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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

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

13. 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

14. 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

15. 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

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