A massive revolution in the health-care industry is already under progress by incorporation of connectivity in the sector. Few examples are as below:
• Integrated systems which merge medical records thru’ various communication avenues, remote care and process administration.
• Redirection of interventions from specialists situated far away or expensive hospitals by use of tele-medicine, remote care and mobile care.
• Engagement of general public with the use of wearables that provide advantages such as mutual and collective decision making, chronic patient monitoring and management.
• Personalized treatments and plans that facilitate coordination of care, target resources and enhance overall quality of life.
The above applications can be demarcated into those that are latency dependent and those that are not. Medical interventions require lower latency than remote care. In remote interventions, the level, intensity and complexity of interaction by the medical expert will determine the latency tolerance of the system. In case of tele-mentoring, the level of communication can vary from audio assistance during a real-time video streaming, to taking control with the assistance of a robotic arm. On the other hand, in a remote surgery scenario, or tele-surgery, the entire procedure is controlled by a surgeon at a remote site. Current surgical equipment and infrastructure is not equipped with tactile sensors that can allow the doctor to feel the stiffness of the tissue, therefore the remote surgeon tends to lose his sense of touch by virtue of his handsbeing replaced by a robotic arm. Previously, tele-surgery trials, with no use of haptic feedback, have shown that doctors can compensate for high levels of latency, depending on their level of interaction.
In the tele-mentoring context, surgeons can compensate delays up to 700 ms in less interactive scenarios, while in more interactive mentoring scenarios a shorter delay of up to 250 ms is required. In actual tele-surgery situations, real experiments have concluded that the maximum tolerable delay is 150ms. Since there’s no haptic feedback included, the reported delays mentioned are all one way delay. However, depriving the surgeon from the ‘feel’ factor and sense of touch, impedes the doctor to fully take advantage of his surgical skills. For example : Haptic feedback in remote surgery and diagnosis scenarios can increase the accuracy in detection of cancer nodules. Hence, the robotic industry in collaboration with the medical fraternity are working together towards the inclusion of such sensors that can allow efficient use of medical palpation.
However, the challenge to adding the haptic feedback is squeezing the demands on latency, since kinesthetic devices operate in closed control loops and the two ends (action and reaction) need to operate in sync with each other. Tele-medical operations in the presence of haptic input requires end to end RTTs of lower than 10m/s. A number of business models have commenced within this technological space.
• Verily, an offshoot of Alphabet Inc (parent company of Google) have declared the creation of their surgical robot division
• Verb Surgical, in order to permit better efficiency and enhanced results across a wide range of surgical procedures, will incorporate technologies such as complex imaging, data analysis, and machine learning.
• SRIs Research prototype tele-robotic surgical system, M7 Auditory, visual, and tactile sensations, including the force or pressure the surgeon feels while making an incision, are communicated directly to the surgeon performing the operation, and also includes motion compensation for operating in a moving vehicle.
• RAVEN and RAVEN-II are surgical robot platforms for research, to enhance performance and abilities of tele-operated surgical robots. The primary aim is to provide a common open platform software and hardware to sustain research innovations.
• Taichung Hospital and the National Taipei University of Technology (NTUT) are launching an ambulance-support Emergency Response system. In this system while the patient is in the ambulance on the way to the hospital, a wireless sensor transmits the patients vital signs / state of health to the emergency wards of hospitals.
The remote surgical consultations can be availed of during complicated life-saving medical procedures and emergency cases especially after serious accidents where patients haveserious health emergenciesand also those that cannot wait to be transported to a hospital. In such cases, paramedics and first-responders at an accident venue may need to connect with surgeons in certain specialist categories in hospital or elsewhere in order to obtain proper medical advice, guidance and procedures to conduct complex medical operations.
On the other hand, in a remote surgery application scenario, the entire treatment procedure of patients is executed by a surgeon at a remote site, where the surgeonshands arereplaced by robotic arms which will perform in synchronization with what the surgeon wants to do.
In these two use cases, the communication networks should be able to support the timely and reliable delivery of audio and video streaming. Moreover, the haptic feedback enabled by various sensors located on the surgical equipment is also needed in remote surgery such that the surgeons can feel what the robotic arms are touching for precise decision making. Among these three types of traffic, it is haptic feed back that requires the tightest delay requirement with the end-to-end round trip times (RTTs) lower than 1ms.
In terms of reliability, rare failures can be tolerated in remote surgical consultations, while the remote surgery demands an extremely reliable system (BLER down to 10-9) since any noticeable error can lead to catastrophic consequences.
B. Intelligent Transportation
The term Intelligent Transport Systems (ITS) refers to the use of IT, sensors and communication infrastructure in transport applications for providing more efficient movement and seamless journeys for individuals in both public and private modes of transportation. Specifically, the automotive market is transitioning to a fully connected car, which empowers exotic user experiences to the level of autonomous or assisted driving to reduce pollution, increase safety, reduce congestion and decouple the driver from the mundane driving activity. Furthermore, conventional internet services, such as music and video streaming, will permit enhancing smart phone applications within the transportation services, delivering HD real-time video streaming or low latency applications as cloud gaming.
Several applications are already under R & D, the most visible and popular being automated driving, which increases the level of automation when driving. Vehicles will communicate with one another on the road and shall benefit from local information dispersed from other vehicles and the road / traffic infrastructure for better understanding and maneuvering of traffic situation. Some useful and popular applications are automated overtake, cooperative collision avoidance and high density platooning. To increase the drivers’ awareness, road safety and traffic efficiency services are incorporated. The connected car is constantly transmitting and receiving information, much like the modern aircraft in flight, to the road and traffic infrastructure, other vehicles on the road or to the network.
Vehicle manufacturers are considering enhanced applications such as see-through other vehicles, vulnerable road user discovery, birds eye view mostly for use in intersections. Efforts are on for Digitization and transport logistics which aims to collect traffic information and use it to facilitate and enhance route optimization, energy consumption and travel times transport systems. Intelligent navigation systems are imbibed to intensify the experience with augmented reality and real-time video streaming of traffic data. Infotainment services (Information coupled with Entertainment) are also in advanced stages of being assimilated in smart vehicles.
The automotive industry have already sensed business potential and current commercial devices start from smart phone applications that share real timeinformation among commuters and drivers, to integrate the”Internet of Things” in the infrastructure and adding more intelligence to thecar with the use of communication systems. Few examplesare: