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. 2022 May 26;6(5):e36824.
doi: 10.2196/36824.

Emergency Telemedicine Mobile Ultrasounds Using a 5G-Enabled Application: Development and Usability Study

Maximilian Berlet  1 , Thomas Vogel  1 , Mohamed Gharba  2 , Joseph Eichinger  2 , Egon Schulz  2 , Helmut Friess  1 , Dirk Wilhelm  1 , Daniel Ostler  3 , Michael Kranzfelder  1
Affiliations

Emergency Telemedicine Mobile Ultrasounds Using a 5G-Enabled Application: Development and Usability Study

Maximilian Berlet et al. JMIR Form Res. .

Abstract

Background: Digitalization affects almost every aspect of modern daily life, including a growing number of health care services along with telemedicine applications. Fifth-generation (5G) mobile communication technology has the potential to meet the requirements for this digitalized future with high bandwidths (10 GB/s), low latency (<1 ms), and high quality of service, enabling wireless real-time data transmission in telemedical emergency health care applications.

Objective: The aim of this study is the development and clinical evaluation of a 5G usability test framework enabling preclinical diagnostics with mobile ultrasound using 5G network technology.

Methods: A bidirectional audio-video data transmission between the ambulance car and hospital was established, combining both 5G-radio and -core network parts. Besides technical performance evaluations, a medical assessment of transferred ultrasound image quality and transmission latency was examined.

Results: Telemedical and clinical application properties of the ultrasound probe were rated 1 (very good) to 2 (good; on a 6 -point Likert scale rated by 20 survey participants). The 5G field test revealed an average end-to-end round trip latency of 10 milliseconds. The measured average throughput for the ultrasound image traffic was 4 Mbps and for the video stream 12 Mbps. Traffic saturation revealed a lower video quality and a slower video stream. Without core slicing, the throughput for the video application was reduced to 8 Mbps. The deployment of core network slicing facilitated quality and latency recovery.

Conclusions: Bidirectional data transmission between ambulance car and remote hospital site was successfully established through the 5G network, facilitating sending/receiving data and measurements from both applications (ultrasound unit and video streaming). Core slicing was implemented for a better user experience. Clinical evaluation of the telemedical transmission and applicability of the ultrasound probe was consistently positive.

Keywords: 5G; ambulance; diagnosis; diagnostic; digital health; digital medicine; digitalized medicine; eHealth; emergency; emergency care; field test; image quality; imaging; mobile ultrasound; slicing; telehealth; telemedicine; ultrasound.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Specifications of 5G new radio providing a set of specifications for the 5G core network as defined in 3GPP Release 15 [11]. CT: computed tomography; MRI: magnetic resonance imaging.
Figure 2
Figure 2
Framework for the 5G field test. Ambulance car (left) equipped with mobile ultrasound and pan, tilt, zoom camera connected to a UE modem. The latter is connected to an RF unit, which is connected to UE antennas on the top roof of the ambulance car. The remote hospital site (right) is connected to the 5G core, which is connected to the gNB. gNB: gNodeB; RF: radio frequency; UE: user equipment.
Figure 3
Figure 3
Average end-to-end round trip delay of the two applications: latency and time (seconds). Additional uplink traffic (traffic saturation) marked with *.
Figure 4
Figure 4
Additional uplink traffic (end-to-end round trip latency *) without core slicing. Ultrasound application (left) and video streaming (right).
Figure 5
Figure 5
Additional uplink traffic (end-to-end round trip latency *) with core slicing. Ultrasound application (left) and video streaming (right).
See this image and copyright information in PMC

References

    1. Tuckson RV, Edmunds M, Hodgkins ML. Telehealth. N Engl J Med. 2017 Oct 19;377(16):1585–1592. doi: 10.1056/nejmsr1503323. - DOI - PubMed
    1. Pedersen PC, Dickson BW, Chakareski J. Telemedicine applications of mobile ultrasound. 2009 IEEE International Workshop on Multimedia Signal Processing; October 5-7, 2009; Rio de Janeiro, Brazil. 2009. - DOI
    1. Garner P, Collins M, Webster S, Rose D. The application of telepresence in medicine. BT Technol J. 1997;15(4):181–187. doi: 10.1023/A:1018699900499. - DOI
    1. Rogers H, Madathil KC, Agnisarman S, Narasimha S, Ashok A, Nair A, Welch BM, McElligott JT. A systematic review of the implementation challenges of telemedicine systems in ambulances. Telemed J E Health. 2017 Sep;23(9):707–717. doi: 10.1089/tmj.2016.0248.10.1089/tmj.2016.0248 - DOI - PubMed
    1. Felzen M, Beckers SK, Kork F, Hirsch F, Bergrath S, Sommer A, Brokmann JC, Czaplik M, Rossaint R. Utilization, safety, and technical performance of a telemedicine system for prehospital emergency care: observational study. J Med Internet Res. 2019 Oct 08;21(10):e14907. doi: 10.2196/14907. https://www.jmir.org/2019/10/e14907/ v21i10e14907 - DOI - PMC - PubMed

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