Need for Data Compression

Objective of Data Compression:

 Data compression aims to reduce disk space requirements for storage and decrease bandwidth usage
on data transmission channels.
 It minimizes redundancy in stored or communicated data, thereby increasing effective data density.
 Used in communication equipment (modems, bridges, routers) to enhance throughput over phone or
leased lines.
 Applied to compress voice telephone calls on leased lines to accommodate more calls.
 Essential for videoconferencing applications over data networks.

Compression Ratio:

 The figure of merit for data compression is the "Compression Ratio."

 Compression Ratio = Size of Compressed File / Size of Original Uncompressed File.
 Example: Compression Ratio of 4:1 means a file that originally took 100 kb is reduced to 25 kb
after compression.
Types of Data Compression
 Lossless Compression:
 Preserves all data during compression; uncompressed data is identical to the original.
 Used when exact reconstruction is required, such as in text files, archival storage, or critical financial data.
 Common in scenarios where even the loss of a single character is unacceptable.
 Compression ratios typically range from 2:1 to 8:1.
 Advantages: Preserves quality, exact duplication of original file during decompression.
 Disadvantages: Moderate compression ratios; no data loss.

Targets for Compression Algorithms:

 Lossless compression methods categorized based on the type of data they compress.
 Main categories: text, images, and sound.
 While general-purpose lossless algorithms can be applied to any data, some are more effective on specific data types.
Examples:
 GIF (Graphical Image Format) is an example of lossless data compression.
 Suitable for reducing file size without degrading visual quality, especially for images with up to 256
colors.
 GIF's 256-color limitation makes it less suitable for transmitting photographs.

Conclusion:
 Data compression is crucial for optimizing storage space and bandwidth, especially in applications like
videoconferencing.
 Lossless compression ensures data integrity but with moderate compression ratios.
 Lossy Compression
Assumptions and Characteristics:
 Operates on the assumption that data do not need to be stored perfectly, and some loss of information is
acceptable.
 Allows for the discarding of certain information from images, video data, and audio data.
 Acceptable quality is maintained after decompression, even with significant information loss.
 Enables compression ratios an order of magnitude greater than those achievable with lossless methods.

Example: Videoconferencing:
 Videoconferencing is a notable example where lossy compression is acceptable.
 Acceptable frame loss occurs to deliver real-time images, resulting in occasional jerky movements.
 Allows for real-time communication with some compromise in image quality.
JPEG (Joint Photographic Experts Group):
 Example of lossy compression standard developed jointly by ISO and ITU for compression and decompression of still
images.
 Primarily used for transmitting still images on the World Wide Web.
 Offers higher compression ratios compared to other formats while maintaining good image quality.
 Commonly achieves compression ratios in the range of 10:1 to 20:1.
 Preferably used for compressing 24-bit color or 8-bit grayscale images, making it suitable for digital photographs.

Conclusion:
 Lossy compression is suitable in scenarios where some loss of information is acceptable, such as in videoconferencing.
 JPEG is a widely used lossy compression standard, providing high compression ratios for still images while
maintaining satisfactory quality.
 The compromise in detail is outweighed by the benefits of reduced file size and efficient data transmission.
 Transmission of Video Images:
Overview:

 Video transmission involves sending a sequence of still images rapidly (25 to 30 frames per second) to create the
illusion of motion.
 Digital video extends digital imagery, utilizing a series of images or "video frames" displayed in quick succession.
 Conventional analog television typically operates at frame rates of 25/30 frames per second.
 Images are obtained through direct visualization using video cameras, lenses, and optical adapters for various medical
applications.
 Charge Coupled Device (CCD) cameras are commonly used in digital imaging, capturing images with resolutions
ranging from 450 TVL to 700 Television Lines (TVL).

