ABSTRACT
With the day to day improvement in the field of
medicine the urban society is enjoying a healthy life, but for the people of
rural and remote areas even the basic health care is not sufficiently
available. For the rural masses to enjoy the breakthroughs in the field of
medicine, 'Telemedicine' can be used. The present form of telemedicine does not
suit the Indian scenario due to the described factors. To make telemedicine suitable
for Indian conditions we design a low cost, efficient prototype system making
use of fixed Wireless Internet. In our system we connect the remote or rural
areas to the nearest well established hospital through the Fixed Wireless
Internet. In the rural center, less trained medical attendant can work upon
patients by the guidance given by the efficient doctor guiding him through the
fixed wireless Internet. The basic structure of our Telemedicining is achieved
through a digital camcorder and VoIP enabled telephones, which are both
compatible with Fixed Wireless Internet. For the effective performance of the
Fixed Wireless Internet system the design criteria of the transceiver is of
utmost importance. The use of Fixed Wireless Internet System as a bridge solves
the problem of Band -width requirements and cost effectiveness. With these
Telemedicine system remote consultations, monitoring is possible. Depending
Upon the infrastructure and the Personnel available in the rural center,
telesurgery can become a reality.
Introduction
Recently, the United Nation's Human Development Report
2000 was released which has praised India's human rights endeavors. In the same
report, it has also been stated that the rural health profile of the country is
disturbing. When the researchers are creating the map of chromosomes, the doctors in US
using 'biochip', many people, from our rural India die because of
unavailability of proper medical facilities. Besides the lack of willingness
from the practitioners side, the paucity of health related data is a major
handicap in providing medicinal facilities in a developing country like ours,
having overburden of population and financial constraints. Moreover India is
undergoing a demographic transition and the age groups of the older are growing
faster than the age groups of the younger. Today India counts over 70 million
elderly people. Approximately 7% of the Indian population is over 60 years of
age. 75% of these elderly live in rural regions and 20% are disabled to varying
degrees. The average life expectation of a person born today is around 62
years. But the sad realities in India show that the greater the longevity, the
higher the chances of disability and frailty. The fact that most of the
government sponsored old age homes are located in urban areas clearly shows
that elderly citizens of rural area do not receive proper care. It is also
difficult to take them to efficient urban hospitals due to our 'kachha' roads.
Communication and computers have brought about
technological wonders in all spheres of life, altering the living style of
people. Information super-highway has really made the world a 'global village'
with the help of innovations taking place both in hardware and software and in
the transmission medium. All the development activities center around urban
areas. We would like to utilize the technology marvel to deliver 'Medical Care'
to reach the needy rural masses with the help of telemedicine.
Telemedicine has the potential to perform this task
more ably and thus profoundly change the health status of rural India.
Rural Center
It provides entry
for patients into wireless telecom network. It comprises of all system, which
digitize data from lab instruments that can be sent to a Hi - Fi hospital that
is connected through Fixed Wireless Internet. In the rural center, the digital
camcorder records the patient's image, which is digitized and fed to the
computer interface.
Hi - Fi Hospital
It provides entry to telemedicine for health care
provider. Here the physician accesses information from the rural center and can
also access database and reference information simultaneously. It includes two
way voices; video, which allows the physician to monitor and communicate with
the person who, is in the rural center with the simultaneous transfer of
digitized data.
VoIP enabled phones empower both the patient as well
as the doctor to have effective conversation with each other.
Digital camcorder is provided in the hospital so that
the patient in the rural hospital can also see the image of the doctor. Hence
the patient can have face to face conversation, which gives a feeling that the
doctor is physically present. This helps to develop an enhanced doctor -
patient relationship, which the Indian patients look for. VoIP Enabled
Phones:
We make use of VoIP
enabled phones so that our system is compatible with Fixed Wireless Internet
network.
The DSP in VoIP is
responsible for signal processing functions such ac analog to digital
conversion of voice signals, voice compression, echo cancellation and voice
-activity detection call origination, call detection, signaling.
>
Signaling in VoIP network is accomplished by exchange
of IP datagram messages between the components. The format of this message is
covered by the standard data link layer protocols.
>
In VoIP digitized voice is bundled into IP packets and
sent out into the network for delivery. Routers, Switches and other network
equipment direct the packets to their destination IP address.
>
In addition to performing the analog to digital
conversion, the CODECs compress the voice data stream. Compression of the voice
wave form results in bandwidth savings. The output from CODECs is a data stream
that is put into IP packets and transported across the network to an end point.
The end points must use the same standards as well as common set of codec
parameters. Use of different parameters at the end points will lead to
unintelligible communication. Use of complex coders with higher compression
ratios reduce the band width consumption. But there is a price paid for the
conversion: increased conversion delay. > Another way to save bandwidth is
the use of silence suppression, in which voice is not sent between the gaps in
human conversations. The voice-activity detection technique allows the
monitoring of silence in speech data.
