Unit Ii Telemedical Technology 9: Multimedia-Text, Audio, Video, Data
Unit Ii Telemedical Technology 9: Multimedia-Text, Audio, Video, Data
Unit Ii Telemedical Technology 9: Multimedia-Text, Audio, Video, Data
Principles of Multimedia - Text, Audio, Video, data, Data communications and networks, PSTN,
POTS, ANT, ISDN, Internet, Air/ wireless communications Communication infrastructure for
telemedicine – LAN and WAN technology. Satellite communication, Mobile communication.
Media Size
Text 9.4KB
Graphics 2.8KB
Bitmap Picture 300-900KB
A4 15-247MB
Continuous Media – Bandwidth
Media Bandwidth
In a face-to-face consultation, a physician might use some combination of all five senses-sight, sound, touch,
smell and taste-to assess a patient’s condition.
The first three methods are by far the most common and the sensory data are transmitted directly from the
patient to the observer. In telemedicine, however, the sensory data are first converted into electrical impulses
for transmission to the remote physician. Methods to convert smell and taste stimuli into electrical signals are
still in the experimental stage and. while the sense of touch can be translated successfully into an electrical
equivalent, the reverse process is more difficult and not well understood. Hence. A teleconsultation relies
primarily on the two senses of sight and sound. The information (useful data) derived from these senses can be
divided into four types:
text and data;
audio;
still (single) images;
video (sequential images).
Table 3 gives telemedicine examples of these types along with their typical file size in kilo- or megabytes
following digitisation. The wide range of electronic files sizes from these sources suggests the need to match
the choice and performance characteristics of the telemedicine equipment to the clinical need. Under- and
over-specification of systems can otherwise lead to disappointment and premature abandonment of a promising
project.
Audio
The public switched telephone network (PSTN but sometimes known as the plain old telephone system, POTS)
can be used to transmit sound (e.g. speech) and establish a remote diagnosis. However, the quality (ease of
understanding) and bandwidth (capacity to carry information) of analogue telephony are seldom adequate for
medical applications. In contrast, digital signals can be transmitted over networks for large distances without
degradation. Digital signals can also be manipulated to improve system performance.
An analogue sound is digitised by sampling its amplitude at discrete time intervals to recreate the waveform.
The discrete nature of the digitization process introduces quantisation or amplitude round-off errors as the
digital sample value approximates the analogue signal at a given instant. The human ear detects this error as a
hissing noise and to reduce the effect the sample value should have a resolution of at least 1 in 65 536 (216),
giving a 16-bit quantisation error.
3.2.5 Video
Our perception of video is conditioned by television to the extent that a videoconference between patient or
carer and consultant is regarded as the normal practice of telemedicine. Where video is needed, for example. to
demonstrate a patient’s mobility after a hip replacement, it is usually sufficient to use a commercial
videoconferencing unit (Section 3.3.2) rather than the much more expensive broadcast television. The output
from such units approaches broadcast quality.
An important consideration for international teleconsultations is the compatibility of the analogue video
signals, and therefore the video equipment, in different countries. There are two widely used formats for
analogue video:
The National Television Standard Committee (NTSC) system adopted in North America and Japan, having
525 lines per picture and a frame rate of 30 pictures per second;
The Phase Alternating Line (PAL) system used throughout Western Europe and Australasia, having 625
lines per picture and a frame rate of 25 pictures per second.
Most modern television receivers and video recorders are able to convert signals from one standard to another.
The Common intermediate Format (CIF) is a format introduced to provide compatibility between NTSC and
PAL and offers a lower resolution of 288 lines per picture at 30 pictures per second.
Spatially shared: Devices can use the link simultaneously or Timeshare: Users take turns
Transmission Modes
There are three modes of transmission for data communications circuits:
In half-duplex(HDX) mode, each station can both transmit and receive, but not at
the same time. When one device is sending, the other can only receive, and vice versa. The
half-duplex mode is used in cases where there is no need for communication in both
directions at the same time; the entire capacity of the channel can be utilized for each
direction. Citizens band (CB) radio is an example where push to talk (PTT) is to be pressed or
depressed while sending and transmitting.
