An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings. 1. Introduction Driven by technological advances, especially in the last decade, mobile-health (m-health) systems and services have refined access to specialized healthcare delivery [1–5]. Advances in wireless and sensor networks, mobile and cloud computing, compression technologies, mobile devices and nanotechnologies, and associated standards and algorithms for efficient communication, interoperability, and ease of integration have fostered the evolution of such systems and services. Toward this end, social media colossal acceptance linked with an overwhelming number of smartphone medical-oriented applications is expected to bring further growth, initiating a decisive subject involvement. While economic benefit is still debatable based on current deployment [6], it is indisputable that widespread adoption in daily clinical practice will provide significant financial savings [7]. Medical video communication systems aim to meet the demand for emergency telematics, within ambulance care, remote diagnosis and care for frail elderly people and people with mobility problems, mass population screening, especially in developing countries and in disaster incidents and battlefields, and for medical
References
[1]
World Health Organization, mHealth: New Horizons for Health Through Mobile Technologies, vol. 3 of Global Observatory for eHealth Series, 2011.
[2]
C. S. Pattichis, E. Kyriacou, S. Voskarides, M. S. Pattichis, R. Istepanian, and C. N. Schizas, “Wireless telemedicine systems: an overview,” IEEE Antennas and Propagation Magazine, vol. 44, no. 2, pp. 143–153, 2002.
[3]
E. Kyriacou, M. S. Pattichis, C. S. Pattichis, A. Panayides, and A. Pitsillides, “m-health e-emergency systems: current status and future directions,” IEEE Antennas and Propagation Magazine, vol. 49, no. 1, pp. 216–231, 2007.
[4]
J. L. DelliFraine and K. H. Dansky, “Home-based telehealth: a review and meta-analysis,” Journal of Telemedicine and Telecare, vol. 14, no. 2, pp. 62–66, 2008.
[5]
R. S. H. Istepanian and Y. T. Zhang, “Guest editorial introduction to the special section: 4G health—the long-term evolution of m-health,” IEEE Transactions on Information Technology in Biomedicine, vol. 16, no. 1, pp. 1–5, 2012.
[6]
H. Mistry, “Systematic review of studies of the cost-effectiveness of telemedicine and telecare. Changes in the economic evidence over twenty years,” Journal of Telemedicine and Telecare, vol. 18, no. 1, pp. 1–6, 2012.
[7]
D. West, “How mobile devices are transforming healthcare,” Issues in Technology Innovation, vol. 18, pp. 1–14, 2012.
[8]
A. Panayides, M. S. Pattichis, C. S. Pattichis, and A. Pitsillides, “A tutorial for emerging wireless medical video transmission systems [Wireless Corner],” IEEE Antennas and Propagation Magazine, vol. 53, no. 2, pp. 202–213, 2011.
[9]
A. S. Panayides, Diagnostically resilient encoding, wireless transmission, and quality assessment of medical video [Ph.D. dissertation], Department of Computer Science, University of Cyprus, Nicosia, Cyprus, 2011.
[10]
A. Alesanco, C. Hernndez, A. Portolés et al., “A clinical distortion index for compressed echocardiogram evaluation: recommendations for Xvid codec,” Physiological Measurement, vol. 30, no. 5, pp. 429–440, 2009.
[11]
E. Cavero, A. Alesanco, L. Castro, J. Montoya, I. Lacambra, and J. Garcia, “SPIHT-based echocardiogram compression: clinical evaluation and recommendations of use,” IEEE Transactions on Information Technology in Biomedicine, 2012.
[12]
A. Panayides, M. S. Pattichis, C. S. Pattichis, C. P. Loizou, M. Pantziaris, and A. Pitsillides, “Atherosclerotic plaque ultrasound video encoding, wireless transmission, and quality assessment using H.264,” IEEE Transactions on Information Technology in Biomedicine, vol. 15, no. 3, pp. 387–397, 2011.
[13]
M. G. Martini and C. T. E. R. Hewage, “Flexible macroblock ordering for context-aware ultrasound video transmission over mobile WiMAX,” International Journal of Telemedicine and Applications, vol. 2010, Article ID 127519, 14 pages, 2010.
[14]
S. P. Rao, N. S. Jayant, M. E. Stachura, E. Astapova, and A. Pearson-Shaver, “Delivering diagnostic quality video over mobile wireless networks for telemedicine,” International Journal of Telemedicine and Applications, vol. 2009, Article ID 406753, 9 pages, 2009.