Digital Camera Operation:

 CCD sensors in digital cameras consist of pixels that accumulate electric charge in proportion to light intensity.
 Single CCD cameras offer resolutions of 450 TVL or higher, while 3-chip CCD cameras provide 700 TVL or higher.
 Video is captured frame by frame, typically in a 640 * 480 pixel format, with an intensity scale of eight bits for
monochrome and 24 bits for color.
 Digital data produced by a video image can have a rate exceeding 100 Mbps (Megabits per second).
Video Compression:
 Communication and storage limitations require compression to reduce the data rate.
 Video compression involves reducing redundant information in each frame.
 Special integrated circuits (codecs) are commonly used for video compression to enhance performance.
 Codecs operate at data rates between 336 kbps and 1536 kbps in telemedicine applications.
 Compression and decompression are carried out by codecs, identifying and removing spatial and temporal
redundancies.

MPEG Standards:
 MPEG stands for the Moving Picture Experts Group, established in 1988 to develop standards for digital audio and
video formats.
 MPEG has developed several video compression standards for international use.
 MPEG-1 and MPEG-2 are specifications for video compression, with the latter being an enhanced version.
 Five MPEG standards are used or in development, each designed for specific applications and bit rates.
 MPEG compression scales well with increased bit rates.

Conclusion:
 Video transmission in telemedicine involves the rapid display of still images to create motion.
 Digital cameras, especially CCD cameras, are commonly used for capturing medical images.
 Video compression is crucial for overcoming communication and storage limitations, with codecs playing a key role.
 MPEG standards are widely used for video compression, addressing various applications and bit rates.
 Transmission of Digital Audio
Overview:
 Audio channels are essential for diagnostic instruments like electronic stethoscopes and Doppler ultrasound in
telemedicine.
 Electronic stethoscopes require uniform frequency response from 20 Hz to 2 kHz, while Doppler ultrasound
needs it from 100 Hz to 10 kHz.
 Audio used for medical diagnosis in telemedicine must be digitized and compressed before combining with
video and other data.
 Typical audio compression algorithms operate at data rates from 16 kbps to 64 kbps.
 Higher fidelity diagnostic applications may require higher data rates, e.g., 120 kbps to reproduce the full auditory
frequency spectrum.
 ITU (International Telecommunication Union) recommendations cover video, audio, multiplexing, control,
multipoint services, security, and communication interfaces.

ITU-T Recommendations:
 ITU-T provides recommendations for various aspects of telecommunication, including video and audio.
 Details on these recommendations and related information are available on the ITU website
(http://www.itu.int/home/).
MPEG-1 Audio Compression:
 MPEG-1 is designed for low-bandwidth video data streams, suitable for multimedia CD-ROMs and
the Internet.
 MPEG-1 audio compression involves digitization of analog audio signals, dividing them into fixed-
size audio frames.
 Three levels of audio compression in MPEG-1 are designated as "Layer 1," "Layer 2," and "Layer 3"
(MP3).
 MP3, a popular format, employs a lossy, high-compression algorithm, significantly reducing file size
but compromising some data.
 MPEG Layer 2 audio compression includes both frequency and temporal masking, allowing temporal
comparisons.
Lossless and Lossy Compression:
 Lossless and lossy compressions are terms associated with MP3 music files.
 MP3, as a lossy compression, sacrifices some data for significantly smaller file sizes.
 Lossless compression retains all original data, providing higher sound quality but larger file sizes.

Windows Media Audio (WMA):

 Microsoft's WMA (Windows Media Audio) is an alternative to MP3, supported by default on Microsoft
Windows.
 WMA claims to offer higher compression ratios than MP3 with comparable quality.
 The popularity of Microsoft has made WMA a widely supported format in digital music players.