In full-duplex mode(FDX) (called duplex), both stations can transmit and receive
simultaneously. One common example of full-duplex communication is the telephone
network. The full-duplex mode is used when communication in both directions is required
all the time. The capacity of the channel must be divided between the two directions.
Network Models
Computer networks can be represented with two basic network models: peer-to-peer
client/server and dedicated client/server. The client/server method specifies the way in
which two computers can communicate with software over a network.
Peer-to-peer client/server network: Here, all the computers share their resources, such as
hard drives, printers and so on with all the other computers on the network. Individual
resources like disk drives, CD-ROM drives, and even printers are transformed into shared,
collective resources that are accessible from every PC. Unlike client-server networks, where
network information is stored on a centralized file server PC and made available to tens,
hundreds, or thousands client PCs, the information stored across peer-to-peer networks is
uniquely decentralized. Because peer-to-peer PCs have their own hard disk drives that are
accessible by all computers, each PC acts as both a client (information requestor) and a
server (information provider). The peer-to-peer network is an appropriate choice when
there are fewer than 10 users on the network, security is not an issue and all the users are
located in the same general area.
Dedicated client/server network: Here, one computer is designated as server and the rest
of the computers are clients. Dedicated Server Architecture can improve the efficiency of
client server systems by using one server for each application that exists within an
organization. The designated servers store all the networks shared files and applications
programs and function only as servers and are not used as a client or workstation. Client
computers can access the servers and have shared files transferred to them over the
transmission medium. In some client/server networks, client computers submit jobs to one
of the servers and once they process the jobs, the results are sent back to the client
computer.
Network Topologies
In computer networking, topology refers to the layout of connected devices, i.e. how the
computers, cables, and other components within a data communications network are
interconnected, both physically and logically. The physical topology describes how the
network is actually laid out, and the logical topology describes how the data actually flow
through the network.
Star topology: A star topology is designed with each node (file server, workstations, and
peripherals) connected directly to a central network hub, switch, or concentrator. Data on a
star network passes through the hub, switch, or concentrator before continuing to its
destination. The hub, switch, or concentrator manages and controls all functions of the
network. It also acts as a repeater for the data flow.
Bus topology: Bus networks use a common backbone to connect all devices. A single
cable, (the backbone) functions as a shared communication medium that devices attach or
tap into with an interface connector. A device wanting to communicate with another device
on the network sends a broadcast message onto the wire that all other devices see, but only
the intended recipient actually accepts and processes the message. The bus topology is the
simplest and most common method of interconnecting computers. The two ends of the
transmission line never touch to form a complete loop. A bus topology is also known as
multidrop or linear bus or a horizontal bus.
Ring topology: In a ring network (sometimes called a loop), every device has exactly
two neighbours for communication purposes. All messages travel through a ring in the
same direction (either "clockwise" or "counter clockwise"). All the stations are
interconnected in tandem (series) to form a closed loop or circle. Transmissions are
unidirectional and must propagate through all the stations in the loop. Each computer acts
like a repeater and the ring topology is similar to bus or star topologies.
Mesh topology: The mesh topology incorporates a unique network design in which each
computer on the network connects to every other, creating a point-to-point connection
between every device on the network. Unlike each of the previous topologies, messages sent on
a mesh network can take any of several possible paths from source to destination
Hybrid topology: This topology (sometimes called mixed topology) is simply combining
two or more of the traditional topologies to form a larger, more complex topology. Main
aim is being able to share the advantages of different topologies.
Network Classifications
One way to categorize the different types of computer netw ork designs is by their scope or
scale. Common examples of area network types are:
LAN - Local Area Network
WLAN - Wireless Local Area Network
WAN - Wide Area Network
MAN - Metropolitan Area Network
SAN - Storage Area Network, System Area Network, Server Area Network, or sometimes Small Area
Network
CAN - Campus Area Network, Controller Area Network, or sometimes Cluster Area Network
Local area network: A local area network (LAN) is a network that connects computers
and devices in a limited geographical area such as home, school, computer laboratory, office
building, or closely positioned group of buildings. LANs use a network operating system to
provide two-way communications at bit rates in the range of 10 Mbps to 100 Mbps. In
addition to operating in a limited space, LANs are also typically owned, controlled, and
managed by a single person or organization. They also tend to use certain connectivity
technologies, primarily Ethernet and Token Ring.
