Converged Broadband Optical and Wireless Communication Infrastructure for Next-Generation Telehealth Arshad Chowdhury, Hung-Chang Chien, Sourabh Khire, Shu-Hao Fan, Nikil Jayant and Gee-Kung Chang Georgia Tech Broadband Institute School of Electrical and Computer Engineering Georgia Institute of Technology, Atlanta, GA 30332, USA arshad@ece.gatech.edu Abstract- Emerging Telehealth and Telemedicine systems need to deliver afordable high-quality health care services by utilizing telecommunication and multimedia technologies in conjunction with medical expertise. In this paper, we propose and demonstrate a telecommunication and networking architecture for implementing next generation Telemedicine and Telehealth systems. Our integrated optical-wireless based network provides super broadband, ultra low-latency connectivity for voice, video, image and data across various telemedicine modalities to facilitate real-time and near real-time communication of remote health care information. Kywors- telemeicine, e-health, optical-wireles, radio-over iber, telemedicne,super broadband I. INTRODUCTION Telehealth and Telemedicine systems facilitate exchange of electronic information such as medical images and real-time video for remote monitoring, remote diagnosis, telesurgery nd other forms of medical services by utilizing telecommunication inrastructure. For implementing an efective telehealth system it is necessary to ensure the availability of universal telecommunication and network access for healthcare professionals such as doctors, nurses, public safety workers, health IT specialists, patients, and the related communities [1] [4]. The telecommunication resources demanded by modem telehealth systems are dramatically increasing due to he rapidly changing natre of remote consultation services which are moving away rom the past generation low bit-rate voice or text based phone consultation, to rich-media visual services. These include high deinition (HD) quality video-centric nd super high resolution image-intensive remote diagnosis applications [5][6]. Real-time delivery of multimedia content is necessary to increase patient reach by extending healthcre to the patients in the rural areas, to facilitate access to specialty cre in large metropolitan areas with shortage of specialists, to request second opinion rom remotely located medical experts, to support remote health monitoring and to facilitate remote education. However, medical services such as teleradiology and telepathology require transmission of high resolution digital images with huge ile sizes. For example, a single Whole Slide Image (WSI) of a 20mm x 15mm region of a glass slide sampled at 0.25 microns/pixel, and 24 bits/pixel (8 bpp/ color channel) can easily occupy in excess of 15GB in ile size. Furthermore, if multiple focal planes (Z-stack images) are acquired the resultant ile size can be in the order of several hundred Gigabytes to Terabytes [7] Transmission of such large images is a very challenging task because of the limited availability of, and the high costs associated with high bandwidth telecommunication resources. This is a major barrier pticularly for time-sensitive applications such as rozen section diagnosis, dynamic telepathology and real-time teleradiology. For example, transferring a 500MB MRI or CT image over a coast-to-coast distance with 50ms round-trip-time (RTT) using the DICOM protocol will take 10 hours over a 1.5Mb/sec T1 line nd approximately 50 seconds over 1Gb/s transmission line. While it is possible to reduce the mount of data transmitted by compressing the medical images prior to transmission, aggressive lossy compression may introduce objectionable artifacts in the image and compromise its diagnostic quality. Furthermore, these compression and decompression techniques may introduce additional computational complexity, thus adding to the overall delay, latency and cost of the system. To address this, evolving telecommunications inrastructure needs to go hand in hand with domain-speciic innovations such as diagnostically lossless compression of rich visual media [8][9]. Although optical iber based wireline communication can satisy the bandwidth requirements of next-generation telemedicine systems, wireless communication is still essential to achieve mobility and greater lexibility in connecting he data acquisition sorce, such as a CT scanner or a slide scanner to the end terminals of a complete telehealth system [10][11]. Today, most of the hospital buildings support only closed wireless communication that is dedicated to a ixed service provider. This type of a closed network limits broadbnd adoption in the hospitals and healthcare facilities and acts as a chokepoint thus creating obstacles to interconnectivity, upgradability and ultimately cost savings. Next-generation healthcare communication system has to be open access in nature by supporting protocol independent, multi-service, multi-carrier broadband services and applications. The requency of the technology-neutral wireless communication services can range rom few hundred MHz public safety nd security systems (VHF, UHF etc.), 2G/3G mobile, 4GILong Term Evolution (LTE), 2.4GHz WiFi up to 6GHz WiMAX services. However, these lower requency wireless services 978-1-4244-6376-3/10/$26.00 ©2010 IEEE