Conclusion:
 Digital audio transmission in telemedicine is crucial for diagnostic instruments, requiring digitization and
compression.
 ITU-T recommendations cover various aspects of telecommunication, ensuring standardized practices.
 MPEG-1 audio compression, with layers including MP3, is widely used for low-bandwidth applications.
 Lossless and lossy compressions, particularly in MP3 files, offer trade-offs between file size and sound
quality.
 Windows Media Audio (WMA), introduced by Microsoft, is an alternative to MP3 with claimed higher
compression ratios.
 Cyber Medicine
Introduction:

 Telemedicine has given rise to a mode of healthcare known as cyber medicine, often involving healthcare
delivery over the Internet.
 Both telemedicine and cyber medicine share methods of providing healthcare remotely, using technologies like
telephone lines.
Definition of Cyber Medicine:
 Cyber Medicine is defined as the discipline of applying internet and global networking technologies to
medicine and public health.
 It encompasses medical education, training, learning, and research.
 Cyber Medicine provides healthcare services through global networking, promoting medical practice,
commerce, scholarship, and empowerment.
 It involves human-centered computing, individualized medicine, and leveraging technology benefits
worldwide.
 In simpler terms, Cyber Medicine involves the use of the Internet to deliver healthcare services, education,
and information.

Various Definitions:
 According to Soe (2004), Cyber Medicine focuses on applying internet and global networking technologies
to various aspects of medicine and public health.
 Ndukwe (2005) defines Cyber Medicine as all medications via the internet, including doctor consultations,
seeking medicine information online, and ordering drugs from internet pharmacies.
 In summary, Cyber Medicine is seen as a tool for personalized healthcare.
Concept of Cyber Medicine:
 Cyber Medicine is illustrated as an academic specialty at the intersection of medical informatics and public
health, emphasizing medicine in cyberspace.
 It is associated with human-centered computing, individualized medicine, positive behavioral changes, and
leveraging technology benefits in global healthcare.

Focus Areas of Cyber Medicine:

 Eysenbach et al. (1999) emphasize that Cyber Medicine explores and exploits the internet for consumer health
education, patient self-support, professional medical education, and research.
 It includes evaluating the quality of medical information on the internet, understanding the impact of the
internet on the patient-physician relationship, and assessing the quality of healthcare.
 Global networking is utilized for evidence-based medicine in the realm of Cyber Medicine.

Conclusion:
 Cyber Medicine represents the application of internet and networking technologies to various aspects of
healthcare, education, and research.
 It involves delivering healthcare services and information globally, promoting individualized medicine and
leveraging technology for positive impacts on healthcare.
 Cyber Medicine is a dynamic field at the crossroads of medical informatics and public health, shaping the
future of healthcare delivery and accessibility.
 Types of Cyber Medicine
1. Information Oriented Sites:

 These websites provide medical information about various illnesses or drugs.

 Patients use these sites to gain knowledge about their conditions and
incorporate the information into their treatment approach.
 Reliability and authenticity of information on these sites may be questionable,
as some are sponsored by advertisers.

2. Consultation Sites:

 This type involves direct communication between cyber doctors and patients.
 Patients receive medical advice through online consultations, either through a
medical questionnaire or simultaneous videoconferencing.
 A consultation fee is usually charged, and after reviewing the patient's
information, the doctor may issue a prescription.
 Doctor, pharmacy, and patient can be located in different parts of the country or
the world.
 Ethical concerns include verifying the credentials of online doctors, ensuring
privacy of patient information, and addressing locational issues in case of
incorrect medical advice.
3. e-Pharmacy Sites:
 These sites function as online drug shops, selling drugs that may or may not require a prescription.
 Two types of drugs are sold: those without a prescription and those requiring one.
 Payments are typically made with a credit card.
 Ethical questions arise regarding responsibility for side effects, competency of pharmacy operators, sale of unapproved
drugs, and the absence of a doctor as an intermediary in the doctor-patient relationship.

Common Ethical Questions Across Cyber Medicine:

 Credentials of consulting doctors in online consultations.
 Locational information of cyber doctors in case of wrong medical advice.
 Privacy of personal information provided by patients.
 Responsibility in case of side effects of drugs sold online.
 Competency of pharmacy operators.
 Sale of unapproved drugs via the internet.
 The absence of a doctor as an intermediary in the doctor-patient relationship.
Challenges in Cyber Medicine:
 Quality of online information.
 Lack of standards in cyber medicine.
 Lack of social equity in accessing online healthcare information.
 The challenge of assessing the credibility of online information and its originators.

