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1 Satellite solutions for Telemedicine Seminar ETSI/Ministry of Health of Mexico, Tuxtla, 18-19 May 2006 Nathalie Ricard Telecommunications Department.

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Presentation on theme: "1 Satellite solutions for Telemedicine Seminar ETSI/Ministry of Health of Mexico, Tuxtla, 18-19 May 2006 Nathalie Ricard Telecommunications Department."— Presentation transcript:

1 1 Satellite solutions for Telemedicine Seminar ETSI/Ministry of Health of Mexico, Tuxtla, May 2006 Nathalie Ricard Telecommunications Department European Space Agency

2 2 All Member States participate in Space Science mandatory programmes. Human space flight and exploration In addition, members chose the level of participation in optional programmes: Microgravity research Earth observation Telecommunications Satellite navigation Launcher development ESA programmes

3 3 Applications represent the ultimate good for which the End Users are willing to pay NO APPLICATIONS = NO BUSINESS Beside the core activities of R&D and industrialisation of Technology, ESA Telecom is active to promote the development of Satcom based Applications Why is ESA involved with Applications?

4 4 ESA Telecom Applications projects

5 5 Hosted in dedicated lines of the ARTES Programme (Advanced Research in Telecommunications Systems) Driving idea: provide evidence of benefits and prepare for a commercial deployment Over 110 Applications Pilot Projects since 1997 for a total value over 150 MEUR (most of them funded 50% by ESA) 60% contracted to SMEs 50% contracted to new entrant into ESA Telecom ESA Telecom Applications Projects

6 6 From Demo Projects to Pilot Service: what makes the difference contents demo platform Exploring Feasibility: Look, it works! Exploring Sustainability: Get it, its worthwhile! IPR issues integration in existing systems deployment users coordination help desk trials evaluation licensing liability stability/ availability security utilisation plan usability pricing impacts on users world Innovation flag

7 7 Project Concluded in Italic Telemedicine/ Medical Education SHARED (I) EUROMEDNET (I) MULTIMED (UK) SECOM (UK) EMN (CH, D) SANTTSUR (UK) IEMN (CDN) MIST (CDN) WEBGMS (I) (I) SKYMED (I) HPS (UK) DELTASS (F, D) TELANY (I, N) MAYFLOWER (I, N) I-DISCARE (F, I, N) Telecare (CDN) HIS (D) NESA (I) SKYNURSE (I) TEMOS (D, F) REACH (CDN) IGEA-SAT (I) V-4DL (I) Community Information Services RCST (CDN) CROCUS (I, NL) TV Beyond 2000 (F) Mediaspace (F, SP) MAMS (IRL) Space For Science (F) TESEO (I) (L) DISaV (I) SILC (D) My Home T.TV (NL) OTV Ch. (UK) Lift Ch.(IRL) Satcom Networks Systems & Services DESNET (I) SKYPLEXNET (I) WEB-SAT (IRL) SATXPRESS (D) SWB (IRL) CollaBOD (CDN) eWAVE V.S. (D) Freetimers Int. (UK) Wired Ocean (UK) Broadband in the Sky (B) SDS (B) ILSE (A) Fusion St. (IRL) World-Link (I) RTI-TVS (L) Disaster Relief/ Emergency Management REMSAT (CDN) EMERGSAT (F, E) REMSAT II (CDN, E) SASS (D) I-GARMENT (P) SARFOS (CH) B2B / B2C ABARIS (UK) SUNRISE (UK) MULTIMAP (UK) JUPITER (NL) VERDI (F, CDN, I) MRSTREAM (UK) E-SCREEN (I, UK) D-CINEMA (B) ESEMAR (I) IMPSAT (UK) (I) TV Snapshot (L) EDIBS (A) MeCA (CDN) Multi-PID (UK) (I) Distance Learning ESPRESSO (UK) HERMES (I) MODUS (I) TRAPEZE (B, UK) HAMLET (I) SchoolSat (B,IRL) ESMEE (I) e-Learning DVB (IRL) SchoolCast (IRL) eLearning DVB (IRL) EODIS (I) BARRD (UK) Pacific Skies (NL) HOST (GR) BB to Train (UK) INDIGO (UK) CampNet (D) Location Based Satcom Services GWAS (CDN) WICOR (D) Mobile WS (NL) Wireless IbDN (F) I4S (F) MoMoSat (D) PERUSE (IRL) MUTIS (A) In Fligth Reporting Tool (IRL) AeroFleet (D) BIRDCOM (I) e-Government e-regSAT (I) ADMiNiSTRA (I) SATMODE (L) SatServ (N) BizSmart (GR) BrandTV (UK) Sat-n-Surf (L) LyngBox (S) 2EDIBS (A) ESA Telecom Applications Projects

