Telemedicine and Networking at the University of ErlangenNuremberg, Germany

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Telemedicine and Networking at the University of
Erlangen-Nuremberg, Germany

• Florian Prester
• Regional Computing Center Erlangen (RRZE)
• HDN.EU, Copenhagen, January 9, 2007

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University Hospital in Erlangen

• 22 clinics
• 10 departments
• 1400 hospital beds
• More than 5500 employees
• All areas of modern medicine
• Over 2800 students of medicine, dentistry and
  molecular medicine

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Two Kinds of Challenges

• Technical Challenges
• Transmission Technology
• Internet VPN
• ATM, (G)MPLS,
• Security-Systems
• Administrative and Legal Challenges
• Different Systems
• Public Hospitals
• Private Hospitals
• Different legal Systems
• 16 federal states federal goverment
• Different communities of interest

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Two Kinds of Challenges

• Technical Challenges
• Transmission Technology
• Internet VPN
• ATM, (G)MPLS,
• Security-Systems
• Administrative and Legal Challenges
• Different Systems
• Public Hospitals
• Private Hospitals
• Different legal Systems
• 16 federal states federal goverment
• Different communities of interest

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Existing Network Infrastructure
2 Class B Networks Additional Private Networks
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Current practice on data exchange and security

• Security Sytems
• At least 2 Firewalls
• ACLs on Routers
• 2 administrative independent departments ?
  security teams
• Each connection has to be allowed, explicitly!
• No automatism to connect different medical
  networks

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Existing network infrastructure
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Firewall-Management existing

• Central Management
• Rule-Management
• Macro-Mechanism
• Syntax-Checker
• Filter-List-Management
• Consistency-Check
• Is the connection open?
• Emergency Solutions
• Inspection of Filterrules

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Firewall-Management in Progress

• Central Management
• Consisteny of all Firewalls
• Administration of all Firewalls
• Securing the complete Network
• Consistency between all Firewalls
• Message/Notification System
• Decentral Management
• Adding local Rules Consisteny-Check
• Investigation of local Rules
• Message/Notification System
• Message System between/for decentral
  Administrators
• Open up/close down Connections
• Notification of central administrators ? open up
  backbone
• Action after Acception

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Research and future needs

• Availability of Live-Data (audio video)
• Online Diagnostics and second Opinion
• Quality Assurence
• Education and interactive Training
• Examples of research projects involving medical
  applications and networking
• Transmission of High Resolution Motion Pictures
  in Tele-Endoscopy
• Transmission and Coding Methods of High
  Resolution Video Signals in Tumor Surgery
• Testbeds that represent future network
  technologies and infrastructures
• VIOLA (optical testbed, German infrastructure)
• MUPBED (optical testbed, European infrastructure)

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Killer-applications in Telemedicine (I)

• Transmission of High Resolution Motion Pictures
  in Tele-Endoscopy
• use of broadband network technology for the
  transmission of endoscopic video consultations.
• In cooperation with the project ODITEB methods
  for recording and archiving video sequences for
  research and education

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Killer-applications in Telemedicine (II)

• Transmission and Coding Methods of High
  Resolution Video Signals in Tumor Surgery
• methods of coding and testing of applications in
  tumor surgery and oral surgery that require
  transmissions of high resolution motion pictures
  with the highest degree of color depths
• An example and main area of the studies are
  transmissions of video signals from operating
  rooms. The desired online presence between two
  clinics aims at establishing external quality
  control in surgery by making it possible to reach
  experts fast and without delay.

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Latest developments in networking

• New network infrastructures and technologies
• Broadband networks for high volume (multimedia)
  data
• Quality of Service (QoS) provisioning to be able
  to guarantee application requirements for
  high-quality applications (e.g. in medicine)
• ASON / GMPLS based networks
• Automatically Switched Optical Networks (ASON)
• Generalized Multiprotocol Label Switching (GMPLS)
• Intelligent optical networking via control
  plane
• Examples
• Testbed VIOLA (www.viola-testbed.de)
• Testbed MUPBED (www.ist-mupbed.eu)

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VIOLA

• German testbed VIOLA
• VIOLA
• Vertically Integrated Optical Testbed for Large
  Applications
• Objectives
• test advanced network equipment and architectures
• develop new measurement and new software tools
  for a user-driven dynamic provisioning of
  bandwidth
• and investigate these objectives within the
  context of new and advanced applications, such as
  GRID computing, virtual reality and high-quality
  multimedia applications.

