Telemedicine Systems DiViSy TM21
A telemedicine system of DiViSy TM21 model stands for the third
generation of telemedicine systems, which incorporate the operating
experience of two previous versions DiViSy PM1and DiViSy TM2000.
These systems are meant for remote medical tutorials on various kinds of
diagnostics and treatment, in the real time mode along with deferred mode
with application of any available communication channels.
features of the systems are as follows:
1. Transmission and
receiving of medical data simultaneously via five channels: two parallel
channels for medical video data, one channel for transmission of medical
telemetric information and command signals for administration of local and
remote medical instruments, duplex sound channel and transceiving channel
for text-type data. The number of channels can be increased on the
1.1. Two parallel channels of medical video data
transmission secure input, digitalizing, representation and transfer of
medical video images with resolution of up to 768х576 dots (for analogue
video cameras) and up to the maximum resolution possible for digital video
and photo cameras (see next Figure 1).
parallel channels for transmission and imaging of medical video data are
required so that a remote-based consulting physician in course of
telemedicine tutorial or a remote-based physician cadet in the framework
of remote medical education system could see basic and auxiliary
information. For instance, in course of different types of operations such
as endoscopic, abdominal, neuro-surgical, ophthalmologic, otolaryngology,
dental etc. it would be possible to view not only the image of surgical
intervention target, but the general picture of operating room along with
the actions taken by members of operating crew. On the other hand, in the
process of ultrasonic examination, a remote-based physician would be able
not only to see a medical image transferred from ultrasound examination
apparatus (UEA), but the picture showing position of ultrasonic sensor
fixed on the body of a patient as well, thus permitting the consulting
physician to render his advice along with correcting of the entire
diagnostics procedure. Besides, in the framework of remote medical
education in case one channel of medical video data transfer plays back a
previously recorded video film on some unique procedure of diagnostics or
operation, the other channel can transmit the picture of a physician, who
is commenting on the broadcast film. In addition to the film transmitted
over the second channel, the latter can transfer documentary texts or
presentation materials along with any other graphic or illustrative data.
Therefore, at a transfer of primary and auxiliary medical information, a
remote-based physician receives almost the identical amount of data, as
does the doctor, who stays in a direct contact with the patient. Both
channels are equal in regard to their respective technical parameters and
secure input and digitalizing of medical images with resolution of up to
768х576 dots (for analogue sources of medical video images) and up to
maximum resolution feasible in respect to digital sources of medical video
images. Compression standards for medical video images can be selected
from the menu that contains the following algorithms: MJPEG, H.263, MPEG-4
1.2. Transceiving channel for medical telemetric
information and command signals for administration of remote medical
equipment is meant for connection of medical devices and techniques
possessing digital outputs for telemetric data (digital
electrocardiographs, encephalographs, etc.) as well as management of local
and remote medical equipment (controlled video cameras, robotized
microscopes in course of pathomorphology diagnostics and in the future
outlook robots destined for remote performance of surgical operations).
Typical supply of a telemedicine system incorporates a channel for
management and control over a video camera. Algorithms in regards to
administration of other medical instruments can be included upon agreement
1.3. Duplex acoustic channel is meant for audio
exchange between remote participants of telemedicine tutorials or for
remote medical education. High quality sound is secured due to
incorporation of the acoustic compression standards set included into
telemedicine systems. Such compression standards are as follows: G.711,
G.728, G.723 etc.
1.4. Channel for text exchange is destined to
procure text dialogue in the real time mode among the participants of
2. DiViSy TM21 telemedicine system
incorporates the feature of a desktop by means of which a joint analysis
is carried on along with combined work with medical images (Fig.2).
the initiative of any telemedicine session participant, an image, which in
a particular moment of time holds the utmost interest, is placed on the
desktop. For example, as it is demonstrated in the corresponding Figure,
such image placed on the desktop depicts the data from endoscope in course
of performance of bronchoscope. Session participants can use
different-color marking pens (each participant selects a separate color)
in order to indicate precise parts of the image where in their respective
opinions a biopsy shall be taken. Moreover, with assistance of integrated
drawing options on top of the image, a consulting physician can show
boundaries of a tumor or the curve along which resection shall be made.
