T4MOD project aims at defining, developing, realising, qualifying and validating a user friendly Telemedicine system, through an interoperable IP overlay satellite network associated with an intelligent end-to-end communication platform, capable of supporting different medical specialities. This solution, to be validated in a military environment, could also be extended for future exploitations in civilian field for organisations (for example national health systems) operating in underserved and/or geographically isolated areas (such as in the case of natural disasters or humanitarian crises) and to develop new medical protocols for a cooperative medical work of diagnosis and therapies. T4MOD involves as users the health Department of four Ministries of Defence: France, Germany, Italy and Spain.
The implementation of telemedicine services on a large scale is inherently affected by a number of barriers that the T4MOD project tries to overcome with the support of institutional entities such as MoDs, National Space Agencies and ESA.
This common effort should mitigate the hurdles of barriers, helping the project to develop an effective solution and address all the necessary issues with adequate answers.
The T4MoD project is expected to deliver costs reduction due to the utilisation of medical information for better decision (e.g. avoiding non necessary medical evacuations), cooperative use of shared technical resources, decrease of medication errors, improved labour productivity and additional health care.
T4MOD aims at offering an innovative architectural solution in terms of a system and associated operational Telemedicine services; strong points will be the provision of broadband communications over very wide coverage in mesh topology, the ability to manage dynamic on demand access using a simple and user friendly interface for the end users and the ability to handle different resources booking according to the four reference Medical Services needs. The proposed solution presents some characteristics:
In this project a number of critical elements will be addressed. The most important of them are those concerning the characterisation of medical services in a military environment, those related to interoperability issues (analysing the technical aspect and implementing a common application layer) and finally those involving the security considerations (aiming at dealing with the aspects of IP acceleration, compression and security that will guarantee the compliance of the architectural proposed solution with the security norms and regulations that are applicable for telemedicine service).
The main need refers to Medical Services deployed for peace keeping and humanitarian missions in geographically isolated and underserved areas, with the most difficult environmental and operational conditions due to the lack of local medical specialists. The T4MOD project will use two space assets (i.e. satellite communications and use of a technology initially developed for manned spaceflights: robotised tele-echography).
The following telemedicine services will be the primary focus of the project:
A high layer application will be developed with the purpose of managing the services within and inter- and ita-operable environment. This layer will simplify the system operations and integrate elements that could simplify the standard medical workflow while keeping the compliance with the working procedure of the end users. Finally it will help to extract, in the friendliest and automatic way, those parameters that could contribute to measuring the clinical performance gain. These important advantages will be enhanced by means of an efficient satellite architecture.
T4MOD relies on two main assets coming from space technologies: on the one side satellite communications, and on the other side a robotized tele-echography solution initially developed to support crews onboard the International Space Station.
The system is addressed at end users belonging to Military Health Services in France, Germany, Italy and Spain. The hospitals involved in the pilot will be in Europe and in some remote areas of operations.
The DQR (Demo Qualification Review) milestone took place on 24 July 2013 in Fucino, Italy. This meeting was the opportunity to repeat in front of ESA a subset of the most important tests performed by the consortium until the DQR and documented into the System Verification Document. In particular, tests included a large medical imaging data (MRI DICOM file) transfer via satellite from Fucino to the Spanish MoD Hospital Gomez Ulla in Madrid and some telemedicine sessions with different scenarios in order to assess the performances of the different components (e.g. Antari, Covotem, Spontania) integrated into a single service. Another demonstrated capability was the possibility to free and reallocate effectively satellite capacity from a planned tele-consultation in order to support an emergency telemedicine session (for instance an urgent neurosurgery).
The DQR allowed to identify a set of features to be optimized in order to make the system fully in line with the needs of the MoDs..
On 26 March 2014, the system was fully qualified by ESA and the DQR considered passed, which marked the start of deployment for the T4MOD Telemedicine Stations to equip the European Reference Hospitals of the MoDs. This phase will end at SDA (System Deployment Acceptance) milestone foreseen in May 2014.
Before the SDA, the User documentation (e.g. user manual) shall be finalised and medical users shall be trained to operate the system. Moreover, the T4MOD sustainability analysis will be updated, comparing ASSIST tool outcomes and costs breakdown belonging to the project initial business plan.
The deployment of the Remote Hospitals Telemedicine Stations will then start immediately after the SDA to start the pre-operational trials stage.