8 8 Telemedicine

9 9 Telemedicine Applications Projects Project Concluded in Italic Telemedicine/ Medical Education SHARED (I) EUROMEDNET (I) MULTIMED (UK) SECOM (UK) EMN (CH, D) SANTTSUR (UK) IEMN (CDN) MIST (CDN) WEBGMS (I) (I) SKYMED (I) HPS (UK) DELTASS (F, D) TELANY (I, N) MAYFLOWER (I, N) I-DISCARE (F, I, N) Telecare (CDN) HIS (D) NESA (I) SKYNURSE (I) TEMOS (D, F) REACH (CDN) IGEA-SAT (I) V-4DL (I) 25 Contracts (20.3% of Applications Projects) ESA Funding: 20,540 kEUR (24.9% of total)

10 10 Emergency Consultation SECOM (UK) IEMN (CDN) MIST (CDN) DELTASS (F,D) TELANY (I, N) I-DISCARE (F, I, N) NESA (I) Distributed Environment for Medical Simulation MULTIMED (UK) Teleconsultation and Tele-Homecare SHARED (I, A) EUROMEDNET (I) RCST (CDN) Telecare (CDN) TEMOS (D,F) REACH (CDN) IGEA SAT (I) High End DELTASS (F,D) Continuing Medical Education EMN (CH, D, F) SANTTSUR (UK) MAYFLOWER (I,N) (I) SKYMED (I) HPS (UK) HIS (D) SKYNURSE (I, R) V-4DL (I) Clinical Research & Access to Patient Multimedia DBs WEBGMS (I]) HERMES (I) TELANY (I, N) Telemedicine Applications Areas Project Concluded in Italic

11 Continuing Medical Education + + Access to Multimedia Electronic Health Record + Clinical Research + + Teleconsultation and Home Care ++ Emergency Consultation + Distributed Environment for Medical Simulation + ++ High-End High Capacity + Fast Deployment for Temporary Use Multicasting/ Dissemination of Multimedia Contents Broadband Access from Underserved Areas High Mobility, Communication in Emergency and Disaster Situations Satcom Assets Telemedicine Areas Satcom Positioning in Telemedicine

12 12 Key Requirements for Telemedicine Activities sponsored by ESA: 1.Provide evidence of the added value to the end users 2.Coexist with traditional medical practise 3.Elaborate a roadmap on how to integrate into the healthcare organisation 4.Serve existing paths of communications among healthcare professionals rather than inventing new ones 5.Have a holistic, end-to-end approach, involving the different actors (from the patient to the political stakeholder) 6.Maintain a project-bounded, business oriented vision to foster the self-sustainability of the initiatives Telemedicine: a Sensible Approach

13 13 Teleconsultation:

14 14 Emergency Telemedicine: NESA

15 15 Teleconsultation: TeleCare

16 16 Teleconsultation: Reach

17 Sites in A, CH, D, I, F, NL, UK Continuous Medical Education:

18 18 1.Review the current market for Telemedicine 2.Identify the key actors, review the typical service value chains and compare with traditional healthcare 3.Assess the market potential for satcom-based telemedicine 4.Analyse the regulatory framework: current and foreseeable technical, operational and legal frameworks directly affecting Telemedicine in general and via satellite in particular (whenever such distinction is relevant) Identify domains where satellite communications can bring added-value to telemedicine services Market and Regulatory study of Telemedicine via Satellite in ESA Member States

19 19 Lessons learnt

20 20 There are a lot of Hardware and Software (systems) providers and many pilot services but few proper running services and very few service providers able to provide and end-to-end service, in a turn key integrated solution State-of-the-Art: mainly tele-radiology, tele-pathology, general medical diagnosis, remote consultations, triage decision-making, and emergency evaluations. Activities are mainly limited to the local level, which prevent them to reach the critical mass necessary to turn a pilot activity into an operational and profitable service. The market is thus very fragmented. Highest number of running services is in the USA and Canada, rather than in Europe Some barriers to widespread diffusion are related to the technology, but most can be attributed to other factors. Telemedicine in Europe today

