Using satellites for health care innovations

In a project called TelAny (Telemedicine Anywhere) funded by ESA, trials showed how satellite telecommunications can allow doctors to monitor and treat emergency cases or long term patients remotely.

The project pooled the experience of medical, software and telecommunications professionals to test three different scenarios:

• the monitoring of patients directly accessing life signals using devices implanted in their bodies
• treating emergencies on board ships in Norway
• making a medical database out of data collected that consulting specialists could access

Monitoring life signals remotely

Taking part in the project were five patients each with a Medtronic cardioverter defibrillator (pacemaker) device implanted into their hearts by the participating cardiologists. These patients were monitored from hospitals in Milan and Rome.

The system used is called TelAny (Telemedicine Anywhere). It provided access to the data that would be used by the medical professionals.

Non-specialised paramedical or non-medical personnel at the home of the patient helped the remote physician by collecting the data from the implanted sensors using an electronic reader.

The information collected was then downloaded to a PC equipped with a Globalstar satellite modem and connected to a relatively small antenna which provided a satellite-based Internet connection. Physicians were able to retrieve data from the PC at the patient’s home in less than 30 seconds.

After analysing the data the physician could give advice to the patient over the phone based on the information he received. Only if the pacemaker needed to be reprogrammed would the doctor invite the patient to the surgery.

“A patient with a long-term heart problem with this set up would be free to move around the world and be able to send data from the implanted sensor for their specialist to check at any time. This can give a patient a new sense of freedom that can only improve their quality of life.” said Cesare Aragno, Telemedicine and Tele-Education Unit Manager at Kell S.r.l.

Treating emergencies remotely

TelAny can also transfer data from the place where a medical emergency occurs to a remotely connected physician for immediate assistance. The demonstration took place on board the MS Trollfjord in co-operation with a doctor on shore at KoKom in Bergen (Norway). The procedure lasted about 20 minutes and involved a patient being examined under the direction from the doctor on shore.

Onboard MS Trollfjord the online application made it possible for the medical assistant on-board ship to have a videoconference with the doctor on shore. The equipment included a wearable computer, a headset, microphone, camera and screen. This equipment was mobile and conveyed information to shore via a wireless network.

Medical equipment was connected to the PC: an ECG, a multi-monitoring device, an electronic stethoscope and a digital camera. Data collected from these different non-invasive medical devices was encrypted and sent to the doctor on shore.

The medical e-mail software (DORIS Professional by Well) was very useful for supplying pictures; a 12 lead ECG is important in the case of a heart attack. Temperature, non-invasive blood pressure, heart rate and oxygen saturation are also important values in a number of cases.

At the same time, this software documented the consultation by digitally recording the question from the boat and the answer from the doctor. This made referring to the details of the procedure much more reliable than notes taken during a phone call.

The medical database

The data collected in the trials was stored on a database server using software called J-Hospital (by Kell). The physicians were able to remotely access and review this stored data over both terrestrial and satellite Internet connections provided by the Telespazio Evolv-e platform.

The physicians monitoring the heart patients remotely were able to fully examine the data transferred from the implanted devices. Having access to both parameters and signals enabled a complete view of the clinical situation that previously required direct use of the Medtronic programmer. An additional benefit was that J-Hospital stored all data from previous readings; the Medtronic programmer only gives access to one set of data at a time.

Clinical records are largely paper-based and available on a daily basis only within the hospital in which they are kept. The future of medical practice however will rely ever more on making this sort of information available in electronic format to physicians wherever they are.