There are only a handful of industries that became early adopters of ultra high-definition 4K technology, and healthcare was one of them. This is because much of the focus has been on video shared between medical professionals, and 4K provides greater detail, contrast and color for a doctor to consider, which means faster and more accurate diagnoses, minimally invasive procedures, and greater likelihood of error-free surgery. 4K, and increasingly 3D, content, along with low-latency IP network infrastructures, are leading the way in the “telehealth” paradigm.
“Distance learning” is the use of live and recorded video from inside operating rooms, for surgeons to share their knowledge, experiences and to collaborate. It is typically sent over a dedicated IP for later recorded video streaming, broadcasting of live procedures, and for storage on Network Attached Storage devices (NAS). A benefit of distance learning is that it connects healthcare education to underserved and remote populations.
“Telemedicine” is the use of various tools and software that help physicians assess, diagnose and monitor patients without having to see them in person. Examples are video conferencing, online patient portals, and portable carts that consist of diagnostic tools (ECG, vital signs monitor, etc.) that stream data from a patient’s location to a remote computer that can be monitored for abnormal results. In this scenario, video is but one part of the remote care “telesolution.” Since most “teleconsultations” can be done over the public Internet, we focus our attention on the dedicated IP distribution needs of distance learning.
As example of distance learning in healthcare in use today,
For Cedars Sinai Hospital’s annual surgical seminar, they connected via IP four operating studios across multiple floors, a production control room, conference rooms for consultations, and a theater, across multiple buildings, for hundreds of visiting physicians to view surgeries live and interact with the surgeons.
The Walton Centre, a major neurology hospital in England, connected their three story rehabilitation building, pain management and medical training facilities, and brain injury unit. In the rehab building, they then launched an education center for doctors and staff with a 100-seat theater and rooms that allow for flexible use, such as meetings, trainings, videoconferencing, conferences and events.
Modesto Junior College, in California’s Central Valley, has a distance learning (“telepresence”) nursing program, where students can go to Columbia College’s classrooms, 55 miles or over an hour drive away, to take MJC courses. MJC also has on-campus classes where students participate in classes at other colleges, such as West Hills Community College, a distance of 119 miles or over 2 hours drive away, using telepresence communications.
MidState Medical Center is a medical learning facility with a global student audience. They have two operating rooms, the Hybrid OR and the Robot Room, which allows students to observe surgical procedures through videoconferencing. After the procedure, the students are allowed to ask questions and interact with the surgeons.
Here is brief overview of how the previous teaching hospital scenarios may be setup, with a focus on hardware solutions that may be used to broadcast the material.
Inside an operating studio we are primarily working with video and endoscopy cameras, which can be DVI, HDMI or SDI signals. Since HD video requires a high bandwidth pipe and there can be no latency, as surgeons are viewing their careful decisions on a local monitor, fiber is the best choice within the OR. Signals can then be routed into classrooms within the same building or across a campus using fiber, up to 10 km (6 miles) distance with a VX receiver. Alternatively, a dedicated Ethernet/IP network may be desired, which requires an encoder on the front end to send the signal over a dedicated IP, and one decoder for each of the classrooms to receive the signal.
Inside a classroom, new collaborative technologies for distance learning may be used, such as facial recognition technology to allow students entrance to the room, interactive projector, interactive whiteboard or touch display, integrated audio that blocks outside noise, lecture capture software to record and archive teaching events, and touchscreen controls to quickly set up calls, switch content and share information. Some also utilize a live mixing console and production switcher, with someone on staff to manage it.
At around 2 inches square, Opticomm-EMCORE’s VX Pro series are the perfect solution for fiber extenders in the OR, through wall or ceiling mounted boom arms. VX’s come in DVI, DVI with audio and serial data, and HDMI options at 1080P/60Hz resolution.
For the IP scenario, Opticomm-EMCORE has several encoder/decoder options depending on the data rate of the network, the image quality needed, and type of signal. The NV Series works for DVI (or HDMI with an adapter – with HDCP) or there is 3G HD-SDI model, but they require a 100 MB/sec data rate for their lossless transmission. The Eclipse HD (EV) Series is available for HDMI with HDCP, and requires a 150 Mbps fixed data rate for visually lossless compression. They also have the HD4 Series, also for HDMI (or VGA), and is for networks providing 256 Kbps to 30 Mbps variable data rates.
For classroom-to-classroom distance learning programs, typically there will be an instructor’s laptop that makes use of HDMI to transmit an audio and video signal. Depending on where the laptop resides would dictate where the signal goes next. If the laptop is right next to the classroom projector, interactive whiteboard or touch display, you can simply connect it direct using copper cabling. If the laptop is across the room, you will need a CATx/HDBaseT cable that can transmit the signal up to 100 meters and a transmitter/receiver link such as the Optiva OTC-HDMI2A-USB-ETH. Similarly, if the laptop is a very long distance away, up to 10 km (6 miles), you can use fiber cabling for the best quality signal transmission and will need a transmitter/receiver link such as Optiva OTP-1HDMI2A-USB-ETH.
With either of these transmitters, you can send HDMI 1.4b with digital audio, stereo analog audio, such as from an analog microphone, and USB KVM (keyboard/video/mouse) so you can control the laptop from the front of the classroom as if you were standing right next to it. Both also connect with the hospital’s Ethernet network, so that you can pull information off the network into the classroom or can send information through the network to long distance learners. On the receiving end, the HDMI video and digital audio can be sent to a projector or interactive whiteboard, while any separate analog audio is sent to analog speakers.
For sending USB 2.0 device signals long-distance over fiber, such as a tablet device or document camera, Opticomm-EMCORE has a USB extender that can take in one signal and output it to up to four output devices (4 port hub).
However you choose to setup your training hospital or higher education distance learning application, the greatest advantage lies in the ability we have now to bring experienced medical practitioners and the next generation of surgeons together through digital technology. Contact Opticomm-EMCORE for a free system design consultation.