honeycomb

camera 1.0 Mpixelrecord: 1.92 Mpixel

Camera(stills + video)

262,144 colors2.2 inch

262,144 colors

2.2 inch

Main display

300hrs140mins

TV:90mins

300hrs

140minsTV:70mins

standbytalk

120gF900i

124gD900i

weight

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Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com7

3G Imaging and Video

Video telephony (32 or 64kbps digital data channel)◆ Quality probably not sufficient for most medical applications, where tissue

needs to be examined. Needs to be combined with still photographtransmission

◆ Maybe sufficient for general overview e.g. scene of an accident◆ Remote observation, e.g. care of seniors, or ill people, or observation of

children in care, nursing applications

Imaging (upload: 64kbps - 144kbps)◆ for DoCoMo’s FOMA-3G: maximum image size for sending over the wireless

network: 480 x 640 = 0.3 Megapixel◆ Applications:◆ emergency care, remote consultations, consult distant specialist at scene of

accident, …

Imaging (download: 384kbps - 2.4Mbps)◆ Applications:◆ remote support at scene of accident◆ remote consultation of patient data, remote consultation of supporting

materials

Page 8: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com8

3G vs WiFi

3G (3G = third generation mobile communications)◆ ubiquitous◆ 99% coverage of the country in the future (now in Japan)◆ towards flat data rate

WiFi, wireless LAN (LAN = Local Area Network)◆ Wireless LAN, local within one building◆ at specific locations◆ replaces ethernet

Note, that there is some discussion that Wireless LAN (WiFi) couldreplace 3G communications. In my view this will not happen: 3G andWiFi will cooperate, not compete. 3G gives ubiquitous access, whileWiFi only operates in certain locations as local networks. Someterminals will contain both 3G and WiFi radio access.

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Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com9

Picture Mail and GPS (Global Positioning System)Applications◆ Location of aged people or blind or handcapped people: the blind

person who has lost his or her way takes an image, determines theposition with GPS, sends this information to his friend, who canaccurately locate the blind person using the photograph and the GPSdata, and come to help.

◆ Police work: Japanese police in cooperation with the security firmSECOM has started to distribute GPS enabled security devices tovictims of stalking or other suspected crime to protect the victim,enable the victim to call for help, and also to enable the victim tocollect evidence for investigations.

More about camera-phones:◆ http://www.eurotechnology.com/store/camera-phone/

Page 10: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 0

GPS (Satellite Positioning) IntegrationKDDI/AU 3G “Infobar (November 2003)

CCCD-Camera0.31 Megapixel

stillss & movies

Lighht/Flash

2inch132 x 176 pixel65,536 colorTFT display

GPS3G (144kbps)JAVA/BrewBattery: 200 hrs standby 150 mins talk

Page 11: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 1

KDDI/AU INFOBAR with GPS

(Images are taken with a P2102V camera phone with 640 x 480 pixel resolution)

Page 12: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 2

Demonstration of Picture Mail & GPS by AU/KDDIrecipient of the image finds the URL to the mapbelow, which shows the location where the picturewas taken (the map is interactive and enlargedmap images zooming into the neighborhood canbe selected)

Image of a AU5302CA handset taken by aAU5302CA handset.640 x 480 pixel (VGA format option fordisplay on PC)

5302CAincludes GPSsatellite globalpositioning

photograph canbe sent with theURL leading to amap with theactual positionwhere the picturewas taken

Page 13: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 3

BioMetric Sensor (DoCoMo F505i by Fujitsu)

Page 14: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 4

Multi-Application Smart Cards integrated into PhonesConcept: up to 40 applications stored in a secure Smartcard in the mobile phone with internet accessSecure wireless access online or offline transactionsJAVA applications have secure access to FeliCa smartcardallows health data, etc to be safely stored in the mobile phone with remote access to server

More about wallet phones and multi-application smartcards:◆http://www.eurotechnology.com/store/walletphone/◆http://www.eurotechnology.com/store/suica/

Page 15: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 5

Imaging and Video

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Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 6

Imaging and Video Applications

■ Telepresence of experts in remote locations

■ Transmit images from the scene of an accident to the operationroom to allow preparations

■ Remote viewing of patent data, images, background information,access to data base, consulting of back-up experts etc.

■ 3G phone can be linked to video-interphone at entrance ofpharmacy, practitioners’ practice. Scenario:◆ Country doctor is called to attend to a patient. While he is out

attending a patient, an emergency case arrives at his practice. Withthe 3G phone the Doctor can answer the door video phone andinterview the emergency patient who has arrived in his absence at thepractice

■ Scenario (not so much talked about…):◆ Deliver healthcare to prisons, difficult circumstances, economically

challenged situations, disaster areas, emergency care, etc…

Page 17: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 7

Ubiquitious Care andHealth Management

Page 18: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 8

Ubiquitious Health Care

■ i-mode (mobile internet) based health managementsystems, e.g. implemented in the mass market in Japan◆Diabetes management system

◆Conception/contraception (base temperature) management

■more about i-mode and mobile internet:◆http://www.eurotechnology.com/store/imode/

■Can be combined with:◆Sensors

◆GPS

◆Smart cards

◆Remote data base

◆Video link to responsible doctor

Page 19: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com1 9

Some Characteristic DifferencesBetween The Mobile

Communications Industry in the“GSM World” and Japan

Page 20: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 0

Some Characteristic Differences BetweenJapan and the “GSM World”

Nokia & VodafoneDoCoMoWho are the 5000pound Gorillas?

Equipment manufacturers (e.g. Nokia,Siemens, Ericsson…)

Carriers (DoCoMo, J-Phone, AU/KDDI)Who is in the drivingseat?

