European Space Agency



Information technology associated with satellite communication can play a fundamental role in the challenge to dematerialize an healthcare process/service, to make the process asynchronous (e.g. deferred tele-counselling), to render more scalable the use of human and material resources, to automatize the process through a direct acquisition of diagnostic data (machine to machine data acquisition), to bring healthcare operators, diagnostic instruments and apparatus near the patient/citizen.

The KosmoMed project aims to develop a series of innovative products and services based on Information & Communication Technology (ICT) – namely on satellite telecommunication technology – in order to improve the quality of healthcare services and sustain the growth of the telemedicine sector. The aim of the Project is to develop a portfolio of ICT applications to provide physicians and other healthcare professionals with efficient telemedicine solutions, despite the status of deployment of terrestrial IP communications’ networks.

Project’s aim is to develop telemedicine services for market exploitation based on the use of a commercial Satcom solution. Services will share a common service for the reservation; the system will provide access to the agenda of healthcare professionals and will allow user to book sessions which will automatically request satellite band reservation.

KosmoMed will provide four categories of services:

  • Tele-consultation service, which will allow two medical specialists to have a consultation in real time by video-conference and/or to share clinical data on their local workstations.
  • Tele-diagnosis service, which will allow a physician or a technical operator to have a consultation with a specialist in real time by video-conference and/or to share clinical data on their local workstations.
  • Tele-counseling service, which will allow a patient to have a counseling with a physician or a specialist in real time by video-conference, optionally supported by sharing of data.
  • Tele-validation service, which will allow a technical operator to have a consultation with a specialist in real time by video-conference and share clinical data so that they can be validated; in this context clinical data are submitted to a validation workflow before being used for statistical processing.


The use of satellite communication for the provision of professional medical services using video-conference sessions, real-time data transmissions between two specialist for clinical studies and remote specialist tele-consultation is today impaired in commercial satellite services by the limited bandwidth in uplink profiles. In order to guarantee an adequate level of QoS that permits to satisfy the Quality of Experience (QoE) requirements of the healthcare operators, a proper sustainable continuous rate is required for the uplink. Starting from this main consideration, KosmoMed project proposes a novel paradigm for Satellite Telemedicine Solution which involves the development of a Bandwidth Reservation Mechanism integrated with a data protection infrastructure. This allows coordinated access to the Service Platform including a guaranteed, on-demand bandwidth allocation and associated billing, which is finally able to satisfy the QoE required for professional and sustainable telemedicine services.

The telemedicine market is growing at a fast pace, and KosmoMed has the ambitions to become a reference on the market. In order to facilitate this challenging objective, a wide range of medical partners are involved in the project, that will eventually run the operational and commercial workflow. Two main sales channels are currently foreseen: the first one involves the recognition by the Italian Ministry of Health in order to benefit from the medical reimbursements. The other channel is the private medical institution and operators that subscribe to KosmoMed to improve the effectiveness of their workflow, increasing quality and/or reducing costs.


KosmoMed aims to provide an answer to various pressing needs of the demand for Healthcare services around the world. The healthcare needs and the main priorities registered in Italy are the reduction of the impact of chronic diseases linked with the progressive aging of the population, improve the life styles of the citizens and empower them to adopt healthy behaviours. The same priorities are set at European level:

  • As the age of EU population increases, the demand for healthcare services increases; a key opportunity is emerging to transform healthcare through the adoption of technological solutions;
  • Due to the age increase, all national healthcare systems need more resources. Clinical data exchange and resource optimization become essential to limit (or even reduce) costs.

Starting from the increasing demand for medical data exchange and telemedicine services from professionals and clinical institutions, KosmoMed intends to provide the following benefits:

  • Increase health personal control by providing instruments and services facilitating a link between the patient and the physician anytime and anywhere; KosmoMed web site is the instrument to provide information and guidelines for patient;
  • Assure the exchange of heterogeneous health data among different healthcare service providers (connected health) such as hospitals, pharmacies, labs and insurance companies;
  • Automate the complex healthcare workflow;
  • Deploy an integrated heterogeneous telecommunication network integrating on demand guaranteed bandwidth using satellite solutions.

KosmoMed is dedicated to change the way we think about “telematics medicine” and healthcare by developing products and services that are:

  • Comprehensive (data-driven, including all medical data for prevention, treatment, preferences);
  • Coordinated across different healthcare professionals, with comprehensive data exchange;
  • Personalised (including post-surgery rehabilitation);
  • Planned (including services to screen populations).


The figure below shows the overall architecture of the services that KosmoMed intends to implement in order to respond to the user needs. Platforms and institutions to be integrated in the overall system and the network architecture are depicted, together with an overview of the services the system will provide.

click for larger image

The following activities are envisaged in the course of the project:

  1. Develop an ICT Platform based on the “Clinical Data Gateway Engine” (CDGE) for public and private institutions to integrate clinical process and data. This allows the interoperability among vertical applications and the exchange of the relevant data. The system is implemented according to open standards and allows a fast deployment of Clinical ICT platform integration;
  2. Develop services and applications for the Professional Market. KosmoMed integrates a Clinical data management platform with a professional videoconference system. This part of the work will start from the results achieved during previous activities of the consortium;
  3. Develop the Clinical data Gateway (CDG), consisting of a client server module to integrate clinical data at the patient side, including innovative instruments. The system gathers information from clinical instruments and transfer them on a dedicated server or to different Clinical data management platforms. An innovative medical instrument provided by the Campus Biomedico consisting of an auxiliary device dedicated to the collection of exhaled air on an adsorbent cartridge (patent pending) is integrated and used in the Pilot Trials;
  4. Deploy a Service Center integrated with web based information for oncological patients and for child obesity;
  5. Develop an integrated and interoperable communication network composed of satellite and terrestrial wired and wireless segments (xDSL, 3G and WiFi). To address and solve the limitations experienced in using video communication applications for Telemedicine over consumer Internet via satellite, the KosmoMed service relies on the next generation Satcom solution based on the Ka-band KA-SAT satellite technology. Moreover, a Bandwidth Reservation Mechanism will be developed together with a Data Protection Infrastructure to meet the Quality of Service and security requirements needed for the provision of the KosmoMed services.


The overall project will be developed in 24 months. The key project milestones include the finalisation of the User Requirements, the System Requirements and the System Architecture. This concludes the development plan at month 8.

The platform implementation, followed by the service centre integration and the deployment of the heterogeneous communication network including the satellite based component will be finalised in 17.

A pilot stage of 6 months will be executed to validate the associated services towards the pilot user communities, in preparation of the commercial deployment phase, which is planned to take place after the conclusion of the contract with ESA.

Current status

After the completion of the Baseline Design Review (BDR) the team has been involved in completing the activities for the definition of the final architecture of the system in view of the Critical Design review (CDR) which has been held with success on 30 July 2013.
The finalisation of the URD required a tight cooperation with the Users for the definition of service scenarios.

For the Regulatory Issues report, the analysis to identify legal issues related to the KosmoMed services has been completed, with specific reference to users and data protection. The analysis of the legal aspects relevant for the use cases has been finalised.

On the market analysis aspects, a complete revision of the KosmoMed services has been done interviewing several stakeholders.

In order to select the videoconference solution that best fits the medical needs in the KosmoMed context, a trade‐off analysis of several commercial products has been performed; the analysis has taken into account not only technical, but also cost and integration aspects.
The architecture of the system has been designed and all new developments have been scheduled. The team is working on the system development and integration in view of the Factory Acceptance Tests, which are expected to take place in March 2014.

Status date

Wednesday, September 25, 2013 - 10:08