1. Corporate Communications April 2007 Satellite based telemedicine : accessibility, quality and safety TTeC 2007, TROMSOE – 12 June, 2007

2. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 E-Health expertise 1997-2007 Pascal LOCHELONGUE THALES ALENIA SPACE e-Health projects & solutions Manager HEALTHWARE and Medicin@pais project coordinator 2007 GALENOS : Interconnection of European and Mediterranean hospitals via a high speed and mesh telecommunication satellite network for second opinion MEDEXIS : Large scale dissemination of invasive surgery methods using DVB-S satellite system, Remote Video-assistance in invasive surgery using DVB-RCS satellite system DELTASS : Design and implementation of a telemedicine system using satellite telecommunication for emergency situations (earthquake, conflict, …) URSAFE : Design and validation of a prototype for telemonitoring of patients at home using terrestrial, mobile and satellite telecommunication networks MEDICINAPAIS: Satellite based network for medical training and teleconsultation between local hospitals in mountain area and littoral main hospitals (DVB-RCS) HEALTHWARE : Development and deployment of European satellite (DVB-RCS) based telemedicine solutions and services in the fields of medical training, second opinion, teleconsultation and homecare. 1997-2007

3. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 DVB-RCS satellite technology  DVB-RCS satellite broadband technology.  Star topology and two way architecture  Ground network independency : answer to the lack of suitable terrestrial broadband networks  DVB-RCS standard compliant : mature and operational technology with powerful capabilities (up to 2 Mbps) on the return link  Interoperability with existing networks and technology (terrestrial, mobile, wireless)  Quality of Service : guaranteed bandwidth, optimised protocols, end to end performances  High Rate IP based services  Compliant with any IP based applications  Guaranteed bandwidth & high rate transmission capabilities allow for interactive and multimedia applications, use and display of high resolution images and live video  Usages  Connecting remote and isolated sites (clinics, local hospitals, nursing homes) to high-speed and interactive e-Health service.  Teleconsultation, tele-expertise/second opinion, remote training, telemonitoring

4. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Solutions : Remote training of medical staffs  Cardiology : Semi automatic defibrillator  Red Cross : Nursery nurses training  Orthophony : Swallowing troubles

5. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Solutions : Primary Teleconsultation  Dermatology  Radiology  Anatomic-pathology

6. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Solutions : Tele-expertise / Second opinion  Tele-radiology  DICOM compliant Video module  Tele-echography  Surgery tele-assistance

7. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Standard & Interoperable Satellite Solution to deploy health care services over wide area Focus on the development of end to end telemedicine solutions/services over the DVB-RCS satellite technology Achieve large scale pilot deployment and validation over networks managed by medical leaders Apply to three conditions : Chronic respiratory diseases, Heart problems, Oncology In four preferred application domains Services at home: monitoring and remote assistance to patient located in isolated areas (islands, campaigns, mountains) Medical training: medical knowledge dissemination towards medical staff, nurses, auxiliary nursing staff Second opinion: interactive video- communication between specialists and document sharing Teleconsultation: interactive video- communication between patient and doctor

8. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007  (3)  (4)  (2)  (5)  (2)  (14)  (3)  (1) Healthware = 40 DVB-RCS sites network over 8 European countries HEALTHWARE

9. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Title of unit 1: CARDIOLOGY, Faculty: ICU Venizelion Gen. Hospital Heraklion 1.Acute coronary syndromes. Emergency diagnostic and therapeutic management 2.Automatic external defibrillation in cardiopulmonary Resuscitation 3.Supraventricular tachyarrhytmias 4.Tahyarrhytmias with wide QRS complexes 5.Bradyarrhytmias 6.Legal and Ethical considerations in Resuscitation Title of unit 2: TRAUMA, Faculty: D. Vourvahakis, director EKAB Crete 1.Ventilator positioning in trauma patient 2.Triage of multicasualty accident, A, B, C, D, E. 3.Thoracic and cranial injuries 4.Immobilization and transfer of trauma patients, Rescue of trauma patients from vehicle 5.Triage and management of multicasualty accidents 6.Shock- coma Start tele-education courses Module 1 Cardiology – May 11-23 Module 2 Trauma – June 4-27 Lesson duration 1 – 1,5 hours Site participation 3-6 health organizations (avg 2 health centers, 2 community offices) EKAB HEALTHWARE

10. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007  Second opinion scenario : main objectives  Common work-up of diagnostic and therapeutic options in complex respiratory cases  Selection of the patients to diagnostic procedures unavailable in peripheral centre  Examples of medical problems for the telemedical interactions  Lung/pleural neoplasms requiring pathological confirmation  Asbestos-related disorders – differentiation between benign and malignant processes  Confirmation of suspected pulmonary embolism HEALTHWARE  Impact of telemedical session on patient management  Continuation of care in peripheral/local medical centre  Additional diagnostics in peripheral/local medical centre

11. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Medicin@pais programme Puget-Theniers St Etienne de Tinee St Martin Vésubie Roquebillière Breil sur Roya Tende Training to medical practice methods Tele-consultation ECG signal analysis Second opinion NICE Elderly people care Support to local care practitioners Medical training of local staff 4 Reference hospitals in Nice Faculty of Medicine=> Medical training Ste Marie Institute=> Mental diseases care Nice University Hospital=> Elderly people, palliative care in end stage Pasteur Hospital  MEDICIN@PAIS

12. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007  Medical training  Faculty of Medicine : Post Academic Education sessions, 7/years  Remote tele-education sessions : 2-3 h  Paediatrics, geriatrics  Cardiology  Psychiatry  Dermatology  Pharmaceutics  Emergency (defibrillator)  French Red Cross : nursing nurses training, 300 h  Teleconsultation  Mental diseases management  Elderly management, End of life preparation  Gerontology : swallowing diseases  Orthophony : speech disorders  Impact for the Region  Rural employment creation (CG06) : nursing nursery  Maintain of skills in rural areas  Improved Quality of Life for elderly/ageing population  Reduction of unnecessary transfer to urban hospitals Medicin@pais programme

13. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Medico-social CultureEducationE-Learning Medical Added value

14. All rights reserved © 2007, Thales Alenia Space Corporate Communications April 2007 Thanks