Evaluation of Videoconferencing Systems for Remote Medical Education

Kuriko Kudo^1*, Shuji Shimizu^1,2, Ti-Chuang Chiang³, Yasuaki Antoku^1,4, Min Hu¹, Yoshiko Houkabe¹, Naoki Nakashima¹

¹Telemedicine Development Center of Asia, Kyushu University Hospital, Fukuoka, Japan.
²Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, Japan.
³Medical Informatics Division, College of Medicine, National Taiwan University, Taipei City.
⁴Medical Information Center, Kyushu University Hospital, Fukuoka, Japan.

DOI: 10.4236/ce.2014.512120                

Abstract

Remote education in medicine has two distinct differences over remote education in other fields. The first is the frequent use of moving images to show techniques and procedures, and the second is the necessity of very high image quality for accurate diagnosis or precise anatomy. The emergence of digital video transport systems (DVTS) has surmounted technological limitations and made remote medical education practical. However, to meet new demands for better quality and wider availability, two additional systems, HD-H.323 and Vidyo, have been developed. Feedbacks from users of these systems are crucial for accurate evaluation and further improvements. We designed questionnaires evaluating image quality, preparations, major problems, and overall satisfaction with each of these systems. These questionnaires, along with answer pads, were administered to 32 participants at the Seventh Asia Telemedicine Symposium, held in Bangkok, Thailand, on December 14, 2013. Of 22 (69%) valid answers on best image quality, nine (41%) chose DVTS, eight (36%) chose HD-H.323, and five (23%) chose Vidyo. Of 27 (84%) valid responses on ease of preparation, 21 (78%) picked Vidyo, six (22%) picked HD-H.323 and none picked DVTS. The biggest problems with DVTS were sound (11/29, 38%) and ease of preparation (8/29, 28%), the biggest problem with HD-H.323 was cost (18/28, 64%), and the biggest problems with Vidyo were sound (8/29, 28%) and cost (8/29, 28%). Overall satisfaction rates were 70% (14/20) for DVTS, 86% (18/21) for HD-H.323, and 77% (20/26) for Vidyo. In conclusion, the three technologies currently used for remote medical education were all satisfactory. Because each has its own advantages and disadvantages, the choice of the most appropriate system should depend on the program being broadcast and the availability of equipment and network at participating stations.

