Wireless TeleMedicine (Swiss Stock Exchange Zurich presentation)

Wireless telemedicine (technology trends) May 5, 2004
©2004 Gerhard Fasol www.eurotechnology.com
1
by
Gerhard Fasol PhD
Eurotechnology Japan K. K.
www.eurotechnology.com
Zurich, May 5, 2004
©2004 Eurotechnology Japan K. K. All Rights Reserved
Wireless TeleMedicine
Technology Trends

2
Executive Summary
Broadband wireless communications (3G and beyond) are in rapid development and
promise great opportunities to improve health care. Integration of internet access, JAVA
programs, 3Mbyte cameras with autofocus and lighting, GPS (satellite global positioning
system), multi-application smartcards enable a great variety of innovative healthcare
applications. Generally mobile communications in Japan are 3-5 years in advance of
developments in Europe. Studying mobile communications in Japan today give a good
indication for which developments to expect in Europe about 3-5 years from now.
◆ Video telephony will allow delivery of generalist or specialist consultation at a distance, for
example at the location of an accident, in disaster area, in emergencies. A general practitioner can
conduct an emergency video conversation with an emergency patient arriving at his/her practice
room while he/she is out on a patient visit.
◆ Mobile phones with 3Mbyte cameras with autofocus and flashlight generate high quality images,
which can be transmitted from the scene of an accident to a waiting operating team, or
consultation of distant experts.
◆ Many mobile phones in Japan have integrated GPS (satellite position determination) services.
Integration of GPS into mobile phone handsets allow to monitor aged people and have many
applications in nursing care and emergency care.
◆ Internet access to remote data bases, and integration of JAVA programs, multi-application
smartcards and sensors, enable mobile phones to be key component of innovative illness
management programs, e.g. for diabetes, where a patient uses specialized mobile phones to
manage his/her illness continuously.
◆ Telemedicine applications are not only “high-end”, telemedicine also has important applications in
economically challenged situations, e.g. in developing countries.

3
Issues
Technology state-of-the-art and trends
◆ Radio layer: 3G state-of-the-art and WiFi integration
◆ Imaging and video
◆ GPS integration
◆ Multi-application smart card integration
◆ Optical diagnostics, bio-chips
Imaging and video:
◆ projecting vision and expertise
Ubiquitous care and health management:
◆ ubiquitous care
◆ positioning systems
Telepresence
◆ Dr. Tachikawa: “what is the impact of SARS on telecommunications?”
◆ Deliver healthcare and consultations at a distance

4
Technology:
State-of-the-Art and Trends

5
3G State of the Art & Trends (Japan)
while 3G (UMTS) is in the introduction phase in Europe, 3G in Japan is already
mainstream and in the second or third stage of upgrades towards 4G
200,00012 million3G/FOMA: 3 million (2004)
(total subscr. 40 million)
Subscribers
384kbpsCDMA 20001x: 144 kbps
CDMA 2000 1xEV-DO: 2.4Mbps
384kbps
HSDPA from 2005:
handsets: 3.6 Mbps
network: 14 Mbps
Data rates
(downlink)
64 kbpsCDMA 20001x: 64 kbps
CDMA 2000 1xEV-DO: 144 kbps
64 kbpsData rates
(uplink)
tests: June 2002
commercial: Dec 20,
2002
wCDMA
Vodafone
April 1, 2002
CDMA 2000-1x
from 28 Nov 2003:
CDMA2000 1xEV-DO
KDDI/AU
tests: May 2001
commercial: Oct 2001
start date
wCDMA3G Network
NTT DoCoMo

6
DoCoMo’s 3G FOMA900i series (2004)
CCD + AUTOFOCUS
camera 2.02 Mpixel
record: 2.0 Mpixel
262,144 colors
2.4 inch
240 x 320
13,000 dpi
300hrs
120mins
TV:80mins
130gSH900i
CCD + AUTOFOCUS
camera 1.28 Mpixel
record: 1.23 Mpixel
65,536 colors
2.4 inch
300hrs
140mins
TV:90mins
130gP900i
Super Honeycomb
camera 1.0 Mpixel
record: 2.0 Mpixel
65,536 colors
2.2 inch
300hrs
140mins
TV:90mins
115gN900i
camera 1.28 Mpixel
record: 1.23 Mpixel
(fingerprint recognition)
Super Honeycomb
camera 1.0 Mpixel
record: 1.92 Mpixel
Camera
(stills + video)
262,144 colors
2.2 inch
262,144 colors
2.2 inch
Main display
300hrs
140mins
TV:90mins
300hrs
140mins
TV:70mins
standby
talk
120gF900i
124gD900i
weight

7
3G Imaging and Video
Video telephony (32 or 64kbps digital data channel)
◆ Quality probably not sufficient for most medical applications, where tissue
needs to be examined. Needs to be combined with still photograph
transmission
◆ Maybe sufficient for general overview e.g. scene of an accident
◆ Remote observation, e.g. care of seniors, or ill people, or observation of
children in care, nursing applications
Imaging (upload: 64kbps - 144kbps)
◆ for DoCoMo’s FOMA-3G: maximum image size for sending over the wireless
network: 480 x 640 = 0.3 Megapixel
◆ Applications:
◆ emergency care, remote consultations, consult distant specialist at scene of
accident, …
Imaging (download: 384kbps - 2.4Mbps)
◆ Applications:
◆ remote support at scene of accident
◆ remote consultation of patient data, remote consultation of supporting
materials