Metropolitan Area Network (MAN):
A metropolitan area network, or MAN, covers a city. The best-known example of a MAN is the
cable television network available in many cities. This system grew from earlier community
antenna systems used in areas with poor over-the-air television reception. In these early systems,
a large antenna was placed on top of a nearby hill and signal was then piped to the subscribers'
houses. At first, these were locally-designed, ad hoc systems. Then companies began jumping
into the business, getting contracts from city governments to wire up an entire city. The next step
was television programming and even entire channels designed for cable only. Often these
channels were highly specialized, such as all news, all sports, all cooking, all gardening, and so
on. But from their inception until the late 1990s, they were intended for television reception only.
To a first approximation, a MAN might look something like the system shown in Fig. In this
figure both television signals and Internet are fed into the centralized head end for subsequent
distribution to people's homes. Cable television is not the only MAN. Recent developments in
high-speed wireless Internet access resulted in another MAN, which has been standardized as
IEEE 802.16.
Wide Area Network (WAN).
A wide area network, or WAN, spans a large geographical area, often a country or continent. It
contains a collection of machines intended for running user (i.e., application) programs. These
machines are called as hosts. The hosts are connected by a communication subnet, or just subnet
for short. The hosts are owned by the customers (e.g., people's personal computers), whereas the
communication subnet is typically owned and operated by a telephone company or Internet
service provider. The job of the subnet is to carry messages from host to host, just as the
telephone system carries words from speaker to listener.
Monitor. to display video images either on a television or monitor according to the NTSC or PAL standards.
Camera: usually an auto-focus, auto-iris, single chip device with remote pan/tilt/zoom to capture information
from any part of the consultation room. The camera can be controlled locally or from the remote site.
Audio system, which needs surprising sophistication to make it an acceptable approximation to normal speech.
The system should provide automatic echo correction and allow full duplex conversation, i.e. the ability to
interrupt and be interrupted. It should also have automatic gain control so that listeners can hear no matter how
close or far a talker is from the microphone.
User interface to make the system easy to operate for all users. A mouse or some other push-button control
may be more acceptable than a keyboard.
The telephone infrastructure at that time could not support the required transmission rates and sales were poor
although the device was a clear 'proof of concept'. AT&T attempted to develop the idea in the late 1960s and
early 1970s, including some telemedicine applications that showed what might be possible if the technology
could be developed further.
The real breakthrough in mass-market terms was made in the early 1990s by Intel with its ProShare personal
videoconferencing product designed to operate over ISDN networks. The market has since expanded to include
PictureTel , VTEL and CLI, all of which offer a range of products and services to suit individual
requirements.
PSTN stands for Public Switched Telephone Network, or the traditional circuit-switched
telephone network. This is the system that has been in general use since the late 1800s.
The phones themselves are known by several names, such as PSTN, landlines, Plain Old
Telephone Service (POTS), or fixed-line telephones.
PSTN phones are widely used and generally still accepted as a standard form of communication.
Put simply, when you dial a phone number your call moves through the network to reach its
destination – and two phones get connected. To fully understand how a POTS actually works,
consider what happens when you dial a number from your own phone.
Step #1 – Your telephone set converts sound waves into electrical signals. These signals are then
transmitted to a terminal via a cable.
Step #2 – The terminal collects the electrical signals and transmits these to the central office
(CO).
Step #3 – The central office routes the calls in the form of electrical signals through fiber optic
cable. The fiber optic conduit then carries these signals in the form of light pulses to their final
destination.
Step #4 – Your call is routed to a tandem office (a regional hub responsible for transmitting calls
to distant central offices) or a central office (for local calls).
Step #5 – When your call reaches the right office, the signal is converted back to an electrical
signal and is then routed to a terminal.
