Grid based telemedicine application Arnaud FESSY, Matteo DIARENA LPC Clermont-Ferrand, France

Content Grid for humanitarian help The telemedicine application Issues Share medical information with Burkina Faso and China The telemedicine application Web services architecture Medical data management (AMGA) Medical images management Issues Patient privacy issues Network issues Application status Next development and perspectives Conclusion Egee User Forum, Manchester - 10 May 2007

Grid for humanitarian help Medical needs in Burkina Faso and Western China Important need for medical support Regular visits of European clinicians are too expensive Need to provide a continuous service especially in remote areas Grid can help to meet the needs Provide tools to easily exchange information and data between distant places Guarantee the high level of security required by medical data Provide a large amount of storage resources Egee User Forum, Manchester - 10 May 2007

Grid for humanitarian help Easy to use application Doctors are reluctant to use new tools They don’t want to change their « modus operandi » They are not grid experts Flexible application Should be adaptable to different medical fields Different hospitals have different formats for medical data Fault tolerant Should be self-consistent No global connectivity requirements Egee User Forum, Manchester - 10 May 2007

Telemedicine application (1) Web service architecture Easy to develop Accessible through standard communication protocol (SOAP)‏ Providing security mechanisms Medical Metadata management (AMGA)‏ DB backend independence Good performances and replication features Data access policy through users, group and ACLs management Easy to use and good support from AMGA developers Medical images management Grid SE to store images Encryption algorithms to ensure privacy and security Egee User Forum, Manchester - 10 May 2007

Telemedicine application (2) Web service architecture Web service for each medical application in each hospital Interface between medical platform and users Performs all security tasks (authentication and authorization) Web services Web services User Interface User Interface SOAP SOAP AMGA AMGA Hospital 1 Hospital 2 client Egee User Forum, Manchester - 10 May 2007

Telemedicine application (3) Flexible Medical Metadata schema Flexible DB schema adaptable to different medical application Used to describe both medical data and medical image metadata Use of XML schema to specify medical data format The metadata schema is stored in local AMGA server Easy to deploy telemedicine application with different medical data layout <?xml version="1.0"?> <table name="Patient" type="data"> <attribute name="NAME" type="varchar(40)"/> <attribute name="BIRTH_DATE" type="timestamp"/> <attribute name="BIRTH_WEIGHT" type="int"/> <attribute name="SEX" type="sel:M/F"/> … Egee User Forum, Manchester - 10 May 2007

Telemedicine application (4) AMGA metadata catalog An AMGA server in each hospital to manage: Medical data Medical images metadata (DICOM)‏ User credentials (password based authentication)‏ Authorization and ACLs management AMGA stores patient data Medical data accessed only through web service Patient data stored only inside the hospital Information sharing managed using AMGA user management features Egee User Forum, Manchester - 10 May 2007

Telemedicine application (5) Medical Images management Medical images are stored anonymized and encrypted in SE Image metadata (and encryption key) are stored in local AMGA server Anonymized image preview stored in AMGA for fast download Egee User Forum, Manchester - 10 May 2007

Issues (1) Patient privacy issues addressed Security solutions adopted How to manage private medical data on the grid ? How to connect the grid and hospitals ? How to share private medical data on the grid ? Security solutions adopted Anonymized medical images are stored encrypted on a SE Medical data are stored exclusively in the hospital AMGA manages data sharing and ACLs Grid authentication, VOMS Egee User Forum, Manchester - 10 May 2007

Issues (2) Network issues Solutions Weak network infrastructure in Burkina-Faso Only 1 ADSL line for each hospital Connection is unstable Solutions Medical images compression (with/without loss ? quality ?) Bandwidth, latency, jitter and packet loss studies to optimize data transfer Optimization of grid sites installation (grid nodes/traffic visualisation tool) Egee User Forum, Manchester - 10 May 2007

Issues (3) Egee User Forum, Manchester - 10 May 2007

Application status Web services implemented: Client application: User authentication (password authentication) Medical data management Medical images management Information sharing between users Client application: Medical images management and visualisation Secure connection between client and server (SSL) Egee User Forum, Manchester - 10 May 2007

Future developments and perspectives Secure data sharing between hospitals (AMGA replication) Integration of new medical images compression algorithms in client Deployment in Burkina Faso and China Installation of grid sites Deployment of Web services First real use cases: Neurosurgery in China Tele-ophthalmology in Burkina Faso Egee User Forum, Manchester - 10 May 2007

Conclusion Grid telemedicine application: Uses Grid to securely share medical data Brings medical support and European medical expertise in remote areas { Grid + Web services + AMGA } gives : Good performances Storage (medical images) Flexibility Security Egee User Forum, Manchester - 10 May 2007

THANK YOU FOR YOUR ATTENTION Egee User Forum, Manchester - 10 May 2007