1. 1Kyushu University UI project Kyudai Taro,2007
Shuji Shimizu, MD
Director,
Telemedicine Development Center of Asia,
Kyushu University Hospital,
Fukuoka, Japan
2. Shuji Shimizu, MD
Director,
Telemedicine Development Center of Asia,
Kyushu University Hospital,
Fukuoka, Japan
May 9, 2013, Cali, Columbia
Remote Medical Education in Asia-Pacific
- Possible expansion to Columbia-
7. Benefits of Endoscopic SurgeryBenefits of Endoscopic Surgery
Small
wound
Open Endoscopic
1 week after surgery
Pain
Walking
Recovery
8. But, NOT popular in medical community yet
Why not?Why not?
Remote education
• New knowledge and procedures keep coming.
• Young doctors do not have enough chances.
• Save time & travel expenses
• Scalability: Daily use & Large audience
HUGE demands in education!
<Economical & Effective!>
11. Situations dramatically changed in 2002Situations dramatically changed in 2002Situations dramatically changed in 2002Situations dramatically changed in 2002
We use BIG Internet!We use BIG Internet!
Korea- Japan was
connected with Big
Broadband
Network (2G).
Korea- Japan was
connected with Big
Broadband
Network (2G).
JapanJapan
KoreaKorea Hub in
Kyushu
Univ.
13. Actual bandwidth in each network
0.4
30
0
5
10
15
20
25
30
ISDN DVTS
Mbps
Compressed,
degraded
Original
quality
D: Digital
V: Video
T: Transport
S: System
Point 1: Big Broadband Network
Digital Video
Internet
Moving images
14. DVTS: Cheap and Simple
DV Camcoder DVTS PC
Microphone
UTP(Ethernet)
Audio
Internet
• DVTS: free but powerful software
• No special teleconferencing equipments
>30Mbps>30Mbps
Commercial network does not work!Commercial network does not work!
Surgical instrument
IEEE1394
15. Point 2: Academic Network
for Research and Education
Columbia: RENATA
Science 1986, “Computer Networking for Scientists”
16. High-speed Network for R&E in Japan
Ministry of
Education
• Government-funded
• No commercial use
• All national universities are connected
• No additional cost if connected
• Big Internet is ready to use anytime
• Government-funded
• No commercial use
• All national universities are connected
• No additional cost if connected
• Big Internet is ready to use anytime
Practical Telemedicine has started.
18. OR Surgical movie
NCC, KoreaKyushu Univ., Japan
Needs! Laparosc. Surg.
Security software used
Aug 1, 2003
The first live demonstration of surgery
25. International academic network (APAN)
All connection
fee is free!
Asia-Pacific Advanced Network
Kyushu Univ.
as secretariat
26. Taipei Beijing
Fukuoka Seoul
2005.3.18
The first multi-station teleconference by DVTSThe first multi-station teleconference by DVTS
Pancreatic Transplantation MeetingPancreatic Transplantation Meeting New technical breakthrough
36. Post-graduate course across border
2012.10.23
KR １
KR ２
KR ３
JP
VN
TH
Seoul Univ.
Prof Kim HH
Select a system depending
on a program/conditions
37. Telemedicine Development Center of
Asia (TEMDEC) 2008.4
http://www.temdec.med.kyushu-u.ac.jp/eg/index.html
Organize all
programs
with doctors
and engineers
38. 2004.7
SapporoSapporo
2004.1
BeijingBeijing
2004.12
2005.1
TokyoTokyo
BangkokBangkok
ShanghaiShanghai
SingaporeSingapore
Kuala LumperKuala Lumper
NUSNUS
2004.7
2004.1
BrisbaneBrisbane
ManilaManila
Philippine UPhilippine U
BandungBandung
ITBITB
2005.11
2005.6
IwateIwate 2005.7
2005.11
TaichungTaichung
2005.11
New DehliNew Dehli
ERNETERNET
2004.10
HaLongHaLong
2006.6
2006.7
2006.7
TaipeiTaipei
MumbaiMumbai
Tata MHTata MH
2003.2
JilinJilin
Jakarta, UIJakarta, UI
HanoiHanoi
MelbourneMelbourne
SydneySydney
AucklandAuckland
2007.3
CanberraCanberra
ANUANU
HawaiiHawaii
Ho Chi MinHo Chi Min
Cho Rai HospCho Rai Hosp
2007.1
2007.1
Before 2005
After 2008
2006 - 2007
2007.1
AdelaideAdelaide
Flinder’s HospFlinder’s Hosp
2005.11
2007.3
CaliforniaCalifornia
2007.1
Stanford, UC IrvineStanford, UC IrvineHongHong
KongKong
BrazilBrazil
FukuokaFukuoka
YokohamaYokohama
CairnesCairnes
EgyptEgypt
Cairo UCairo U
2007.8＜＜ Asia Medical ProjectAsia Medical Project ＞＞
34 countries
221 institutions
360 events
SeoulSeoul
EuropeEurope
South AfricaSouth Africa
44. Visiting Latin America with engineers
Alemana Hosp/CL
USP/BR
Univ. of La Plata/ARINNSZ/MX
45. Endoscopy teleconf. with Central/Latin America
2013.1
Hawaii
Mexico
Brazil
Chile
APAN venue
Dr Yao
Dr Uedo
UNAM
Dr Tanimoto
UERJ
Dr Fatima
REUNA
Dr Ignacio
46. RENATA is expanding networkRENATA is expanding network
in Columbiain Columbia
Good timing to start the project!
You need…
•Engineers (network & system)
- who make it possible
•Doctors (programs)
- who make it meaningful
47. Engineers: Network to the very endEngineers: Network to the very end
1) International
network
2) Domestic
(NREN)
•APAN
•RedClara
RENATA/C
O
RNP/BR
Internet2/US
Network
Point
Big academic
network
Connected
to hospital?
Network
Point
3) Hospital
Network
Point
Support of
engineers
Big enough and stable network at all steps
Firewall
48. Doctors: Make attractive programs
• Surgery/Endoscopy
• Cardiac intervention
• Rehabilitation
• Dental
• Bird flu, SARS, HIV
• Basic Science
• Nursing
• Medical students, etc.
A lot more needs…
49. Cardiac Intervention: live demonstration
2012.2.16APAN-Chiang Mai
Taiwan Univ.
Osaka Univ./JPSingapore Univ.
Thai main venue
51. Team buildingTeam building
National REN
Engineers
Local Engineer
(Network &
Audio-visual)
The success depends on how good team you can make.
Medical
Doctors
Medical
Doctors
Local Engineer
(Network &
Audio-visual)
National REN
Engineers
52. Conclusions
1. Quality preservation of moving image
transmission is essential in telemedicine.
2. R&E network has made the clear and smooth
medical streaming possible with low cost.
3. Good time to foster continuous remote medical
education programs in Columbia.
Let us start working together!
Editor's Notes
These two pictures demonstrate the differences in surgical wound between conventional open and endoscopic surgery. The big wound on your left was made by open surgery. In contrast, the same operation can now be performed with four tiny wounds shown on your right.
Menu for my presentation is as follows. First, I would like to explain what the endoscopic surgery is to the audience for the first place. Then, I will show you the current network system working in our hospital to send our surgical movies on real-time basis. After that, Mr. Uchikubo from Olympus Company will tell us about actual plan for the present project.