Technology focus - brands are abbreviations:“GSM”, “GPRS”, “SIM” , “UMTS”

Consumer focus: “ I-mode”, “ sha-mail” ,“ movie-mail” , FOMA, “H”

Brands

very high (around 20%-30%)very low (around 1% to 2%)Churn

low - typically: subscriptions: US$ 30prepay: US$ 10

high - typically: US$ 80/monthARPU

Prepaid dominatesAlmost only monthly creditsubscribers, almost no prepaid

Prepaid vs. credit

Corporate executives (“busy executive in theairport business class lounge”)

Consumers (“ young people havingfun on the beach” )

Marketing focus

Nokia dominatesMany manufacturers competeHandsets

Single Standardized radio networkMany competing radio networksNetworks

GSM-WorldJapan

Page 21: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 1

ARPU (Average Revenue per User/Month) in Japanis a lot higher than in other countries

Total US$ 29.3 6/monthCredit: US$ 47.75

Prepay: US$ 12.2 9

Vodafone D2

(ex-Mannesmann)

Total US$ 66.50/monthvoice: US$ 52.40

I-mode: US$ 14.10

Prepay: ? (very small number of users in Japan)

DoCoMo

ARPUCarrier

Page 22: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 2

Japan vs “GSM World” -> Trends

SMSMMS, WAP

i-mode (full mobile internet) + full emailwireless data

yesyes, to be integrated with 3G, 4GWIFI -HotSpots…

?R&D, testing4G

UMTS (=wCDMA)-

1. wCDMA (DoCoMo + J-Phone/Vodafone)2. CDMA 2000-1X -> WIN (KDDI/AU) download:2.4Mb/s3. Upgrades to 14Mb/s planned for 2005

3G

does not exist inEurope

full ubiquitous low-price wireless internetaccess (128 kb/s) + voice

2G - PHS

GSMGRPS-

PDC (DoCoMo + J-Phone)PDC-DoPa packet data serviceCDMA (AU)

2G

GSM-WorldJapan

Page 23: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 3

SummaryThird generation (3G) wireless communications already today allow transmissionof data at up to 2.4 Mbps in Japan, and we expect that similar transition rateswill become available in Europe in the future.Integration of internet access, JAVA programs, 3Mbyte cameras with autofocusand lighting, GPS (satellite global positioning system), multi-applicationsmartcards enable a great variety of innovative healthcare applications.Generally mobile communications in Japan are 3-5 years in advance ofdevelopments in Europe. Studying mobile communications in Japan today give agood indication for which developments to expect in Europe about 3-5 yearsfrom now.We expect these new developments to enhance medical care. Some examplesof new services are:◆ Video telephony for remote consultation◆ Transmission of high-quality photographs from scenes of accidents or for remote

consultation◆ Access to data base during a patient visit or from an emergency location◆ Using mobile phones with bio-sensors, GPS, JAVA programs, multi-application smart

cards by chronically ill patients for managing their illness on a continuous basis, e.g.diabetes or heart disease

◆ Telemedicine applications are not only “ high-end”, telemedicine also has importantapplications in economically challenged situations, e.g. in developing countries.

Page 24: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 4

More information:We publish insights and market reports in our online store:

◆ http://www.eurotechnology.com/store/

i-mode◆ “Understanding i-mode and how it drives the wireless internet industry” (version 5

of August 25, 2003) http://www.eurotechnology.com/store/imode/

Camera phones◆ “Camera phones and wireless imaging: disruptive innovation for the photographic

industry” (version 4 of January 14, 2004)http:/ /www.eurotechnology.com/store/camera-phone/

Wallet Phones◆ “Wallet phones - internet phones with smartcards” (version 3 of March 3, 2004)

http:/ /www.eurotechnology.com/store/walletphone/

Wireless Japan 2003 trade show◆ “Wireless Japan 2003 trade show” (version 1 of July 23, 2003)

http:/ /www.eurotechnology.com/store/wirelessjapan2003/

Blue laser report◆ “Blue and white GaN light emitters and lasers for lighting, displays, data storage,

and traffic signals - background and implications” (version 6 of April 21, 2004)http:/ /www.eurotechnology.com/store/bluelaser/

Page 25: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

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©2004 Gerhard Fasol www.eurotechnology.com2 5

aboutEurotechnology Japan Corporation

www.eurotechnology.com

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Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 6

About Eurotechnology Japan Corporation

We are the only European company in Tokyo 100% focused ondeveloping high-tech business between Europe-Japan and US-JapanProjects:

◆ Market research, strategy development, business development◆ Spin-outs, incubation of Japan-subsidiaries◆ Restructuring, acquisitions, corporate finance, corporate transactions◆ Technology business development, development of licensing business

Customers: Siemens, NTT, Electronics for Imaging, Cubic, DeutscheTelekom, Asahi Glass, Schott Glass, UNAXIS, and many more largeand small corporations from US, Europe and JapanMore information:

◆ http://www.eurotechnology.com/Contact us:

[email protected]◆ Tel. +81-3-6717-4160

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Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 7

Thank You

We are looking forward toworking with you

Page 28: Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004

©2004 Gerhard Fasol www.eurotechnology.com2 8

Eurotechnology Japan K. K.Shinagawa Intercity Tower A 28F2-15-1 Konan, Minato-kuTokyo 108-6028, JapanTel. +81-3-6717-4160FAX +81-3-6717-4141 and +81-3-5477-7044http://www.eurotechnology.com/[email protected]

CEO: Gerhard Fasol, [email protected]: +81-90-8594-6291