Shimizu S, Kudo K, Antoku Y, Nakashima N Telemedicine Development Center of Asia, Kyushu University Hospital, Fukuoka, Japan June 18, 2015, TNC, Porto Telemedicine project in Asia-Pacific: Changing needs and current problems

Today’s menu Background Activities Changes Kyushu Univ., Fukuoka

Key-hole operation: Open Endoscopic Many doctors want to learn the new surgeries. Big medical needs

Int’l Teleconf/Live demo Expensive! Satellite ISDN/Narrow Poor image! ? 1990s

Specific characteristics/conditions in telemedicine  High resolution  Moving images  Varieties at each hospital ＊ Common videoconference 1. Sit in front of monitor 2. Slides at most 3. Uniform equipment

Our project started in 2002 Korea- Japan: Big Broadband Network (2G). Korea- Japan: Big Broadband Network (2G). Japan Korea Network revolution

Mbps Compressed, degraded Original quality Big broadband Internet Clear & Smooth Movie transmission Cheap & Simple

Key technologies DVTS (Digital video transport system) Academic network (Research and education network) 2000s Only method to satisfy doctors.

Today’s menu Background Activities Changes Kyushu Univ., Fukuoka

KR China Gastric cancer Indonesia Thailand India Vietnam Malaysia JP Taiwan Singapore Philippines Recovery Less cost Back to work Endosc Early Admission Recurrence Death Ope Advanced Diagnosis and treatment Early detection is very important!

China-Japan Early Gastric Cancer Teleconference Tokyo/JP Fukuoka/JP Shanghai/CN Beijing/CN For diagnosis Video

Endoscopic Demonstration in Asia & Europe Bangkok, TH Kyoto, JP Hamburg, GR Kuala Lumpur, MY Taipei, TW Xian, CN Fukuoka, JP Seoul, KR For treatment: Endoscopic resection Video

Laparoscopic gastrectomy: Asia to Europe Tokyo/JP Fukuoka/JP Shanghai/CN Trondheim/NO Video

Bird Flu Teleconference: Infection Indonesia VietnamPhilippines Australia USA China ThailandJapan Dengue Ebola MERS

Sapporo Beijing Tokyo Bangkok Shanghai Singapore Kuala Lumper NUS Brisbane Manila Philippine U BandungITB Iwate Taichung New Dehli ERNET HaLong Taipei Mumbai Tata MH Jilin Jakarta, UI Hanoi MelbourneSydney Auckland Canberra ANU Hawaii Ho Chi Min Cho Rai Hosp Before 2005 After Adelaide Flinder’s Hosp California Stanford, UC Irvine Hong Kong Chile Fukuoka Yokohama Cairnes Egypt Cairo U ＜ Asia Medical Project ＞ 55 countries 389 institutions 537 programsSeoul Europe South Africa

Today’s menu Background Activities Changes Kyushu Univ., Fukuoka

Choice of new technologies DVTS Vidyo Image quality Equipment Network Global IP Mobile Bottom line u-SD PC Big (30) Yes No Network c-HD Server, PC Small (2) No Easy Sending image HD-H323 c-HD VC system Small (2) Yes MCU *One-way streaming is another handy option. 2010s

Changes in Systems DVTS Vidyo H323

Changes in: REN vs Commercial Non- REN Newly connected institution /year REN

“Network threshold is decreasing ” H H H H NOW H H H H H H H H H H H H H H H H H 10 years ago H H H H H H REN DVTS Commercial Network HD-H323 Vidyo

Live surgery Japan to North America Tokyo => New York (2012), Canada (2014) with HD-H323 Bariatric surgery

Global endoscopic conference with Vidyo IN LK TW KR GE IN KR SG HK Video

Teleconference with Latin America: Vidyo Osaka, JP INNCZ, MX MX BR Alemana, CL Cali, CO La Paz, BO KUH, JP

Success and Failures in Telehealth, 4 th Annual Meeting of he Australian Telehealth Society Conclusions 1.There is no doubt that REN can provide better quality and that the network is much more stable. 2.However, the connectivity to hospitals is less with RENs, and more telemedicine has recently been done with commercial NWs with tech. development. 3.We may have to reconsider the role of RENs for telemedicine with the changing environment. EngineersMedical Staff