Step #6 – The terminal routes the call to the appropriate telephone number. Upon receiving the
call, the telephone set converts the electrical signals back to sound waves.
This may sound complicated, but the thing to remember is that it takes a few seconds for your
call to reach its destination. This process is facilitated by using fiber optic cables and a global
network of switching centers.
PSTN – Understanding The Art of Switching
Now, let’s have a look at each of the four types of switching which take place at different levels.
A local exchange – which may consist of one or more exchanges – hooks up subscribers to a
PSTN line. Also known as a central office or a switching exchange, a telephone exchange may
have as many as 10,000 lines. All telephones are connected to the local exchange in a specific
area. Interestingly, if you were to dial the number of your supplier located in the building next to
yours, the call won’t leave your local exchange and will be routed to the supplier as soon as it
reaches the exchange.
The exchange then identifies the number dialed so it can route the call towards the correct end
destination. This process works as follows:
The first three digits of a phone number represent the exchange (the local switch), while the last
four digits identify the individual subscriber within that exchange.
This means that when you dial a number and it reaches your local exchange, your call is
immediately linked to the subscriber without the need for any further routing.
Also known as a junction network, a tandem office serves a large geographical area comprising
several local exchanges while managing switches between local exchanges.
Let’s say you dialed the number of a client who lives in the same city but in another suburb. In
this case your call will be routed to a tandem office from your local exchange, and the tandem
office will route the signal on to the local exchange near your client’s location.
A toll office is connected to all the tandem offices. For instance, if you have an office in another
city you’ll find that, whenever you dial that branch’s number, your call will be switched through
a toll office.
4. The International Gateway
International gateways manage international call switching, routing domestic calls to the
appropriate countries.
PBX
Large organizations with 40 or more employees usually go with a Private Branch Exchange
(PBX). A PBX converts your organization into a local exchange where all the phones in your
organization are connected and you get to enjoy a range of services such as call transfer, call
conferencing, auto attendant, voicemail, call hold, and more.
The PBX is connected to your local exchange. It routes external calls to a local exchange while
all internal calls are routed by your PBX.
A PBX is a combination of software and hardware, so it will cost you some serious bucks. It
comes with hubs, switches, phone adapters, routers, and several telephone sets. It is like creating
your own small exchange where your PBX handles switches internally.
Most businesses use PBX phone systems to manage calls because they are easier. However,
installing and managing a PBX is costly. The actual cost may vary depending on the number of
features you prefer to have and the complexity of the PBX. A massive, complex, and feature-rich
PBX will cost your business more than a simple PBX system with just some basic capabilities.
POTS is an acronym for plain old telephone service, which refers to the standard low
speed, analog telephone service that is still used by most homes and many businesses.
The term is sometimes used to distinguish that service from the newer
telecommunications services which are digital and have much larger bandwidths. These
include ADSL (asymmetric digital subscriber line), ISDN (integrated services digital
network) and FDDI (fiber distributed data interface).
POTS is basically an analog voice transmission phone system implemented over copper
twisted pair wires. It is the phone line technology most of us grew up with at home and is
exactly what you think it is: copper wires dangling overhead, carrying your voice from
one place to another.
POTS networks were created to facilitate voice communication over copper cables that
traversed countries and continents, and it has been the standard voice-grade telephone
system used by residences and businesses across the world since the 1880’s. But the
POTS most of us are familiar with is an upgrade over the rudimentary phone system
invented by Alexander Graham Bell.
The newer services provide some part of their channels for POTS while using most of
their bandwidth for digital data transmission. The newer services also make possible
added features such as call waiting or call forwarding.
POTS utilizes the lowest 4kHz of bandwidth on twisted pair wiring (i.e., conventional
low-speed copper wiring). Any service sharing a line with POTS (e.g., DSL) must either
use frequencies above POTS or convert POTS to digital signals and interleave them with
other data signals.
POTS, is a term which describes the voice-grade telephone service that remains the basic
form of residential and small business service connection to the telephone network in
most parts of the world. The system was originally known as the Post Office Telephone
Service or Post Office Telephone System. Today the term Plain Old Telephone Service is
used, after the services were removed from the control of national post offices.