[15]
A. Panayides, Z. Antoniou, V. I. Barberis, M. S. Pattichis, C. S. Pattichis, and E. Kyriacou, “Abdominal Aortic Aneurysm medical video transmission,” in Proceedings of the IEEE-EMBS International Conference on Biomedical and Health Informatics (BHI '12), pp. 679–682, January 2012.
[16]
C. Debono, B. Micallef, N. Philip, A. Alinejad, R. Istepanian, and N. Amso, “Cross layer design for optimised region of interest of ultrasound video data over mobile WiMAX,” IEEE Transactions on Information Technology in Biomedicine, vol. 16, no. 6, pp. 1007–1014, 2012.
[17]
A. Panayides, Z. Antoniou, Y. Mylonas, M. S. Pattichis, A. Pitsillides, and C. S. Pattichis, “High-resolution, low-delay, and error-resilient medical ultrasound video communication using H.264/AVC over mobile WiMAX networks,” IEEE Transactions on Information Technology in Biomedicine, 2012.
[18]
A. Alinejad, N. Philip, and R. Istepanian, “Cross layer ultrasound video streaming over mobile WiMAX and HSUPA networks,” IEEE Transactions on Information Technology in Biomedicine, vol. 16, no. 1, pp. 31–39, 2012.
[19]
M. G. Martini, R. S. H. Istepanian, M. Mazzotti, and N. Philip, “Robust multi-layer control for enhanced wireless tele-medical video streaming,” IEEE Transactions on Mobile Computing, vol. 9, no. 1, pp. 5–16, 2010.
[20]
E. Cavero, A. Alesanco, and J. Garcia, “Enhanced protocol for real time transmission of echocardiograms over wireless channels,” IEEE Transactions on Biomedical Engineering, vol. 59, no. 11, pp. 3212–3220, 2012.
[21]
A. Panayides, M. S. Pattichis, C. S. Pattichis, C. N. Schizas, A. Spanias, and E. C. Kyriacou, “An overview of recent end-to-end wireless medical video telemedicine systems using 3G,” in Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC '10), pp. 1045–1048, Buenos Aires, Argentina, August-September 2010.
[22]
S. A. Garawi, R. S. H. Istepanian, and M. A. Abu-Rgheff, “3G wireless communications for mobile robotic tele-ultrasonography systems,” IEEE Communications Magazine, vol. 44, no. 4, pp. 91–96, 2006.
[23]
Y. Chu and A. Ganz, “A mobile teletrauma system using 3G networks,” IEEE Transactions on Information Technology in Biomedicine, vol. 8, no. 4, pp. 456–462, 2004.
[24]
P. C. Pedersen, B. W. Dickson, and J. Chakareski, “Telemedicine applications of mobile ultrasound,” in Proceedings of IEEE International Workshop on Multimedia Signal Processing (MMSP '09), pp. 1–6, October 2009.
3GPP, “Overview of 3GPP Release 6”, V0.1.1, 2010, http://www.3gpp.org/ftp/Information/WORK_PLAN/Description_Releases/.
[33]
K. Seshadrinathan, R. Soundararajan, A. C. Bovik, and L. K. Cormack, “Study of subjective and objective quality assessment of video,” IEEE Transactions on Image Processing, vol. 19, no. 6, pp. 1427–1441, 2010.
[34]
A. Panayides, M. S. Pattichis, C. S. Pattichis, C. P. Loizou, M. Pantziaris, and A. Pitsillides, “Towards diagnostically robust medical ultrasound video streaming using H.264,” in Biomedical Engineering, C. Alexandre Barros De Mello, Ed., pp. 219–237, IN-TECH, Vienna, Austria, 2009.
[35]
802.11aa-2012—IEEE Standard for Information technology—Telecommunications and information exchange between systems Local and metropolitan area networks—Specific requirements Part 11: Wireless LAN Medium Access Control (MAC) and Physical Layer (PHY) Specifications Amendment 2: MAC Enhancements for Robust Audio Video Streaming, pp. 1–161, May 2012.
[36]
A. Panayides, Z. Antoniou, M. S. Pattichis, C. S. Pattichis, and A. G. Constantinides, “High efficiency video coding for ultrasound video communication in m-health systems,” in Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC '12), pp. 2170–2173, San Diego, Calif, USA, August-September 2012.