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MUPBED

• MUPBED Multi-Partner European Test Beds for
  Research Networking
• Project funded by European Union (EU)
• 16 partners in 8 countries
• Composed of five local networks interconnected
  over the networks of European NRENs and GEANT
  (ASON/GMPLS, GMPLS, IP/MPLS and Ethernet based)
• MUPBED investigates
• inter-operability topics, interactions among
  network layers and/or application and IT
  platforms
• QoS issues and QoS provisioning

MUPBED Testbeds (http//www.ist-mupbed.eu)
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Publications

• Naegele-Jackson S., Holleczek P., Rabenstein T.,
  Maiss J., Hahn E. G., Sackmann M., Influence of
  Compression and Network Impairments on the
  Picture Quality of Video Transmissions in
  Telemedicine, Proceedings of the 35th Hawaii
  International Conference of System Sciences
  (HICSS), January 7-10, 2002, Big Island, Hawaii,
  USA, IEEE Computer Society, pp. 2060-2068, ISBN
  0-7695-1435-9.
• Rabenstein T., Maiss J., Naegele-Jackson S.,
  Liebl K., Hengstenberg T., Radespiel-Troeger M.,
  Holleczek P., Hahn E.G., Sackmann M.,
  Tele-Endoscopy Influence of Data Compression,
  Bandwidth and Simulated Impairments on the
  Usability of Real-Time Digital Video Endoscopy
  Transmissions for Medical Diagnoses, Endoscopy,
  Vol. 34, No. 9, September 2002, pp. 703-710.
• Maiss J., Rabenstein T., Naegele-Jackson S.,
  Radespiel-Troeger M., Hengstenberg T., Holleczek
  P., Hahn E.G., Sackmann M., Einflussfaktoren auf
  die medizinisch-diagnostische Beurteilbarkeit des
  endoskopischen Videobildes bei digitaler
  real-time Datenübertragung (Gigabit Testbed Süd,
  Teilprojekt 1.15), Endoskopie heute 2002, Thema
  Abstracts XXXII. Kongress der Deutschen
  Gesellschaft fuer Endoskopie.
• Rabenstein T., Maiss J., Naegele-Jackson S.,
  Liebl K., Radespiel-Tröger M., Rosette R.,
  Holleczek P., Hahn E. G., Sackmann M.,
  Teleendoskopie im Gigabit Testbed Süd
  (Teilprojekt 1.15) Eine prospektive
  Anwendungsstudie, In Biomedizinische Technik
  2001, pp. 396-397. 35. Jahrestagung der deutschen
  Gesellschaft für Biomedizinische Technik e.V.
  (DGBMT), Ruhr Universität Bochum, Germany, Sept.
  19-21, 2001.
• Rabenstein T., Maiss J., Naegele-Jackson S.,
  Liebl K., Radespiel-Tröger M., Rosette R.,
  Holleczek P., Hahn E. G., Sackmann M.,
  Teleendoskopie im Gigabit Testbed Süd
  (Teilprojekt 1.15) Einfluss von
  Datenkomprimierung, Bandbreite und Bildstörungen
  auf die medizinisch-diagnostische Beurteilbarkeit
  des endoskopischen Videobildes, 35. Jahrestagung
  der deutschen Gesellschaft fuer Biomedizinische
  Technik e.V. (DGBMT), Ruhr University of Bochum,
  Germany, Sept. 19-21, 2001, In Deutsche
  Gesellschaft für Biomedizinische Technik
  e.V.(DGBMT) (Hrsg.), Biomedizinische Technik
  2001, Bd. 46, pp. 398-399.

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Questions?

• Thank you for your attention, any questions?
• Contact florian.prester_at_rrze.uni-erlangen.de