Keywords

Telemedicine, Remote Medical Education, Internet

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Cao, M. D., Shimizu, S., Antoku, Y., Torata, N., Kudo, K., Okamura, K. et al. (2012). Emerging Technologies for Telemedicine. Korean Journal of Radiology, 13, S21-S30. http://dx.doi.org/10.3348/kjr.2012.13.S1.S21
[2]	Carati, C., Shimizu, S., Okamura, K., Lomanto, D., Tanaka, M., & Toouli, J. (2006). High Definition Digital Video Links for Surgical Training. Journal of Telemedicine and Telecare, 12, S26-S28. http://dx.doi.org/10.1258/135763306779380237
[3]	Eto, M., Lee, T. Y., Gill, I. S., Koga, H., Tatsugami, K., Shimizu, S. et al. (2007). Broadcast of Live Endoscopic Surgery from Korea to Japan Using the Digital Video Transport System. Journal of Endourology, 21, 1517-1520. http://dx.doi.org/10.1089/end.2007.9886
[4]	Hahm, J. S., Lee, H. L., Choi, H. S., & Shimizu, S. (2009). Telemedicine System Using a High-Speed Network: Past, Present, and Future. Gut and Liver, 3, 247-251. http://dx.doi.org/10.5009/gnl.2009.3.4.247
[5]	Huang, K. J., Qiu, Z. J., Fu, C. Y., Shimizu, S., & Okamura, K. (2008). Uncompressed Video Image Transmission of Laparoscopic or Endoscopic Suregery for Telemedicine. Telemedicine and E-Health, 14, 479-485. http://dx.doi.org/10.1089/tmj.2007.0088
[6]	Huang, K. J., Cen, G., Qiu, Z. J., Jiang, T., Cao, J., & Fu, C. Y. (2014). Application of International Videoconferences for Continuing Medical Education Programs Related to Laparoscopic Surgery. Telemedicine and E-Health, 20, 157-160. http://dx.doi.org/10.1089/tmj.2013.0070
[7]	Kaltenbach, T., Muto, M., Soetikno, R., Dev, P., Okamura, K., Hahm, J. et al. (2009).Teleteaching Endoscopy: The Feasibility of Real-Time, Uncompressed Video Transmission by Using Advanced-Network Technologies. Gastrointestinal Endoscopy, 70, 1013-1017. http://dx.doi.org/10.1016/j.gie.2009.05.016
[8]	Jennings, D. M., Landweber, L. H., Fuchs, I. H., Farber, D. J., & Adrion, W. R. (1986). Computer Networking for Scientists. Science, 231, 943-950. http://dx.doi.org/10.1126/science.231.4741.943
[9]	Kwon, S., Tamhankar, A., & Rao, K. R. (2006). Overview of H.264/MPEG-4 Part 10. Journal of Visual Communication and Image Representation, 17, 186-216. http://dx.doi.org/10.1016/j.jvcir.2005.05.010
[10]	Lee, S. P., Lee, H. L., Hahm, J. S., Choi, H. S., Joe, I., & Shimizu, S. (2012). International Live Endoscopic Multichannel Demonstration Using Superfast Broadband Internet Connections. Clinical Endoscopy, 45, 73-77. http://dx.doi.org/10.5946/ce.2012.45.1.73
[11]	Reid, M. (1999). Multimedia Conferencing over ISDN and IP Networks Using ITU-T H-Series Recommendations: Architecture, Control and Coordination. Computer Networks, 31, 225-235. http://dx.doi.org/10.1016/S0169-7552(98)00264-5
[12]	Ogawa, A., Kobayashi, K., Sugiura, K., Nakamura, O., & Murai, J. (1999). Design and Implementation of DV Stream over Internet. Proceedings of the Internet Workshop IWS '99, 255-260.
[13]	Rabenstein, T., Maiss, J., Naegele-Jackson, S., Liebl, K., Hengstenberg, T., Radespiel-Troger, M. et al. (2002). Tele-Endos-copy: Influence of Data Compression, Bandwidth and Simulated Impairments on the Usability of Real-Time Digital Video Endoscopy Transmissions for Medical Diagnoses. Endoscopy, 34, 703-710. http://dx.doi.org/10.1055/s-2002-33568
[14]	Rafiq, A., Moore, J. A., Zhao, X., Doarn, C. R., & Merrell, R. C. (2004). Digital Video Capture and Synchronous Consultation in Open Surgery. Annals of Surgery, 239, 567-573. http://dx.doi.org/10.1097/01.sla.0000118749.24645.45
[15]	Shimizu, S., Nakashima, N., Okamura, K., Hahm, J. S., Kim, Y. W., Moon, B. I. et al. (2006). International Transmission of Uncompressed Endoscopic Surgery Images via Superfast Broadband Internet Connections. Surgical Endoscopy, 20, 167-170. http://dx.doi.org/10.1007/s00464-005-0282-7
[16]	Shimizu, S., Nakashima, N., Okamura, K., & Tanaka, M. (2009). One Hundred Case Studies of Asia-Pacific Telemedicine Using a Digital Video Transport System over a Research and Education Network. Telemedicine and E-Health, 15, 112-117. http://dx.doi.org/10.1089/tmj.2008.0067
[17]	Shimizu, S., Okamura, K., Nakashima, N., Kitamura, Y., Torata, N., Yamashita, T. et al. (2011). High-Quality Telemedicine Using Digital Video Transport System over Global Research and Education Network. In G. Graschew, & T. A. Roelefs (Eds.), Advances in Telemedicine: Technologies, Enabling Factors and Scenarios (pp. 87-110). Rijeka, Croatia: InTech.
[18]	Shimizu, S., Antoku, Y., Min, H., Okamura, K., & Nakashima, N. (2014). Ten-Year Experience of Remote Medical Education in Asia. Telemedicine and E-Health, in Press.