Benefits of Cyber Medicine:

 Internet provides access to valuable information on current medical research.
 Patients are becoming more informed, putting pressure on doctors to stay updated.
 Well-informed patients actively participate in their treatment.
 Patients have access to extensive databases, contributing to increased consumer knowledge.
 Promotes higher quality standards and evidence-based medicine.
Issues in Cyber Medicine:
 Quality of online information.
 Lack of standards.
 Lack of social equity.
 Anyone can be a publisher on the internet, leading to potential credibility issues.
 Difficulty in assessing the credibility of information originators.

Conclusion:
 Cyber Medicine encompasses various types, each posing unique ethical questions and challenges.
 While patients benefit from increased access to information, concerns about reliability, privacy, and ethical
practices need careful consideration.
 Addressing these issues is crucial for the responsible development and practice of Cyber Medicine.
 Cyber Medicine vs. Telemedicine:

1. Distinctive Nature:
 Internet is used for both cyber medicine and telemedicine, but they have distinctive characteristics.
 Telemedicine involves restricted exchange of clinical data, primarily between patients and physicians.
 Cyber medicine deals with a global exchange of open, non-clinical information, often between patients and
patients, and sometimes involving patients and physicians or physicians and physicians.

2. Participants and Information Exchange:

 Telemedicine primarily involves the exchange of clinical data between a limited number of participants, mostly
patients and physicians.
 Cyber medicine involves a broader global exchange of non-clinical information, with interactions between
patients, physicians, and sometimes exclusively between patients.

3. Historical Development:
 Telehealth technology has been developed within the medical profession for an extended period.
 Integration of classic telemedicine and telehealth technologies with the internet represents the next logical step.
4. Current Landscape:
 The integration of technology is leading to significant growth.
 Specialized websites already exist for various functions such as billing, back-office tasks, marketing, medical
records processing, communications, and the provision of medical supplies and equipment.

5. Concept of "eHealth":
 The term "eHealth" has emerged to describe healthcare services available through the internet.
 Similar to the development of "eCommerce" for the business world, eHealth is a preferred term for online
healthcare services.

6. Patient-Hosted Websites:
 Patients suffering from complex diseases often host websites for the benefit of other patients.
 These websites, like the inkanet health portal in Germany, play a significant role in providing self-help resources
and information to patients.

7. Evolution Over Time:

 The concept of cyber medicine has been practiced since the establishment of email.
 The term "eHealth" has gained prominence, signifying the evolution and integration of healthcare services with
internet technology.
8. Example of Inkanet Health Portal:
 Anja Forbriger launched the inkanet health portal in Germany, a crucial self-help website for cancer
patients.
 Patients like Anja, who have survived complex diseases, advocate for internet access for all patients in
hospitals as a fundamental right.

Conclusion:
 While telemedicine and cyber medicine share the use of the internet in healthcare, they have distinctive
features and applications.
 Telemedicine focuses on clinical data exchange between a limited number of participants, while cyber
medicine involves a broader global exchange of non-clinical information.
 The integration of technology and the emergence of eHealth signify the evolving landscape of healthcare
services in the digital age.
 Applications of Telemedicine

Introduction
 Telemedicine bridges healthcare gaps, particularly in remote
areas.
 Vital in emergency cases, ensuring timely medical responses
and specialized care.

Diverse Medical Specialties

 Radiology, dermatology, cardiology, pathology, psychiatry, and
surgery embrace telemedicine.
 Integration of telemedicine facilities reshaping healthcare
delivery.

Telemedical Upgrade
 Medical disciplines adopting "tele-" prefix (e.g.,
telecardiology, teleophthalmology).
 Core feature: Transmission of images and/or data.
Telemedicine's Evolution
 Telemedicine as a distinct discipline in development.
 Continuous expansion of applications and identity.