Further on that image with all remarks rendered can be saved and stored by
every participant of telemedicine session under a specifically created
data format, designated as *.tmi. This format is brand new as the above
listed features are not present in any other types of medical systems.
Incorporation of those functions of analysis and work with medical images
allows remote-based physicians concentrating their attention on precise
and most informational sectors, whereas the option of saving and storing
of images along with all remarks made, permits to rapidly restore later on
the course of discussion held, along with the logic of decision making.
Telemedicine system has an integrated local database for instant saving of
images while holding telemedicine sessions.
4. In order to process
and improve the quality of medical images, telemedicine system
incorporates as an option the DiViSy IP21 (Image Processing)
software package that permits to perform the following operations:
to scale image with positive zooming of 2, 4, 8 and 16 times, along with
negative zooming of 2, 4 and 8 times.
· to integrate frame sequence for
the purpose of noise attenuation and , possibly, image contrast improving.
Number of integrated frames can vary within the range from 2 to 300.
to alter brightness and contrast of the input video signal.
· to alter
brightness and contrast of a frozen image, inclusive of images received
due to integration.
· to convert stilled image with assistance of
single or several consecutive mathematical filter-operations. Filtration
can be applied to entire image or to an arbitrarily chosen rectangular
area of the same. Filters composition can be varied in accordance with
· to calculate and depict a bar chart of image
dots brightness distribution or that of selected rectangular area of the
· to normalize entire image or its selected rectangular area.
to measure linear sizes of the images elements.
· to calibrate
· to save images in form of files pertaining to
certain graphic format.
· to copy images to the systems clipboard for
their following processing by means of other programs and applications.
to load images from a graphic file or from the systems clipboard.
following photo depicts user interface in regard to the program of medical
images processing and their quality improvement DiViSy IP21 (Fig3).
addition to the above-mentioned program, telemedicine systems can
incorporate other software programs and applications meant for processing
of images, in conformity with customers requests.
5. DiViSy TM21
telemedicine systems permit to carry out consulting and remote medical
education sessions not only with a single remote-based physician or
patient, but with many of them, including the option of video conference
holding. To achieve this goal a telemedicine server DiViSy TM21VS
has been designed. With assistance of this server it has become feasible
to combine local telemedicine networks of medical institutions into one
global network (wide area network) by means of servers cascading method.
More to that, within the framework of such global telemedicine network it
is possible to simultaneously hold several independent telemedicine
sessions. Telemedicine server performs control and administration of the
data streams in course of sessions, as well as performs multipoint
6. DiViSy TM21 telemedicine systems are meant
for operation with application of virtually any available channels of
communication, in particular: telephone, radio, cellular, fiber optic,
satellite and so on, inclusive of the channels secured by certified means
of data protection. Transfer rate for medical information is limited by
the data effective transmission speed in regards to certain applied
communication channels. Minimum rate passed in course of testing of DiViSy
TM21 telemedicine systems equals to 9,600 bits per second (GSM
cellular channels), while the maximum rate reached the mark of up to 8
megabits per second. Technological settings are incorporated to the system
through which it is feasible to select parameters of video and audio
information quality, depending on actual rate of data transfer within the
channel, in particular: alteration of images resolution within a wide
range, modification of number of frames transferred per second, changing
of algorithm and ratio of compression in respect to video images, etc.
On request of customers DiViSy TM21 telemedicine systems can hold
integrated standard means of user authentication on the basis of, for
example, individual USB key, biometrical devices that scan a fingerprint,
and so forth. Besides, detachable memory disks can be used that in the
absence of user can be stored in a safe box.
