A collaborative video-conferencing system for improving care during neonatal transport

Abstract

The need for real-time telemedicine to support urgent care is growing. The primary focus of our work has been on improving the care provided to critically ill infants born at community hospitals who need to be transported to tertiary care centers for specialized neonatal treatment. Providing real-time effective communication between community physicians, transport teams, and specialists will lead to better decisions about where to transport patients, better patient care during transfers, and reduced time to proper treatment upon arrival at the receiving hospital. There are a number of challenges in implementing a system that meets these needs: creating a reliable high-bandwidth channel on a moving ambulance by aggregating unreliable low-bandwidth cellular channels, providing a user interface that can be easily and effectively used by physicians, and instrumenting the incubator in which the infants are transported. We have built a bi-directional near real-time video-conferencing system designed to facilitate better communication between physicians and transport teams. In addition to providing much higher-quality video than current mobile telemedicine applications, our application provides collaborative and domain-specific features not offered by a regular teleconferencing system: doctors and transport team members can save and email snapshots and video clips for further analysis and discussion, zoom in on different portions of the video, switch between several cameras for different views of the patient and a vitals signs monitor, and set the video transmission parameters (e.g., frame rate and latency).