Expert Advice in Remote Areas

 Telemedicine provides expert advice in rural dispensaries and small clinics.
 Addresses complex cases, offering valuable second opinions.

Telemedicine and Distance Learning

 Technology facilitates live, real-time, interactive videoconferencing.
 Connects physicians for educational purposes, from teaching procedures to ongoing professional education.
 Empowers patients with knowledge about medical conditions and treatment plans.

Conclusion
 Telemedicine extends beyond clinical consultations.
 Dynamic and evolving, impacting healthcare education, collaboration, and accessibility.

Future Prospects
 Continued integration into diverse medical fields.
 Advancements in technology and increased accessibility.
 Teleradiology
Definition and Scope
 Teleradiology involves electronic transmission of
radiological images for interpretation and consultation.
 Widely deployed telemedicine technology, mature and
established.

Image Transfer and Modalities

 Images transmitted digitally over standard telephone
lines or LAN.
 Modalities covered include X-rays, CT, MRI,
ultrasound, nuclear medicine, thermography,
fluoroscopy, digital subtraction, and more.
 Broader term suggestion: "tele-imaging.“
Film Digitizers
 Components at sending station: Image (film) digitizer and
network interface device.
 Three general categories: TV camera digitizers, CCD
scanner digitizers, Laser scanner digitizers.
 Differences: Image resolution, ease of use, cost.
Camera Digitizer Systems
 Utilizes light box and high sensitivity video camera with zoom lens.
 Inexpensive but produces poor results.

Film Scanners or Digitizers

 Convert analog information on X-ray film to digital data stream.
 Feed digital data stream to PC; resolution and color details mentioned.
 Two types: CCD-based scanners and laser scanners.

Digital Imaging Modalities

 CT, nuclear medicine, digital subtraction angiography, MRI produce direct digital images.
 Digital images advantages: high resolution, greater dynamic range, better color, manipulable.

Data Transmission
 Digital format data sent to modem for electrical impulse conversion.
 Data transmission methods: POTS, ISDN, switched-56, microwave, satellite, T1 links.

Receive/Image Review Station

 Components: Network interface (modem), PC with storage, TV monitors, optional printer.
 Modem converts electrical impulses back to digital image data.
 Radiologist performs software manipulation functions for image enhancement.
Hard Copy Imagers
 If printer attached, hard copy images can be printed.
 Two types: multiformat camera or laser printer.

Data Storage
 Teleradiology systems store data in non-compressed or compressed format.
 Disk size considerations for storage needs (Table ).
 Telepathology

Introduction
 Pathology: the science of diseases in
tissues and organs.
 Telepathology: remote diagnostic
service using transmitted microscopic
images.

Applications
 Telepathology applications:
telediagnosis, distant learning,
teaching, remote image processing,
and quality control.
 Telediagnosis importance:
intraoperative frozen section service,
remote expert consultation.
Telepathology Methods
 Two methods: Remote dynamic screening by robotic video microscopy and remote diagnosis from selected still
video microscopical images.
 Former requires high-speed telecommunication links, latter is cost-effective but with reduced data.

Components of Telepathology System

 High-resolution video camera (1000 * 750 pixels) on a microscope.
 Telecommunication setup for image transmission.
 Telepathology workstation: Computer, graphics card, color monitor, and image management software.
 Image capture board or card.
 Software for image acquisition, database storage, retrieval, and manipulation.

Microscope System Requirements

 Modular concept microscope upgradeable to phase contrast, dark field contrast, fluorescence (optional),
photomicrograph, and analysis.
 Binocular with fixed photo tube/1X, 30 deg. viewing angle, adjustable inter-papillary distance.
 Constant focus, beam splitter position vision/photo 50/50% fixed, universal condenser upgradeable for various
contrasts.

Camera Types for Image Acquisition

 Analogue camera: Requires frame grabber card, spatial resolution up to 600 lines, color resolution 24 bits.
 Digital camera: Direct connection, at least 1 million CCD elements, slower readout but higher image quality.
Digital Camera System
 Composition: C-mount CCD camera ½” image sensor with RGB 3 prime color filter, resolution 2.1 mega
pixels or better.
 Minimum illumination of 5 lux/F2.0 with an interface to the computer.