The pair of wires from the central switch office to a subscriber’s home was called the
subscriber loop. It was typically powered by 40V(DC) and backed up by a large bank of
batteries in the central office, resulting in continuation of service during most commercial
power outages.
This 64Kbps service is a bi-directional, or full duplex, voice path with limited frequency
range of 300 to 3400 Hz: in other words, a signal to carry the sound of the human voice
both ways at once. Today, it is also used for internet access via a dial modem, DSL, fax,
credit card terminals, etc.
Users accessing the Internet with the same twisted pair copper wiring as is used by their
telephone are using a POTS connection. The TCP/IP (transmission control
protocol/Internet protocol) digital data from their computer or LAN (local area network)
is converted to analog format using a modem prior to transmission over the POTS.
The POTS setup has remained virtually the same for decades. There have been many upgrades to
usher components of the POTS telephone system into the digital era, but the copper wire
connection has weathered the storm.
As far as the mechanics of a POTS lines go, this phone service works by establishing a dedicated
circuit between Point A and Point B for the duration of a transmission.
Circuit Switching
Back in the old days, circuit switching was the reason you needed an operator’s assistance when
making calls.
In those days, operators would sit by one giant wooden switchboard, plugging copper wires into
a common patch panel. In the case of connections that required two exchanges, two operators
would go about simultaneously plugging the caller’s and receiver’s wires into the same inter-
exchange wire.
Long distance calls were unbearably costly because calling long distance was akin to renting the
use of a very long piece of copper wire each time you wanted to make a call.
Transistors
The transistor heralded the electronic exchange era, which slowly paved the way for the digital
network. Current phone lines have been upgraded to carry digital signals in the form of
“packets.” Packet-based technology does not dominate the transmission channel by demanding a
continuously open and dedicated circuit, unlike its analog counterpart. Rather, it uses the
underlying network to transmit voice (and data) messages independently through the switches. A
copper line is a bi-directional 64Kbps service capable of carrying human voice both ways at the
same time
Modems
This is a device that was designed to exploit the digital nature of the public switched telephone
network without overhauling your entire phone system. This should come as good news for
small business owners who are not planning to upgrade their analog communications systems
any time soon, especially considering the wealth of options available on the market.
NT1:
Physical and electrical terminal of ISDN at user
Isolates the user from the transmission technology of the subscriber loop
Line maintenance functions such as loop back testing and monitoring
Bit multiplexes various B and D channels m Supports multi-drop lines
Telephone, personal computer, and alarm on one NT1
NT2:
Digital PBX, LAN, Terminal controller Switching and concentration
It is a new set of integrated systems that can integrate many different communication services into a
single digital network capability called the Integrated Services Digital Network. ISDN is specially designed
for transmission of digital data and is about twice as fast as conventional telephone lines. It categorized
into two generations:
ISDN provide greater flexibility. The fundamental objectives of ISDN is that it be based on the telephony
network and gives much better audio quality and much faster data transfer. Future versions of ISDN-
Based Telemedicine system will include facilities for on-line interaction between practitioner and
specialist with simultaneous speech.
Internet technology
Internet technology created in 1969 at UCLA by US Department of Defense (4 computers) expanded
to include 50 research sites by 1972 interconnected with other private and public networks during
1970s and 1980s currently a privately run system.
Internet technology World-Wide Web (WWW) –invented by Swiss physicists in 1989 –access
improved through development of browsers (Mosaic, Netscape, Internet Explorer) –usefulness
improved through development of search engines (Yahoo, Infoseek, Alta Vista) –growing in
popularity (53.5 million US adults) .
Taking advantage of technology for medical care medical informatics –computerized patient records
(history, insurance claim processing) –integrated information management systems –expert systems
for advice or warnings –on-line journals and research reports .