8
3G vs WiFi
3G (3G = third generation mobile communications)
◆ ubiquitous
◆ 99% coverage of the country in the future (now in Japan)
◆ towards flat data rate
WiFi, wireless LAN (LAN = Local Area Network)
◆ Wireless LAN, local within one building
◆ at specific locations
◆ replaces ethernet
Note, that there is some discussion that Wireless LAN (WiFi) could
replace 3G communications. In my view this will not happen: 3G and
WiFi will cooperate, not compete. 3G gives ubiquitous access, while
WiFi only operates in certain locations as local networks. Some
terminals will contain both 3G and WiFi radio access.

9
Picture Mail and GPS (Global Positioning System)
Applications
◆ Location of aged people or blind or handcapped people: the blind
person who has lost his or her way takes an image, determines the
position with GPS, sends this information to his friend, who can
accurately locate the blind person using the photograph and the GPS
data, and come to help.
◆ Police work: Japanese police in cooperation with the security firm
SECOM has started to distribute GPS enabled security devices to
victims of stalking or other suspected crime to protect the victim,
enable the victim to call for help, and also to enable the victim to
collect evidence for investigations.
More about camera-phones:
◆ http://www.eurotechnology.com/store/camera-phone/

1 0
GPS (Satellite Positioning) Integration
KDDI/AU 3G “Infobar (November 2003)
CCCD-Camera
0.31 Megapixel
stillss & movies
Lighht/Flash
2inch
132 x 176 pixel
65,536 color
TFT display
GPS
3G (144kbps)
JAVA/Brew
Battery:
200 hrs standby
150 mins talk

1 1
KDDI/AU INFOBAR with GPS
(Images are taken with a P2102V camera phone with 640 x 480 pixel resolution)

1 2
Demonstration of Picture Mail & GPS by AU/KDDI
recipient of the image finds the URL to the map
below, which shows the location where the picture
was taken (the map is interactive and enlarged
map images zooming into the neighborhood can
be selected)
Image of a AU5302CA handset taken by a
AU5302CA handset.
640 x 480 pixel (VGA format option for
display on PC)
5302CA
includes GPS
satellite global
positioning
photograph can
be sent with the
URL leading to a
map with the
actual position
where the picture
was taken

1 3
BioMetric Sensor (DoCoMo F505i by Fujitsu)

1 4
Multi-Application Smart Cards integrated into Phones
Concept: up to 40 applications stored in a secure Smartcard in the mobile phone with internet access
Secure wireless access online or offline transactions
JAVA applications have secure access to FeliCa smartcard
allows health data, etc to be safely stored in the mobile phone with remote access to server
More about wallet phones and multi-application smartcards:
◆http://www.eurotechnology.com/store/walletphone/
◆http://www.eurotechnology.com/store/suica/

1 5
Imaging and Video

1 6
Imaging and Video Applications
■ Telepresence of experts in remote locations
■ Transmit images from the scene of an accident to the operation
room to allow preparations
■ Remote viewing of patent data, images, background information,
access to data base, consulting of back-up experts etc.
■ 3G phone can be linked to video-interphone at entrance of
pharmacy, practitioners’ practice. Scenario:
◆ Country doctor is called to attend to a patient. While he is out
attending a patient, an emergency case arrives at his practice. With
the 3G phone the Doctor can answer the door video phone and
interview the emergency patient who has arrived in his absence at the
practice
■ Scenario (not so much talked about…):
◆ Deliver healthcare to prisons, difficult circumstances, economically
challenged situations, disaster areas, emergency care, etc…

1 7
Ubiquitious Care and
Health Management

1 8
Ubiquitious Health Care
■i-mode (mobile internet) based health management
systems, e.g. implemented in the mass market in Japan
◆Diabetes management system
◆Conception/contraception (base temperature) management
■more about i-mode and mobile internet:
◆http://www.eurotechnology.com/store/imode/
■Can be combined with:
◆Sensors
◆GPS
◆Smart cards
◆Remote data base
◆Video link to responsible doctor

1 9
Some Characteristic Differences
Between The Mobile
Communications Industry in the
“GSM World” and Japan

2 0
Some Characteristic Differences Between
Japan and the “GSM World”
Nokia & VodafoneDoCoMoWho are the 5000
pound Gorillas?
Equipment manufacturers (e.g. Nokia,
Siemens, Ericsson…)
Carriers (DoCoMo, J-Phone, AU/KDDI)Who is in the driving
seat?
Technology focus - brands are abbreviations:
“GSM”, “GPRS”, “SIM”, “UMTS”
Consumer focus: “I-mode”, “sha-mail”,
“movie-mail”, FOMA, “H”
Brands
very high (around 20%-30%)very low (around 1% to 2%)Churn
low - typically: subscriptions: US$ 30
prepay: US$ 10
high - typically: US$ 80/monthARPU
Prepaid dominatesAlmost only monthly credit
subscribers, almost no prepaid
Prepaid vs. credit
Corporate executives (“busy executive in the
airport business class lounge”)
Consumers (“young people having
fun on the beach”)
Marketing focus
Nokia dominatesMany manufacturers competeHandsets
Single Standardized radio networkMany competing radio networksNetworks
GSM-WorldJapan