Telepathology in Medical Clinics

 Common application: Distance control of a computerized microscope in clinics without onsite pathology.
 Internet used for transmitting data and images for diagnosis.
 Figure illustrates telepathology using high-speed communication network.

High-Speed Internet Connection

 Gigabit fiber optic network for transmitting pathology results via high-speed Internet.
 Allows medical staff control over magnification, focus, and position of microscope image.

Current Uses and Future Trends

 Telepathology's significance in today's healthcare system.
 Growing importance in telemedicine with promising future trends.
 Telecardiology
Introduction
 Telecardiology: Transmission of cardiac data to a remote location from the patient site.
 Historical context: Telephones used for auscultating heart and breath sounds for over 70 years.
Technologies in Telecardiology
 Similarity with other specialties relying on clinical examination in telemedicine.
 Adequate transmission technologies at 256 or 384 kbps.
 Figure: Telecardiology system modes telephone network, GSM network, or satellite.

Store-and-Forward Application
 Recording and transmission of ECG for consultations.
 Transmission via standard phone lines or hard copy sent.
 Suitability for emergency care situations and on-call consultations.

Interactive Systems for Live Consultations

 Efficient alternative for diagnostic and confirmatory consultations.
 Interview-structured nature of telecardiology.
 Technical considerations: bandwidth, video input/output devices, lighting, background color, audio input devices.
Key Equipment for Telecardiology
 Digital stethoscope and ECG monitor as essential equipment.
 Importance of these tools in examining body structures for cardiac function assessment.

Technical Challenges
 Bandwidth requirements.
 Video input/output devices for accurate examination.
 Lighting, background color, and audio input devices for effective telecardiology sessions.

Conclusion
 Telecardiology's long history and evolution.
 Integration of technology for efficient remote cardiac examinations.
 Ongoing advancements in the field.
 Telesurgery

Telesurgery: Surgery at a Distance

Introduction
 Definition: Provision of surgical care over a distance
with real-time visualization.
 Challenges: Complexity and high cost, especially in
today's economic climate.

Categories of Telesurgery
 Telepresence Surgery: Surgeon's actions transmitted to
the operative site through a computerized interface.
 Telerobotic Surgery: Robotic arms reproduce surgeon's
hand motions.
 Telementoring: Experienced surgeon mentors a less
experienced one through interactive vid An urological surgical operation (telesurgery) being
performed using three-armed ZEUS robot
Integration in Telesurgery
 Involves telecommunication equipment, network, medical devices, and robotics.
 Enables remote surgical collaboration and telementoring.
 Surgical instruments with rings connected to motors for precise translation of surgeon's motions.

Telesurgery Process
 Surgeon's fingers in rings of surgical instruments.
 Rings connected to motors, gears, and belts.
 Digital signals are transmitted to robotic arms at the remote surgical station.

Telesurgery Station Example

 Example: 3-armed Zeus robot from CSTAR.
 Degrees of Freedom (DoF): Human arm 7 DoF, hand over 20 DoF, robotic telesurgery 4 DoF.
 Figure: Illustration of a telesurgery station.
Movement Scaling
 Challenge: Movement scaling for precise control.
 Mathematical and engineering techniques used.
 Example: 1-cm movement of surgeon's finger translates into 1-mm movement of remote instrument tip.

Application Challenges
 Foreseeable limitation: Telepresence surgery more for telementoring than remote manipulation.
 Telementoring's role: Allows surgeon to teach or proctor advanced techniques at a remote site.
 Real-time teleobservation and monitoring for effective telementoring.

Future Prospects
 Advances and experiments in telesurgery.
 Ongoing research and development.
 Potential for wider adoption in the future.
 Telemedicine in Home Care
Shifting Healthcare to Home
 Role of telemedicine in making home the hub of
healthcare.
 Shift from a hospital-based system to a patient-
centered system.
 Potential to drive down healthcare costs.