Internet Patient Console Referral Hospital Step 1. Upload Information step2. Download Information Step
3. Post Suggestions Telemedicine Server Step 4. Receive Suggestion Telemedicine over web
e biosignal sensors are responsible for
acquiring the
physiological data (patient’s vital signs)
and transmitting
it to the signal processing unit. Several
studies are made
focusing only on designing these sensors
to be tiny in
size [], maintain patient mobility [],
and consume low
operating power to reduce battery size
which can last for
longer durations []. A collection of
wearable medical sensors
could communicate using personal area
network or body
network [], which can be even
integrated into user’s clothes
[]. At the next stage, sensor layer of
every remote monitoring
system is typically connected to the
processing device fo
e biosignal sensors are responsible for
acquiring the
physiological data (patient’s vital signs)
and transmitting
it to the signal processing unit. Several
studies are made
focusing only on designing these sensors
to be tiny in
size [], maintain patient mobility [],
and consume low
operating power to reduce battery size
which can last for
longer durations []. A collection of
wearable medical sensors
could communicate using personal area
network or body
network [], which can be even
integrated into user’s clothes
[]. At the next stage, sensor layer of
every remote monitoring
system is typically connected to the
processing device fo
e biosignal sensors are responsible for
acquiring the
physiological data (patient’s vital signs)
and transmitting
it to the signal processing unit. Several
studies are made
focusing only on designing these sensors
to be tiny in
size [], maintain patient mobility [],
and consume low
operating power to reduce battery size
which can last for
longer durations []. A collection of
wearable medical sensors
could communicate using personal area
network or body
network [], which can be even
integrated into user’s clothes
[]. At the next stage, sensor layer of
every remote monitoring
system is typically connected to the
processing device fo
e biosignal sensors are responsible for
acquiring the
physiological data (patient’s vital signs)
and transmitting
it to the signal processing unit. Several
studies are made
focusing only on designing these sensors
to be tiny in
size [], maintain patient mobility [],
and consume low
operating power to reduce battery size
which can last for
longer durations []. A collection of
wearable medical sensors
could communicate using personal area
network or body
network [], which can be even
integrated into user’s clothes
[]. At the next stage, sensor layer of
every remote monitoring
system is typically connected to the
processing device fo
The biosignal sensors are responsible for acquiring the physiological data (patient’s vital signs) and
transmitting it to the signal processing unit. Several studies are made focusing only on designing these
sensors to be tiny in size , maintain patient mobility , and consume low operating power to reduce
battery size which can last for longer durations . A collection of wearable medical sensors could
communicate using personal area network or body network [8], which can be even integrated into
user’s clothes . At the next stage, sensor layer of every remote monitoring system is typically connected
to the processing device for signal acquisition, processing, analysis, and formatting data to be sent to the
communication layer. The processing unit may evaluate patient status and trends in patient’s medical
condition. Processing unit can be PC , mobile phone , or embedded system (microcontroller, DSP
processor, and FPGA) . Many medical algorithms were developed in recent telemedicine studies to help
in patient diagnosis and early detection of cardiovascular diseases .
Health Care and the Internet
• Patients canAccess health care information
Join chat groups
Purchase drugs and other medical items
Consult a health care practitioner online
Informatics describes the development and use of information technology
Assign groups of students the task of finding examples of the Internet services mentioned.
Wireless Technology
Online Module
Telehealth – Wireless Communication -Multipath Propagation
• Signal can take many different paths between sender and receiver due to reflection, diffraction
and scattering
1G Wireless Systems
The geographical area divided into cells
Each with own antenna
Each with own range of frequencies
Served by base station - Transmitter, receiver, control unit to carry out actual radio
communications with the device
Adjacent cells on different frequencies to avoid crosstalk
Mobile Switching Center Controls all calls attached to this device, Maintains billing information
&Switches calls
PSTN Public Switched Telephone Network
4G Wireless systems
Highly integrated
High bandwidth / high-speed wireless
Highly compatible with wired network infrastructures
provides mobile ultra-broadband Internet access
Integration of multi-networks using IP technology
applications include mobile web access, IP telephony, gaming services, high-definition mobile
TV, video conferencing and 3D television.
A work to internet connections would most likely require broadcast network (LAN) with a connection to
the internet (packet switched network).
MERITS
• Cost reductions through sharing of information and databases, resources and network
services.