2 1
ARPU (Average Revenue per User/Month) in Japan
is a lot higher than in other countries
Total US$ 29.3 6/month
Credit: US$ 47.75
Prepay: US$ 12.2 9
Vodafone D2
(ex-Mannesmann)
Total US$ 66.50/month
voice: US$ 52.40
I-mode: US$ 14.10
Prepay: ? (very small number of users in Japan)
DoCoMo
ARPUCarrier

2 2
Japan vs “GSM World” -> Trends
SMS
MMS, WAP
i-mode (full mobile internet) + full emailwireless data
yesyes, to be integrated with 3G, 4GWIFI -
HotSpots…
?R&D, testing4G
UMTS (=wCDMA)
-
1. wCDMA (DoCoMo + J-Phone/Vodafone)
2. CDMA 2000-1X -> WIN (KDDI/AU)
download:2.4Mb/s
3. Upgrades to 14Mb/s planned for 2005
3G
does not exist in
Europe
full ubiquitous low-price wireless internet
access (128 kb/s) + voice
2G - PHS
GSM
GRPS
-
PDC (DoCoMo + J-Phone)
PDC-DoPa packet data service
CDMA (AU)
2G
GSM-WorldJapan

2 3
Summary
Third generation (3G) wireless communications already today allow transmission
of data at up to 2.4 Mbps in Japan, and we expect that similar transition rates
will become available in Europe in the future.
Integration of internet access, JAVA programs, 3Mbyte cameras with autofocus
and lighting, GPS (satellite global positioning system), multi-application
smartcards enable a great variety of innovative healthcare applications.
Generally mobile communications in Japan are 3-5 years in advance of
developments in Europe. Studying mobile communications in Japan today give a
good indication for which developments to expect in Europe about 3-5 years
from now.
We expect these new developments to enhance medical care. Some examples
of new services are:
◆ Video telephony for remote consultation
◆ Transmission of high-quality photographs from scenes of accidents or for remote
consultation
◆ Access to data base during a patient visit or from an emergency location
◆ Using mobile phones with bio-sensors, GPS, JAVA programs, multi-application smart
cards by chronically ill patients for managing their illness on a continuous basis, e.g.
diabetes or heart disease
◆ Telemedicine applications are not only “high-end”, telemedicine also has important
applications in economically challenged situations, e.g. in developing countries.

2 4
More information:
We publish insights and market reports in our online store:
◆ http://www.eurotechnology.com/store/
i-mode
◆ “Understanding i-mode and how it drives the wireless internet industry” (version 5
of August 25, 2003) http://www.eurotechnology.com/store/imode/
Camera phones
◆ “Camera phones and wireless imaging: disruptive innovation for the photographic
industry” (version 4 of January 14, 2004)
http://www.eurotechnology.com/store/camera-phone/
Wallet Phones
◆ “Wallet phones - internet phones with smartcards” (version 3 of March 3, 2004)
http://www.eurotechnology.com/store/walletphone/
Wireless Japan 2003 trade show
◆ “Wireless Japan 2003 trade show” (version 1 of July 23, 2003)
http://www.eurotechnology.com/store/wirelessjapan2003/
Blue laser report
◆ “Blue and white GaN light emitters and lasers for lighting, displays, data storage,
and traffic signals - background and implications” (version 6 of April 21, 2004)
http://www.eurotechnology.com/store/bluelaser/

2 5
about
Eurotechnology Japan Corporation
www.eurotechnology.com

2 6
About Eurotechnology Japan Corporation
We are the only European company in Tokyo 100% focused on
developing high-tech business between Europe-Japan and US-Japan
Projects:
◆ Market research, strategy development, business development
◆ Spin-outs, incubation of Japan-subsidiaries
◆ Restructuring, acquisitions, corporate finance, corporate transactions
◆ Technology business development, development of licensing business
Customers: Siemens, NTT, Electronics for Imaging, Cubic, Deutsche
Telekom, Asahi Glass, Schott Glass, UNAXIS, and many more large
and small corporations from US, Europe and Japan
More information:
◆ http://www.eurotechnology.com/
Contact us:
◆ info@eurotechnology.com
◆ Tel. +81-3-6717-4160

2 7
Thank You
We are looking forward to
working with you

2 8
Eurotechnology Japan K. K.
Shinagawa Intercity Tower A 28F
2-15-1 Konan, Minato-ku
Tokyo 108-6028, Japan
Tel. +81-3-6717-4160
FAX +81-3-6717-4141 and +81-3-5477-7044
http://www.eurotechnology.com/
info@eurotechnology.com
CEO: Gerhard Fasol, PhD
fasol@eurotechnology.com
Mobile: +81-90-8594-6291

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