Tele-Home Care Technology

 Enabling people to overcome barriers to care.
 Assisting those with limited mobility or residing in
remote areas.
 Managing chronic illnesses through personalized
reminders and monitoring.
Evolution of Home Care Technology
 Early focus on alarm systems for the elderly and
disabled.
 Wearable alarm button linked to a central system.
 Limitations: Requires patient awareness and manual
triggering.

Technology Driving Home Care

 Micro-electronics, MEMS, chip technology,
advanced signal processing, wireless
communication.
 Portable monitoring devices for home use.
 Making home care a viable and effective healthcare
methodology.

Wearable Patient Monitors

 Development of patient monitors sewn into wearable
garments.
 Combination of bioelectrodes, biosensors,
microphones, and mechanical sensors.
 Sensors pick up physiological signals and transmit
data for remote monitoring.
Home Care Scheme (Dan and Luprano, 2003)
 Utilization of personal and public communication networks.
 Wireless connections through WPAN and wireless body area network.
 Integration of Bluetooth, WLAN, and UWB technologies.

Automatic Monitoring and Fall Detection

 Monitoring vital parameters: ECG, oximetry, body temperature, heart rate.
 Incorporation of a 'Fall' detection system.
 Real-time measurement with noise reduction and data fusion.

Mobile Technology in Home Care

 Integration of mobile phone or cellular technology for wireless access.
 Real-time remote monitoring system for cardiac patients (Jasemian et al., 2004).
 Components: Patient-Unit, GSM mobile phone, modem server, monitoring station.
ECG Transmission via GSM
 ECG telemetry transmitter connected to a mobile phone.
 Data transmission over GSM network to a Modem
Server.
 Monitoring station receives and converts data to
graphical ECG.

GSM-Based ECG Monitoring

 Use of BPSK modulation and CRC error correction.
 Real-time transmission of physiological data.
 Extended battery life for mobile phone and telemetry
transmitter.

Telemedicine with Cellular Telephony

 Use of digital communication techniques over GSM
cellular network.
 Simultaneous transmission of 12 lead ECG recording
and digitized speech.
 Extension to cover various physiological parameters.
Patient-Worn Device for Telemedicine
 Application of patient-worn devices as a relay
between implants and telemedicine infrastructure.
 Connectivity through cellular telephony or
wireless LAN.
 Reliable communication under challenging
conditions.

Virtual Medical Check-ups

 Telemedicine facilitating virtual medical check-
ups.
 Monitoring vital signs through telemedicine.
 Examples of basic kiosks and advanced devices
with videoconferencing.
Commercial Products with Wireless Technology
 Availability of commercial products with wired
or Bluetooth wireless technology.
 Seamless connection to monitoring devices and
access points.
 Instant data collection and transmission to
central stations for healthcare monitoring.

 Wireless Body Area Networking (WBAN)

 Emerging technology: Wireless Body Area
Networking (WBAN).
 IEEE 802.15 definition and cooperation for user
benefit.
 WBAN for continuous monitoring, early
detection, and supervised rehabilitation.
 Future of WBAN in Healthcare
 Potential for continuous monitoring in ambulatory settings.
 Early detection of abnormal conditions.
 Integration of intelligent sensors as coin-sized skin patches.

 Conclusion
 Telemedicine in home care enhances accessibility, monitoring, and management of health.
 Ongoing technological advancements hold promise for the future.
 Evolution towards a patient-centric and cost-effective healthcare system.
 PACS (Picture Archiving and Communication System)

Definition of PACS
 PACS is an interand intra-
institutional system for
managing medical images.
 Enables acquisition,
transmission, storage,
distribution, display, and
interpretation of medical
images.
 Also known as a medical
imaging network or medical
image management system
(MIMS).
Functionality of PACS
 Broadband telecommunications network for medical imaging.
 Allows different hospital departments to retrieve and transfer patient records and accounts.
 Facilitates sending medical images for remote examinations and second opinions.

