Development of an ultralow-latency communication system using shared internet access: promoting the implementation of telemedicine

Abstract

Telemedicine is becoming increasingly important to address the shortage of gastrointestinal surgeons and disparities in domestic and international treatment outcomes for patients with colorectal cancer. The development of a low-latency communication system using existing communication infrastructure (shared internet access: SIA) is necessary to promote the use of telemedicine. The aim of this study was to develop a low-latency communication system using SIA. We conducted an experiment between Sapporo and Tokyo using an ultralow-latency communication system for remote medical education (TELEPRO®). The latency was measured using 2000 annotations from a monitor in Sapporo, which confirmed a median latency of 27.5 ms. A low-latency communication system based on SIA with latency lower than the maximum allowable latency for telemedicine was developed successfully.

Tele‐proctoring for minimally invasive surgery across Japan: An initial step toward a new approach to improving the disparity of surgical care and supporting surgical education

“…Currently, communication latency has become a problem for tele‐proctoring using SIA (Latency; 425–1500 ms) 6,17,18,19 . In our previous report, the median latency between Sapporo and Tokyo (1150 km) was 27.5 ms, 10 and the same latency was measured in tele‐proctoring with a hospital in Tokyo. Moreover, even between two locations with the longest distance of 3200 km, the median latency was 48.5 ms, representing a significant reduction in latency.…”

“…The TELEPRO MENTEE Workstation in the operating room is used to encode and decode audio and video data (Figure 3). The resolution of each camera was automatically downgraded to 720 p (or 1080 p) for any higher display resolution (e.g., 4 K, full high definition, and 1080 p), depending on the maximum internet speed 10 . We purposefully limited the band to 100 Mbps at Sapporo Medical University's doctor's office so that the verified applicability can hold up even in facilities where dedicated internet access lines cannot be installed because of financial, geographical, and infrastructural reasons (Appendix S1).…”

“…The development of a low‐latency communication system using an existing communication infrastructure, shared internet access (SIA), is necessary for the increased adoption of tele‐proctoring; however, SIA exhibits a noticeable latency and is not clinically applicable 9 . Thus, we successfully developed a communication system based on SIA with a latency lower than the maximum allowable latency for tele‐proctoring 10 . Now that the infrastructure for a low‐latency communication system using SIA has been completed, the feasibility of tele‐proctoring between hospitals needs to be verified.…”

“… 9 Thus, we successfully developed a communication system based on SIA with a latency lower than the maximum allowable latency for tele‐proctoring. 10 Now that the infrastructure for a low‐latency communication system using SIA has been completed, the feasibility of tele‐proctoring between hospitals needs to be verified. Therefore, this study aimed to verify the feasibility of the clinical application of tele‐proctoring using SIA.…”