ATA InTouch
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Transcript of ATA InTouch
Creation of A Cyber-Hospital: IT Considerations
Ralph Madeb, MDRalph Madeb, MDDirector of Telemedicine
Assistant Professor of UrologyRochester General Hospitaloc este Ge e a osp ta
Rochester, NY
Static and Dynamic SettingsStatic and Dynamic Settings
St ti D iStatic• Outpatient Clinics
N i
Dynamic• Assisted Living and
Nursing Homes• Non-patient encounters• Radiology
Nursing Homes• Wards
ICU• Radiology• Pathology
• LCA ICU
• ICU• ED and Triage
T d OR• LCA ICU • Trauma and OR• HCA for Clinic
BasicsBasics
• ISDN• ISDN• ITU standard (H.320)• Integrated Services Digital Network• Integrated Services Digital Network• Secure digital circuit – it’s a digital phone
lineline• Therefore looks like a phone number
(888)-888-8888( )• Two types BRI(basic rate) and PRI
(primary rate interface)
BasicsBasics
• IP • IP • Internet Protocol• ITU standard (H 323)• ITU standard (H.323)• IP address (192.168.2.4)• Method of addressing network devices• Method of addressing network devices• IP can be transmitted over T1, DSL, cable,• Advantages: leverage infrastructure • Advantages: leverage infrastructure,
reliability, enhanced manageability, simplicity, decreased cost, predictable
f h dusage fees, enhanced security
CORE NETWORK
EXAM ROOM SYSTEM
General Exam Camera
WIRELESS MOBILE SYSTEM @ PATIENT END
Hi Def Camera with Hi-Def. Camera with far-end control
Monitor with split-screen viewingscreen viewing
Wireless laptop with
UPS B tt k ith
p pclinical care data/EMR
UPS Battery-pack with 6 hours of operating time
SYSTEM @ CONSULTANT END
Hi Def Camera with Hi-Def Camera with far-end control
Hi-Def Monitor with split-screen viewingsplit-screen viewing
Doubles as PC-monitor
IMAGES
WIRELESS ROBOTIC SYSTEM @ PATIENT END
IP-Network
The RP Robots
Control Station
Doctor-Robot-Patient RelationshipRelationship
Robot BasicsRobot Basics
• Runs on wireless 802 11 a/b/g• Runs on wireless: 802.11 a/b/g• Ability to roam: follow SSID from one
Access Point to the nextAccess Point to the next• Network Quality:
B d id h id l b d id h i d i • Bandwidth: ideal bandwidth required is 600 kbps in both directions, can run on as little as 200 kbpslittle as 200 kbps
• Latency: latency should be < 400 ms• Quality of Service (QoS) a.k.a. variation in Q y (Q )
latency – poor QoS is bad for the system
SecuritySecurity• Encryption: • Encryption:
• encryption methodology utilizing a combination of RSA public/private key and DES 56 bit t i tiDES 56-bit symmetric encryption
• Key System: • Control stations and robots contain their own • Control stations and robots contain their own
unique private keys • They also contain public keys for all systems
they are allowed to connect tothey are allowed to connect to• Rochester user is only able to connect to Rochester
robots and not UCLA (user must request permission to be able to connect to other health permission to be able to connect to other health network robots)
Video InformationVideo Information
F t • Frame rate: • Video is captured at 30 frames per second
• Codec (video and audio compression): • InTouch Health uses proprietary video and y
audio codecs
Integrated System
Main ConsiderationMain Consideration
Cli i l li ti h ld d i • Clinical applications should drive technology – NOT vice versa
• “One-size-fits-all” won’t work –Customize technology to meet clinical needs
IT CONSIDERATIONS
• Standards-based• Interoperable• TransparentTransparent• User-friendly – for clinical staff NOT for
IT staffIT staff• “Kick-the-tires” – use before purchase• Low-cost approach
“Imagination is more important than “Imagination is more important than knowledge”knowledge”