8. In compliance with
customers request, the information received in course of holding of
telemedicine tutorials can be transferred over to pre-existing medical
data systems of running medical institutions. To reach this target, after
analysis of formats of databases operating within medical informational
systems of a customer has been complete, a specialized program module is
being designed, by means of which telemedicine information is directed to
the databases and as well similar information can be requested from other
databases in course of telemedicine tutorials with the purpose of
9. DiViSy TM21 telemedicine systems
are based on unique program software with the same name designed and
worked out in course of several years by the experts of DiViSy Group of
Companies. That software incorporates the experience of practical running
operation of previous versions of telemedicine systems: DiViSy PM1
and DiViSy TM2000. Therefore, if so required, it would not render
any trouble to integrate a docking module to the system that would secure
compatible connection with telemedicine systems of other manufacturing
companies, provided however, that those systems, as well as DiViSy TM21,
possess an open interface of data formats.
telemedicine systems have friendly Russian-speaking interface. At
customers request, the current interface can be supplemented with native
language speaking users interface.
DiViSy TM21 telemedicine
systems can be easily adapted in consideration of the purpose of holding
telemedicine consultations and remote education accounting traits and
peculiarities of modern and irregular methods of diagnostics, treatment
and surgical intervention.
Possibilities of DiViSy TM21
telemedicine systems can be expanded through the connection of any
peripheral devices, such as printers, scanners, interactive boards,
documentary cameras, audio systems, projecting systems, etc.
TM21 telemedicine systems are manufactured in several constructional
10.1. Manufacturing version meant for diagnostics units and
operating rooms (Fig.4).
above listed manufacturing version stands for a 19 rack on rollers
designed to shift the equipment within the medical premise. The rack
comprises: Video and audio data processing unit VADPU DiViSy, integrated
to the Rack Mount case, uninterruptible power supply (UPS) system to
secure fail-free operation within 15 minutes in case of power supply
breakdown, power supply splitter to procure connection of all components
of telemedicine system, sliding drawer for storing of documents and
software CDs, a 17, 19 or 20 (in accordance with customers choice)
monitor, radio microphone, audio speakers or audio head set, fixed or
controlled video camera, cable set for connection to local area network
and to other medical equipment. The rack provides spaces for installation
and connection of printer, scanner, documentary camera or other peripheral
devices. Video camera can be mounted over the rack or on a special
supporting bracket (of wall, floor or ceiling mounting type), depending on
ergonomics of work in each office or in an operating room.
Manufacturing version meant for offices of medical institutions heads as
well as for separate departments of such establishments. The present
version represents two possible variants: on the basis of a personal
computer or on the basis of a notebook, depending on customers choice.
Provided there are computers allotted to the heads of medical institutions
or heads of medical departments of the same, these machines can be
converted into telemedicine systems through installation of appropriate
hardware and software expanding applications. It is worth highlighting
that all personal computers functions remain intact and unimpaired. (Fig.5)
following photo shows DiViSy TM21 telemedicine system destined for
managers and heads of medical institutions of various levels.
Mobile version of telemedicine systems meant for ambulance vehicles, field
diagnostics units or mobile hospitals. Pictures of this manufacturing
option are exposed below(Fig.6,7) .
The present photo depicts a mobile telemedicine system DiViSy TM21
in an extended version with self-contained power supply on the basis
of UAZ vehicle.
The present photo shows a mobile telemedicine system DiViSy TM21
in a portable and protected manufacturing version, fitted with
R-Bgan satellite station of Inmarsat system securing data transfer
rate of up to 144 kilobits per second.
Mobile telemedicine system manufactured for moving objects can be mounted
over vehicles, vessels, aircrafts, helicopters and other transportation
means. Therefore mobile telemedicine diagnostics units along with
telemedicine ambulance vehicles have been created. Such moving offices are
fitted with mobile diagnostics equipment: digital electrocardiographs,
compact ultrasonic examination apparatuses, compact X-ray units, etc. In
addition to that, by means of supplied cables these mobile stations can be
connected to stationary equipment installed in a remote polyclinic or
hospital. With assistance of such mobile telemedicine systems it would be
possible to arrange field diagnostics and prophylactic raids with the
purpose of examining patients in hard-to-access areas as well as to
receive prompt consultations in course of leaving for emergency calls.
telemedicine system in a portable manufacturing version can be placed as
integral part of mobile hospitals, as well as used individually by a
physician upon his leave for a call to hard accessible regions.