Steffen Ortmann¹; Stephanie Hoffmann¹; Ali Haddadi Esfahani¹; Christian Wenger¹; Vilmar Frauendorf², Dieter Nürnberg²

¹ IHP – Leibniz-Institut für innovative Mikroelektronik, Im Technologiepark 25, 15236 Frankfurt (Oder), Germany; {ortmann|haddadi|}
² Brandenburg Medical School Theodor Fontane, Neuruppin, Fehrbelliner Straße 38, 16816 Neuruppin, Germany; {,}

Recent technological advances have enabled complex ultrasound devices to be available as portable variants that can be used in point-of-care ultrasound (POCUS) applications in ambulant care, especially in rural areas. Although technically feasible, adequate implementation of such scenarios often fails due to the lack of highly qualified personnel. Our concept of Sono-Teleconsulting allows the use of a mobile POCUS device in ambulant scenarios with broad area coverage by enabling additional live conferences to a remotely-connected ultrasound expert who remains in the clinic.

The aim of Sono-Teleconsulting is not only to deliver the pure ultrasound images to a remote expert, but moreover to simultaneously provide a visual impression of the patient, the handling of the ultrasound device and an audio link within a live conference between the on-site doctor and the connected expert. To enable this, images from the POCUS device are synchronized and merged with parallel image data of another camera and transmitted live during the examination, while the people involved can talk to each other.

Required communication links are actually implemented as fixed connections to one or more tablets in the network of the participating hospital. Later, in regular operations the communication links between the practitioner and the remote physicians will be coordinated via the eHealth Center, see Figure 1 for the architecture. The ultrasound data documented and stored during the Sono-Teleconsultating are transferred as diagnosis results to the eHealth Center after the session and then automatically transmitted to the hospital's Picture Archiving and Communication System (PACS).

The Sono-Teleconsulting concept enables the use of mobile ultrasound devices from different manufacturers with wired and wireless data connection. A first wired application was successfully completed with the ultrasound device from the American manufacturer Interson, see Figure 2 for the user interface. This sample application also allows the remote expert to control / adjust the ultrasound device at the treatment center. Image data of other various devices can be integrated wirelessly into the same user interface via a standardized streaming interface (currently Miracast protocol). This is exemplarily implemented for the use of the VScan device by General Electrics, see Figure 3, which is also used in the trials of the clinics in Neuruppin and Wriezen in the state of Brandenburg.

At least 2 Mbit transmission speed is currently required for the remote connection in order to achieve a minimum frame rate of 20 frames per second. This corresponds to about a 30 percent utilization of the maximum bit rate of a wireless transmission using the HSDPA standard. Hence, our research results show that even a 3G mobile phone connection technically allows a remote ultrasound conference between the on-site physician and the telemonitoring expert. This work is funded by the German Federal Ministry of Education and Research (BMBF), the Health Campus Brandenburg and the Ministry for Science, Research and Culture (Brandenburg) in the context of the joint project "Digital and analogue companions for an aging population".


Abbildung 1: Architekur des Sono-Teleconsulting Konzeptes. / Architecture of the Sono-Teleconsulting concept.

Abbildung 2: Remote-Nutzerinterface des Sono-Teleconsulting. Dabei werden gleichzeitig Ultraschall-Bilddaten (links), Videodaten von der Behandlung (rechts) und eine Audioverbindung live übertragen. / Remote user interface of Sono-Teleconsulting. Ultrasound image data (left), video data from the treatment (right) and an audio connection are transmitted live in parallel.

Abbildung 3: Drahtlose Übertragung mobiler Ultraschallbilder eines VScan Gerätes (links) direkt in die Klinik (rechts). / Wireless transmission of Ultrasound data from VScan device at home (left) to the clinic side (right).

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