DEMERITS
Special security measures are needed to stop users from using programs and data that they
should not have access to;
• Networks are difficult to set up and need to be maintained by skilled technicians.
• If the file server develops a serious fault, all the users are affected, rather than just one user
in the case of a stand-alone machine.
There are three topologies of LAN Network
A Wide Area Network (WAN) connects two or more LANs, often over long distance.
ADVANTAGES OF WAN
• Covers a large geographical area so long distance businesses can connect on the one network.
• Messages can be sent very quickly to anyone else on the network. These messages can have
pictures, sounds, or data included with them.
• Expensive things can be shared by all the computers on the network without having to buy a
different peripheral for each computer.
DISADVANTAGES OF WAN
• Need a good firewall to restrict outsiders from entering and disrupting the network
• Once set up, maintaining a network is a full-time job which requires network supervisors and
technicians to be employed.
• Security is a real issue when many different people have the ability to use information from
other computers. Protection against hackers and viruses adds more complexity and expense.
Technologies Involved
• Medical Instrumentation
Sensing Bio-medical Signals,
Medical Imaging, Measurement of Physical Parameters e.g. Body Temperature, Pressure etc.
• Telecommunication Technology
Trans-receiver on different communication channels and network such as, on wired network,
wireless medium etc.
• Information Technology
Information representation, storage, retrieval, processing, and presentation.
Satellite communication in telemedicine is an application of satellites in medicine that resolves the issue of the
lack of professional healthcare in locations where it cannot be originally accessed . A patient can very well be
diagnosed regardless of long distances using telecommunication equipment that enables the health care specialist,
wherever they may be, to interact with the patient and local healthcare giver, thereby, providing almost accurate
diagnosis and treatment to an individual. Satellite communications transmits digital signals at a very high data rate
with low bit error rate . Satellite communication is the transmission of signals from one earth station to a satellite
in space orbiting in the galaxy which will in turn transmit the signals to another earth station .
The frequency bands are the L-Band, S-Band, C-Band, X-Band, Ka-Band and the Ku-Band [1]. For the purpose of
this research, the brief focus will lie on all with the exception of the S and X-BANDS.
Satellite communication has been adopted to allow telemedicine function globally. Telemedicine requires a high
bandwidth transmission for clear and quality digital signals for proper diagnosis and treatments. Satellite
communication has the ability to transmit at high frequencies and long distances, making it better than any other
communication technology that can be used in telemedicine.
VSAT IN TELEMEDICINE
VSAT (Very Small Aperture Terminals) is satellite communication system. As shown in Fig. 1, it comprises of a HUB
station that acts as an earth station for a group of VSATs in a network for transmitting signals to the satellite’s
transponder which will retransmit back to the earth station. VSATs are capable of providing high capacity links to
users providing 35- 45 Mbps internet backbone connectivity [3], [2]. The VSATs in a network are all connected to
each other via the HUB in a star topology network [3]. VSAT provides all the necessary connectivity including
videoconferencing, media streaming, real time video, IP multicast, where it does not necessarily mean that only a
single specialist from a location can interact with an emergency patient but, different health professionals from
different locations can interact with that patient at the same time. It also allows for immediate access to
information via the internet for medical research needed in the communication between doctors and patients in
remote area to the specialists in distant locations.
The concept of VSAT in telemedicine by ISRO (Indian Space Research Organization) consists of an integration of
medical software and computer hardware, medical equipment for cardiology, pathology, imaging and video
conferencing. At each hospital, the VSAT is installed, making it a VSAT network. Detailed information containing
medical history of patients are sent to the medical specialists, then diagnosis, and treatments can be given by
specialists via videoconferencing to the health care professional to carry out on the patient at the other hospital.
VSATs provide real time transmission media as required in telemedicine and are portable because of the very small
terminals. The cost of implementation is independent of the distance and volume of data and can provide 99.5-
99.9% availability in relation to the requirements [5]. VSAT option is much better than terrestrial communication in
terms of cost of wiring, availability of the network and installation. It is cheaper and easy to implement in rural
areas.
VSAT is capable of multiplexing video, voice and data on one connection [1].