21 21 Recurrent problems in ESA Telemedicine projects Telemedicine projects all face common problems: - Users are forced to find technical solutions on their own with 3 options: build in-house expertise before taking decisions define requirements and blind trust suppliers partner with industry (which drives towards its own solutions) - Technical and operational issues absorb a lot of resources and disrupt the operations, leading to discover the same barriers again and again - Difficulty of providing generic evidence of viability beyond the specific context of the pilot project ESAs initiatives to help: De-risk the access to Satcom solutions with access to a set of facilities and associated services for initiatives not ready for the open market Proxy between the supply side and the demand originated by projects Encourage the use of Open Standards (DVB-RCS)

22 22 Telecommunications Provider Hardware & Software Provider Medical Service Provider Hospital Departments GPs & Specialists Scientific Centers Final User Citizen Telemedicine Service Provider Network Integrator Turn Key Solutions Telemedicine Value Chain Medical Provider Telemedicine Provider

23 23 Telemedicine Service Provider: Coordinate all system integration tasks Intervene as one-stop-shop access point for the customer and the user Provide round-the-clock technical support, hotline and user training support Ensure the continuity of the service, quality assurance measures, integrity and confidentiality of data in full compliance with the applicable regulations Organize user feedback and continuous maintenance of the proposed applications Perform the telemedicine service between two or more physically separated parties. Its main skills are to Integrate Networks and provide Turnkey Solutions Role & position of key players Medical Service Provider Supply professional expertise in the field of medicine Usually is a healthcare institution specialized in a specific area

24 24 Disaster Relief Telemedicine Rural area Telemedicine Home Monitoring E-learning and Tele-training Maritime/Off-shore/Aviation Telemedicine The following Application areas are the most promising for telemedicine via satellite: Market forecast

25 25 Current number of initiatives European Market For all cases telemedicine and telecommunications costs are very small percentages of the yearly costs of providing medical services (contradicts the preconceived idea that investment in HW, SW and telecom cost is the main obstacle)

26 26 Home monitoring, rural telemedicine and e-learning/teletraining are led by regional and/or national governments, so funding is partially available E-learning/teletraining shows greatest promise for wide-scale market uptake Home monitoring is currently not the most attractive application in terms of revenues but is seen by experts as having very strong development prospects, driven by demographics, the increase in preventive medicine and the adoption of cost-containment measures by national health authorities. Rural telemedicine uptake is hampered by poor reimbursement status and perceptions of high telecom cost where broadband access is not available Disaster relief, aviation, maritime and offshore telemedicine are still to be implemented on a wide scale. European Market

27 27 Key issues for telemedicine via satellite in Europe today

28 28 Investment is limited to narrow healthcare activities when application to a wider scale could yield a financial and economic return: ability to be expanded on a large scale is key Economic and financial case studies become available but do not seem to deal with factors such as patient benefits, health outcomes or health status Costs of project management, procurement processes, change management, develop new clinical and working practices, implementation, training etc. are often not taken into account but they are essential resources for the success of telemedicine The benefits are not necessarily passed on to those that actually have to invest in the telemedicine service (e.g. cruise telemedicine: passengers benefit while investment comes from the ship owner) Key issues in Europe today: sustainability

29 29 In Europe the majority of telemedicine initiatives are funded by academic research, government subsidies, EU-level programmes or as part of local government development plans. Industry players across the market perceive that telemedicine is on life-support through this public funding, which is a double-edged sword: It is a necessity to allow the benefits of telemedicine to be fully assessed and evaluated in what is a relative commercial vacuum, but it is not allowing the laws of supply and demand to operate, postponing the reality check that the level of demand for telemedicine remains low and dissimulating the real difficulties associated with implementing self-sustaining business models in this market. … Nevertheless, major industry players and key opinion leaders interviewed are in majority very optimistic about the future of telemedicine Key issues in Europe today: public funding vs commercial market

30 30 ESA Telecom website

31 31 ESA Telecom Contact Points ESA - ESTEC Telecommunications Department Directorate of EU and Industrial Programmes

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