This blog examines the situation of Iwamizawa City, Japan, as an example of private 5G in hospitals, which combines mobile medical vehicles (medical buses), 8K cameras, realhaptics telecopy robots, and ultrasound diagnostics to perform remote diagnostics.

 

<Medical bus-based rural telemedicine system - Iwamizawa City, Japan>

 

NTT EAST, Iwamizawa City, and Hokkaido University Hospital built a private 5G network in public facility in rural area from January to March 2023, and deployed a medical bus in the parking lot of the facility.

 

By connecting remote specialists (Hokkaido University Hospital) through the private 5G network, they demonstrated a remote diagnosis service based on 8K  video streaming and robotic arms with realhaptics capabilities that can transmit tactile sensations^[1][2].

 

As in Korea, non-urban/rural areas in Japan do not receive the same level of professional medical care as urban areas due to a lack of doctors and cutting-edge medical equipment.

 

In Iwamizawa City (population 79,000), the demonstration area, there is only one obstetrician and gynecologist, and most mothers travel long distances to a large hospital in Sapporo, a neighboring city.

 

The inconvenience of healthcare services, including the dangerous and long travel time for mothers, reduces the quality of life, causing young people to leave the rural areas and contributing to the extinction of rural cities.

 

Many local governments in Japan are considering and providing services that allow residents living in rural areas to receive advanced medical care and health screening services that can be found in urban hospitals at public facilities near their homes. However, most of these services are limited to simple video calls with a remote specialist on a large-screen monitor, reducing the effectiveness of telemedicine (patient-monitor-communication-network-monitor-specialist).  

 

In this demonstration project, a mobile medical vehicle (medical bus) is deployed to the area where rural residents live, and it is equipped with an 8K camera, an 8K 360^o camera, an ultrasound diagnostic device, a dermoscope (medical microscope), and a real-haptics telecopy robot (tactile transmission synchronization robot), which enables remote specialists to share images of various angles and fields of view and medical devices in the bus, providing a treatment environment similar to that of a remote specialist who can directly diagnose patients in a medical bus.

 

It is very expensive to build such an advanced medical environment for each public facility in rural areas, but in this demonstration, the environment is built on a mobile vehicle (medical bus) and the concept is that the medical bus regularly moves to various rural locations, so only one set is needed.

 

<Medical bus visits several rural areas to provide medical care service>

 

Private 5G network: 5G core control plane sharing (5G equipment: Samsung Electronics)

 

The 5G core data plane, UPF, and 5G base stations (CU, DU, RU) are installed in a rural public facility (in this case, the Kitamura branch of Iwamizawa City Hall). Only the RU is installed on the roof of the branch office, while the rest of the 5G equipment is installed indoors.

 

The 5G core control plane is hosted in the cloud 5G core. This is to reduce the cost of 5G network construction per public facility by hosting the 5G core control plane, the most expensive element of 5G network construction, in the public cloud and sharing it among multiple rural public facilities (scalability).

 

When a medical bus enters the parking lot of the Kitamura branch office, the UEs on the medical bus connect to the branch office's private 5G network. One 5G UE is deployed on the medical bus, and the 8K 360o camera, 8K camera, ultrasound diagnostic device, and real-haptics telecopy robot arm (copy side) deployed on the bus are connected to this 5G UE via wireline.

 

Communication between the devices on the medical bus and Hokkaido University Hospital is done via a private 5G network and a VPN network.

 

In Japan, 4.7GHz (4.6-4.9GHz) and 28GHz(28.2-29.1GHz) are allocated for private 5G. Since other vehicles in the branch parking lot and the medical bus itself are obstacles to radio wave transmission between RU and UE, the local 5G frequency was used as 4.8-4.9 GHz, which has strong radio wave diffraction and wide coverage.

 

<Telemedicine in rural areas using medical buses, cameras, and realhaptics – Iwamizawa City case>

 

Telemedicine application based on a private 5G network

 

From a medical bus parked in the parking lot of a rural public facility[3], three streams - an 8K 360^o camera (for high angle view), an 8K camera (for imaging the patient's body), and the output image of an ultrasound diagnostic device - are delivered to a specialist's monitor at a Fukaido hospital via a high-capacity, low-latency private 5G network[4]. The remote specialist can adjust the field of view (pan/tilt/zoom) of the camera on the bus using a joystick.

 

<Telemedicine: Maternal ultrasound examination>

 

In addition to the camera, a realhaptics telecopy (synchronized movement between two remote robots[5]) robotic arm was used to perform ultrasound examinations of mothers remotely. Realhaptics is a technique that conveys human senses - Kinesthetic and haptic sensation - and may transmit the hardness or softness, hardness or bend, of an object with great precision.

 

When the remote specialist moves the master robot arm with his hands, the copy robot arm in the medical bus moves the same as the master, and the haptic sensations received by the copy robot arm's transducer from the mother's abdomen are transmitted to the master robot arm with low latency.

The remote specialist can feel the kinesthetic and haptic sensations and adjust the appropriate application of force as if he or she were performing the ultrasound examination with the copy arm in front of the mother (synchronization of haptics and tactile sensations between the master and copy arms improves ultrasound diagnostic maneuverability).

 

In the figure below, an obstetrician-gynecologist at Hokkaido University Hospital uses his right hand to move the master robot arm while viewing ultrasound images of mothers in a medical bus for real-time diagnosis.

 

Based on (1) the movement of the copy robot arm in the medical bus while watching the 8K camera image and (2) the change in the sensation of the hand holding the master robot arm, the specialist adjusts the master robot arm in the hospital (increasing the force, adjusting the speed of movement, etc.) to confirm the image he wants to see.

 

<A remote specialist performing an ultrasound examination using realhaptics telecopy robots>

 

A second example of a medical practice using realhaptics telecopy (synchronized movement between two remote robots) robot arms is dermatology. A dermoscope is attached to the copy robot arm in the medical bus, and a remote specialist adjusts the master robot arm to view and diagnose specific areas of skin disease from the desired angle.

 

<Telemedicine: Dermatologic Care>

 

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With the introduction of a private 5G network with high-capacity and low-latency data delivery, medical buses that provide a high-end medical environment near rural residents' homes, high-definition cameras in the vehicle, and robots with real-haptics capabilities, rural residents can quickly receive high-end medical services from specialists similar to those in urban areas.

 

By improving the medical gap between urban and rural areas, rural residents can live safely in rural areas, which is one way to solve the problem of the extinction of rural cities.