Table Of ContentADVANCES IN
TELEMEDICINE:
TECHNOLOGIES,
ENABLING FACTORS
AND SCENARIOS
Edited by Georgi Graschew
and Theo A. Roelofs
Advances in Telemedicine: Technologies, Enabling Factors and Scenarios
Edited by Georgi Graschew and Theo A. Roelofs
Published by InTech
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Advances in Telemedicine: Technologies, Enabling Factors and Scenarios,
Edited by Georgi Graschew and Theo A. Roelofs
p. cm.
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Contents
Preface IX
Part 1 Fundamental Technologies 1
Chapter 1 Cross Layer Design of Wireless LAN for Telemedicine
Application Considering QoS Provision 3
Eko Supriyanto, Emansa Hasri Putra, Jafri bin Din,
Haikal Satria and Hamid Azwar
Chapter 2 Novel Wireless Communication Protocol
for e-Health Applications 27
A. Zvikhachevskaya and L. Mihaylova
Chapter 3 Safety and Electromagnetic Compatibility
in Wireless Telemedicine Applications 63
Victoria Ramos and José Luís Monteagudo
Part 2 Applied Technologies 85
Chapter 4 High-Quality Telemedicine Using
Digital Video Transport System
over Global Research and Education Network 87
Shuji Shimizu, Koji Okamura, Naoki Nakashima,
Yasuichi Kitamura, Nobuhiro Torata, Yasuaki Antoku,
Takanori Yamashita, Toshitaka Yamanokuchi,
Shinya Kuwahara and Masao Tanaka
Chapter 5 Lossless Compression Techniques
for Medical Images In Telemedicine 111
J.Janet, Divya Mohandass and S.Meenalosini
Chapter 6 Video-Telemedicine with Reliable Color
Based on Multispectral Technology 131
Masahiro Yamaguchi, Yuri Murakami,
Yasuhiro Komiya, Yoshifumi Kanno,
Junko Kishimoto, Ryo Iwama, Hiroyuki Hashizume,
Michiko Aihara and Masaki Furukawa
VI Contents
Chapter 7 Sharp Wave Based HHT Time-frequency
Features with Transmission Error 149
Chin-Feng Lin, Bing-Han Yang, Tsung-Ii Peng,
Shun-Hsyung Chang, Yu-Yi Chien, and Jung-Hua Wang
Chapter 8 Teleconsultation Enhanced via Session Retrieval Capabilities:
Smart Playback Functions and Recovery Mechanism 165
Pau-Choo Chung and Cheng-Hsiung Wang
Chapter 9 Statistics in Telemedicine 191
Anastasia N. Kastania and Sophia Kossida
Chapter 10 Video Communication in Telemedicine 211
Dejan Dinevski, Robi Kelc and Bogdan Dugonik
Chapter 11 Telemedicine & Broadband 233
Annarita Tedesco, Donatella Di Lieto, Leopoldo Angrisani,
Marta Campanile, Marianna De Falco and Andrea Di Lieto
Part 3 Enabling Factors 259
Chapter 12 Quality Control in Telemedicine - “CE” Label 261
O. Ferrer-Roca
Chapter 13 Innovative Healthcare Delivery:
the Quest for Effective Telemedicine-based Services 271
Laura Bartoli, Emanuele Lettieri and Cristina Masella
Part 4 Scenarios 295
Chapter 14 Real-time Interactive Telemedicine for Ubiquitous Healthcare:
Networks, Services and Scenarios 297
Georgi Graschew, Theo A. Roelofs
Stefan Rakowsky and Peter M. Schlag
Chapter 15 Could There Be a Role for Home Telemedicine
in the U.S. Medicare Program? 319
Lorenzo Moreno, Arnold Chen, Rachel Shapiro and Stacy Dale
Chapter 16 Development of a Portable Vital Sensing
System for Home Telemedicine 345
F. Ichihashi and Y. Sankai
Chapter 17 Implementing the Chronic Disease Self
Management Model in Vulnerable Patient Populations:
Bridging the Chasm through Telemedicine 357
Cardozo Lavoisier J, Steinberg Joel, Cardozo Shaun,
Vikas Veeranna, Deol Bibban and Lepczyk Marybeth
Contents VII
Chapter 18 The Spanish Ministry of Defence (MOD)
Telemedicine System 379
Alberto Hernandez Abadia de Barbara
Chapter 19 A Telemedicine System for Hostile Environments 397
Ebrahim Nageba, Jocelyne Fayn and Paul Rubel
Preface
Innovative developments in information and communication technologies (ICT) irre-
vocably change our lives and enable new possibilities for society. One of the fi elds that
strongly profi ts from this trend is Telemedicine, which can be defi ned as novel ICT-
enabled medical services that help to overcome classical barriers in space and time.