Applicability in Telemedicine
 Physician can send X-rays to a radiologist for examination, regardless of location.
 Enables remote consultation and second opinions.
 Addresses the trend towards increased use of out-patient facilities and separate imaging buildings.

Integration of Imaging Modalities

 PACS links various imaging modalities.
 Integration of different imaging modalities for convenient display.
 Modern technology allows digital storage of patient images along with radiologist's reports.

Standardization and DICOM

 Standardization efforts by DICOM accelerate PACS growth.
 DICOM (Digital Imaging and Communications in Medicine) sets standards for PACS technology.
 Joint initiative by the American College of Radiology and the National Electrical Manufacturers Association.
Components of PACS
 Block diagram of PACS components explained in Figure.
 Network serves as the data connection highway.
 Intermediary computers transfer images between modalities and the Radiological Information System (RIS).

Network Technologies (Table)

 Overview of common network technologies for PACS.
 Maximum image transfer performance for typical digital images.
 Essential for efficient data connections in PACS.
PACS Objectives
 Original objective: Filmless Radiology departments.
 Films are still used in many PACS operations, but digital printers may eliminate film printing.
 High-resolution digital printers maintain cost-effectiveness.

Conclusion
 PACS revolutionizes medical imaging management.
 Enables seamless transmission, storage, and interpretation of medical images.
 Ongoing advancements, standardization efforts, and integration with telemedicine contribute to
its continued growth.
 Telemedicine: Today and Tomorrow
Evolution of Telemedicine
 First-generation telemedicine was experimental and based in academic medical centers.
 Focus was on feasibility, not cost-efficiency.
 Telemedicine has evolved into a valuable tool for physicians and healthcare providers.

Factors Driving Telemedicine Growth

 Increased availability of high-bandwidth communication networks.
 Rapid decrease in communication costs.
 Advancements in computing, communications, databases, and multimedia technologies.
 Adoption of universally agreed-upon communication standards like TCP/IP, H.32x, and DICOM.
 Integration of telemedicine with the broader healthcare delivery system.

Telecommunication and IT Convergence

 Convergence of telecommunication and information technology enables practical telemedicine.
 Exponential growth in telecommunication services.
 Wireless paging, cell phones, and advanced compression technologies contribute to growth.
Information Science in Healthcare
 Widespread use of information science in managing human resources, materials, safety, and finances in
healthcare.
 Hospitals adopting paperless records for nationwide patient follow-up.
 Medical personnel trained as information managers.

Telemedicine's Integration
 Telemedicine integrated into the broader healthcare system.
 Physicians can supervise compliance monitoring for chronic diseases.
 Immediate triage for on-the-job injuries.
 Specialist treatment teams can develop plans without travel costs.

Future Vision of Telemedicine

 Telemedicine becoming a common way to see health professionals.
 Possibility of Personal Diagnosis System at home.
 Continuous monitoring of daily health status.
 Automatic notification to health professionals for immediate attention.
Telemedicine Market Opportunity
 Telemedicine is a multi-billion market opportunity.
 Goes beyond distance-separated doctor-patient encounters.
 Emphasizes the need for secure and available information.
Challenges in Telemedicine
 Interoperability, compatibility, scalability, portability, and reliability are key challenges.
 Frameworks must define guidelines and standards.

Professional Associations and Journals

 ATA (American Telemedicine Association) established in 1993.
 ATA works towards integrating telemedicine fully into medical practice.
 Telemedicine journals and literature provide resources for professionals.

Telemedicine's Influence on Modern Medicine

 Telemedicine exercises a significant influence on modern medicine.
 Potential to replace impoverished healthcare systems in rural areas with affordable, efficient, and accessible
healthcare.

Conclusion
 Telemedicine has evolved into a critical component of healthcare.
 Continued advancements, standards, and integration will shape its future.
 Enables accessible healthcare from various locations, contributing to the improvement of healthcare systems
worldwide.