Advantages of VoIP
S Reduced cost
S Compelling
technical advantages over circuit switching
• Based on open
architecture, hence more interchange able and more modular.
S Is suitable for
computer telephony integration.
Digital Camcorder
The raw content is obtained by filming video
instructions already captured on tape to digital format using a graphics card
and A/D converter. The raw video content is edited and compressed and then
saved in a format in which it is eventually distributed.
It incorporates software with limited editing
capability and save video files to standard formats, such as 'avi' and 'mpeg'.
Once digital video scenes are created and edited, a
range of file format options are available for storing and distributing images.
Delay can be minimized by using file formats that optimize the media and retain
quality, which the smallest possible file size. File sizes should be small and
streamable to eliminate delays wherever possible.
Fixed Wireless Internet
With highly reliable RF transmission systems, it has
been made possible to build economical, high-speed Fixed Wireless Internet
networks. It acts as a bridge in linking the rural center with the Hi - Fi
hospital. The bridge includes hardware and software of telemedicine as well as
the wireless system design. It enables the transmission of higher resolution
pictures of patient injuries and X - rays for consultation and opinion. The
system facilitates anything from large e-mail attachments to interactive
medical examinations. Working
The computer would digitize the voice and set up an
Internet protocol address which packets the data. The packet signals are
converted into RF signals. Spread Spectrum technology is made use of so as not
interfere with the other frequency bands existing.
Design of Fixed Wireless Internet System
The design of Fixed Wireless Internet is the most
important aspect in our system as it is unique, supporting the kind of bandwidth
required for sophisticated operations in our country in a cost efficient
manner. So utmost care is taken in the location and design of transceivers
i.e., antennas and receivers. Once the design of Fixed Wireless System is taken
care of in the physical layer, the information flows in familiar well-defined
protocols through the data link and network layer and layers above them.
Antenna Design
The design and
position of antenna, both for hospital center and rural center is a critical
criterion for the efficient and successful working of the system. Higher gain
antennas with narrow beam are made use of in our system. This reduces the
interference transmissions from several remote stations. Line Of Sight
For Fixed Wireless Internet Network to work an
unobstructed LOS is needed in between transmitting and receiving points, but
practically it is no possible. Following criteria are taken in to consideration
for the location of transceivers.
A series of imaginary concentric circles around direct
LOS between two transceivers are drawn.
Those that fall within the first circle, known, as the
first Fresnel zone is the most serious. For a reasonable loss less
communication there should be no obstructions within the 0.61 times the radius
of First Fresnel Zone at any point between the transceivers.
Based on the above criteria, assuming that our system
operates at 2.4 GHz with transceivers placed at a distance of 10 Km apart,
reliable communication depends that there are no objects at mid point lying
within 10.59 m of LOS.
Receiver Location
Location of receivers in high frequency Fixed Wireless
Internet systems is subject to quirks of environment, multipath fading is the
most important of them. Seasonal changes in refractive indices of atmospheric
layer will give rise to multipath fading.
Multipath Fading
The different atmospheric layers having different
refractive indices cause it. It tends to manifest itself as a narrow band notch
that moves dynamically through the received power range causing severe bit
error rate.
To reduce effects of selective fading and to improve
the path reliability three methods can be used:
a. Space Diversity, in which two antennas are
spaced slightly to transmit the
same message at different times.
b. Frequency diversity, in which the same
message is transmitted at two different
frequencies.
c. Different Polarization's.
Under these circumstances the receiver must be
designed to pick up the more reliable signal.
Features of Fixed Wireless Internet
S Higher reliable communication with enough
bandwidth to deliver video signals
high-speed data as
well as VoIP. • Design, installation
and operation are much simpler and cheaper than the
conventional
wired local loops and optical fibers. S Makes use of spread spectrum technology so
as not to interfere with other existing
frequency bands.
S
2.4-2.4835
GHz band can be made use of, because it is unlicensed and no fee is required
for its use. The use of 2.4GHZ has been made possible because, recently IEEE
has made it compatible with 802.11b.This allows the use of 2.4 GHz for long
transmission distance with data transmission at the rate of 11MBps, fulfilling
our requirements.
S Transmitted power can carry signals as for
as 50 Km from the transmitter, but the
receiver
must lie in the Line Of Sight. S Using extra amplifiers to boost up the
transmission can increase distance.
Conclusion
Our prototype system addresses the technical
requirements for the efficient implementation of telemedicine in India. In
future all the hi-fi centers can be connected through Ethernet. This enables
the rural center not only to access the hi-fi center to which it is primarily
connected through Fixe wireless Internet, but also to more than one hi-fi
centers. Thus saving money, time to rural people and giving access to all the
medical facilities that urban people enjoy. We hope our system is brought into
practical implementation in near future. So that more lives of the people in
rural India can be saved.
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