VSAT is unaffected by natural disasters, geographical barriers and can be located anywhere, even in the middle of
the desert where satellite network is the only option.
VSAT does not provides a customized bandwidth depending on the requirement of the user.
Installation of VSAT takes less than a week and is cheaper in terms of time [1]. It is a scalable network, adding new
sites and reconfiguring existing ones takes only a few days.
The wide coverage and high availability of the network makes telemedicine an efficient way of medical access
which means if there are occurrences when telemedicine cannot be of aid to patients who require immediate
medical attention, it will be 0.1-0.5% of the time.
VSAT technology is also implemented in aircrafts and marine vessels, fulfilling the goals of telemedicine. Whereas,
it is almost impossible for terrestrial cabling to provide telemedicine service on sea and in air .
Data transmission rate is very important in telemedicine and can determine the survival of a sick patient especially
in emergency cases, to which satellite communication can provide it with the speed it needs in its functionality. This
saves a lot of time and money if the specialist needed to come and treat the patient personally because of a poor
speed internet access.
The availability of the satellite transmission is about 99.95% making it possible to for patients to receive medical
health care almost every time and any time of the year .
Satellites transmitting in the C-Band are very reliable and cannot be affected by rainfall, snow, or extremely terrible
conditions. Although, the case of mutual interference exists from terrestrial microwave users . There are now
solutions that converge the Ku-Band and the C-Band frequency bands . With this, telemedicine using the satellite
does not have to be dependent on weather condition.
Aircrafts also have the access to telemedicine via satellite communication. Telephone lines and other means of
communication are not as reliable as the high broadband transmission speed providing video and data services
associated to satellite transmission. It is a much more reliable, faster and safer way of saving lives by giving
instructions to doctors on board to carry out on patients .
Telemedicine on sea is only possible with satellite connectivity by attaching telemedicine devices to satellite feeds
for communication between doctor on ship and the healthcare specialist away . This is a much safer way of travel
since travels on water can take months before arriving the destination. If a crew or passenger were to fall ill during
those months, immediate treatments would be impossible, and the ship might have to make a stop at a closer port for
the patient to get access to healthcare. This is time wasting and can cause the shipping corporations to lose millions
of money in the long run .
Satellite communication is a frequency spectrum efficient method of broadcasting and can cover about 5.2-6.7% of
the total land area in the world with a single range of frequency and 100 W transponder in the BSS (Business
Satellite Services) and FSS (Frequency Satellite Services) band. Implementing a satellite network in telemedicine
with an efficient spectrum which can cover wide areas optimizes the network and saves cost.
Satellite transmissions can provide bandwidth greater than the needs of telemedicine unlike regular telephone lines,
or digital subscriber lines .
Satellite technology e.g. VSAT technology is not only important in the rural areas but, also important on sea and in
air where only the satellite connectivity is possible. Oceans, mountains, deserts are not obstructions in satellite and
transmission.
Mobile Telemedicine Unit
The telecommunication equipment for MTU allows transmitting results of medical examinations to
hospitals and receives corresponding conclusions, recommendations and instructions, plus providing
national medical centers and MTU with videoconference services. The telecommunication equipment
for MTU can be used for training purposes to teach local population about healthy life style, methods of
caring for sick persons, various social and other issues.
The MTU is equipped with a fast deploying ground satellite station (GSS) intended for transfer and
receipt of digital information through the allocated communication networks using channels of the
geostationary satellite. The station provides for delivery of information from any location within the area
serviced by the satellite, to central or intermediary stations-nodes of the communication network.
•
• Figure 1: Mobile Telemedicine Unit
The medical equipment of MTU allows conducting examinations necessary for effective
screening of population, including chest X-ray with the lowest possible exposure to x-ray
radiation, biochemical examinations and functional diagnostic.
This is equipped with registration, data acquisition and imaging devices. There are autonomous tools of
satellite communications, autonomous power supply systems and “life-support system” providing
comfortable working conditions for personal in any climate. The station provides collection and
exchange of ES information and the delivery of the decisions and commands directly to liquidators of ES
consequences.