European Space Agency



The MultiMED project is designed around the concept of providing remote access to the high fidelity medical simulation services at the Bristol Medical Simulation Centre (BMSC).

In addition to providing indirect and direct access to the simulator itself, MultiMED adds several layers of context-sensitive information, database and news resources which combine to provide a high quality education and training product suite.

Initially, the principal service components will include customised access to on-line reference systems such as MEDLINE and pharmaceutical databases, interactive training courses based around advanced simulation and virtual reality technology and live broadcasts of simulator-based teaching sessions. Simulation allows students to work through realistic medical scenarios without the need for live patients.

Through a single PC based workstation MultiMED will extend the reach of the BMSC. Remote users will work interactively with the Human Patient Simulator (HPS) at Bristol whilst following guided procedures on screen. Context-sensitive hotlinks to up-to-date reference databases provide immediate access to supporting information. The development phase will focus on anaesthesia, with other disciplines being added to the fully operational service.

The Human Patient Simulator at the Bristol Medical Simulation Centre




The principal challenges which the project addresses are:

  • Interfacing the METI Human Patient Simulator to the MultiMED communications infrastructure;

  • Replicating the BMSC environment using video and virtual reality tools;

  • Designing and implementing a context-aware multimedia-enabled reference data system.


MultiMED will provide cost-effective high quality training to a range of users in the healthcare and associated industries. The technical solutions developed to implement the initial service offering will provide the basis for further development of new services and support for other medical disciplines.


MultiMED is designed around 4 Service Levels, which combine to deliver a range of products. The 4 levels are:

  1. On-line reference. A fully integrated archive of reference material, training material and news feeds, cross-referenced both internally and externally (to support other Service Levels). It will be based on existing commercial products, re-purposed for the market segment for anaesthesia.

  2. Tailored courseware. A suite of interactive specialist teaching programs built on scripted sessions within the Bristol Medical Simulation Centre, offering very high quality multimedia tuition. These may include cross-referencing of information to Service Level 4.

  3. Passive simulation. Passive participation in live simulation sessions at the Bristol Medical Simulation Centre. This will allow colleagues and associates of delegates to the Centre itself to participate in training and debriefing sessions. The sessions themselves may be offered later, reconfigured for Service Level 3.

  4. Active simulation. Active participation in simulation sessions at the Bristol Medical Simulation Centre. Using advanced multimedia techniques such as Photographic Virtual Reality, full remote control will be provided for remote users of the Centre, with the complete range of feedback available in-situ relayed over satellite to user terminals.

The system infrastructure is based around the Hughes Olivetti Telecom DirecPC service, uplinked from Griesheim in Germany. The MultiMED infrastructure includes the following principal components:

Uplink Server: This is a Sun workstation hosted at Griesheim and running http, streaming media and database servers. It supports the facilities provided under Service Level 4 and Service Level 3, and also provides all system adminstration, control and monitoring services.

Primary Server: T


During the development phase, MultiMED will be offered to a team of 10 pilot users, representing teaching hospitals, research centres and paramedic training facilities. The planned rollout of service to pilot users is:

  • Service Level 4 (Reference services): November 98

  • Service Level 3 (Interactive training): January 99

  • Service Level 2 (one to many simulation services): April 99

  • Service Level 1 (full remote control of simulator): June 99

MultiMED will evolve into a commercial service following the initial ARTES supported development.

Current status

Further live sessions were broadcast during the month. The Defence College of Medicine and the first overseas site came on line and observed two sessions. Work continues on bringing further sites on line in the next few weeks.

Multimed was presented at a major conference in the month with a further conference to be attended in June.

Status date

Thursday, June 19, 2008 - 17:46