Through Telemedicine patients can access medical expertise that may not be available
at the patient’s site. The use of specifi cally designed communication networks with
sophisticated quality-of-service for Telemedicine (distributed medical intelligence)
contributes not only to the continuous improvement of patient care, but also to reduc-
ing the regional disparity in access to high-level healthcare. Telemedicine services can
range from simply sending a fax message to a colleague to the use of broadband net-
works with multimodal video- and data streaming for obtaining second opinions as
well as medical telepresence. Depending on the specifi c medical service requirements,
a range of classes-of-services is used, each requiring its own technological quality-of-
service.
Originally started as interdisciplinary eff orts of engineers and medical experts, Telemed-
icine is more and more evolving into a multidisciplinary approach. Consequently, com-
piling a book on recent “Advances in Telemedicine” will have to cover a correspond-
ingly wide range of topics. In addition, if each topic shall be treated in suffi cient depth
to allow the reader to get a comprehensive understanding of both the developmental
state-of-the-art as well as the broad spectrum of issues relevant to Telemedicine, one
might easily end up with a huge tome, too big to be practical in handling. Therefore,
this book “Advances in Telemedicine” has been split into two volumes, each covering
specifi c themes: Volume 1: Technologies, Enabling Factors and Scenarios; Volume 2:
Applications in Various Medical Disciplines and Geographical Regions. The Chapters
of each volume are clustered into four thematic sections.
The current Volume 1 “Advances in Telemedicine: Technologies, Enabling Factors and
Scenarios” contains 19 Chapters clustered into the following thematic sections:
• Fundamental Technologies (Chapters 1-3),
• Applied Technologies (Chapters 4-11),
• Enabling Factors (Chapters 12-13),
• Scenarios (Chapters 14-19).
The section on Fundamental Technologies starts off with a thorough study on a novel
cross-layer design of wireless-LAN (1) that combines the SVC extension of the H.264
X Preface
video coding standard with the recent IEEE 802.11e WLAN standard. This new ap-
proach allows for the transmission of video streams over WLAN with an assigned
guaranteed bandwidth (QoS) as required for telemedicine video applications in suf-
fi ciently high quality. The next study reports on the development of a wireless cross-
standard communication protocol (2) that supports the creation of network-of-net-
works for e-Health applications from existing commercial (WiFi, WiMAX) and military
(HIDL, Link 11) communication systems. This new protocol has been implemented
in a demonstrator network that allows for the operation and investigation of various
real-life healthcare scenarios. The section is closed up by extensive considerations on
safety and electromagnetic compatibility (3) in wireless WiFi-, DECT- or GSM-based
telemedicine applications. The electromagnetic environment of typical urban homes
is characterised and an assessment for the potential safe use of home telemonitoring
systems is presented. The need for adequate and harmonised legislation and regula-
tion is also addressed.
The next section on Applied Technologies begins with an exploration of combining
digital video transport systems with global research and education networks (4) for
high quality video streaming in telemedicine. This new combination can help to over-
come many of the bott lenecks in telemedicine implementation in daily routine, such as:
insuffi cient image quality, too-high cost for set-up and operation, too diffi cult to use by
medical experts. Next, a new algorithm for lossless compression of medical images
(5) of various kinds using Huff man-based contourlet transform coding is presented. It
is demonstrated that this new algorithm achieves higher compression ratios and yet
superior image quality for diff erent classes of medical images as compared to existing
methods in the literature. The next chapter addresses the critical question as to the reli-
ability of colour representation in transmission and display of medical videos and still
images by presenting a novel sophisticated multispectral colour reproduction system
(6). Experimental evaluation of this new system used in video-based telemedicine ap-
plications for dermatology, surgery and general teleconsultation demonstrates that the
reproduced colour is perceived as almost identical to the original, enabling improved
remote diagnosis. The following chapter describes the application of Hilbert Huang
transformation-based time-frequency analysis approach for studying normal and
sharp waves in electroencephalograms contaminated by transmission errors (7). Es-
pecially when applied as a tool to diagnose, diff erentiate and classify various stages of
epilepsy this novel analysis approach yields more accurate results. The section contin-
ues with a presentation of three-level indexing hierarchy (TIH)-based smart playback
and recovery functions to enrich teleconsultation systems with retrieval capabili-
ties (8). Thanks to the smart combination of cross-linked referencing and prioritised
recovery the system allows a range of smart playback functions (e.g. replaying all the
segments of a session controlled by a particular physician, or replaying all the session
segments for which a particular medical image is discussed). The next chapter exten-
sively treats a wide range of diff erent aspects of the application of statistics in telemed-
icine (9). It treats diverse aspects of qualitative and quantitative statistical methods
in telemedicine such as for research and evaluation, for testing web-based platforms
with diff erent numbers of users, for new biomarker detection, or for electronic medical
records and bio-banks. This work uncovers corresponding opportunities and challeng-
es and provides the reader with useful guidelines. The subsequent chapter provides
a survey on the technological and perceptive aspects of video communication (10)
as used in various classes of services in telemedicine. It describes video applications
