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ESA context: telemedicine via satellite transition phase
ESA wants to create a telemedicine programme in partnership with WHO.
Creation of a European expert group to advise ESA on the actions to be promoted in the telemedicine field.
Identifications of 3 activities by the expert groupHealth Early Warning -> SAFE projectManagement of Medical Emergency for commercial aviation Interconnectivity for Healthcare Services and Professional Medical Education bridging communities in Eastern and Western Europe
Approach: User driven, user co-funding for sustainability, promotion of a transition phase
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Context (Source WHO, InVS)
Among current biological threats Avian Influenza
Since 2003: 235 cases, 137 deaths (WHO, 8/08/2006) Increasing geographical spread in animals, increasing number of species affected…
Current or emerging and re-emerging diseasesGlobal challenges for AIDS, Tuberculosis, Malaria, and many othersEnvironmental/climate changes influence microbial geographical distribution, persistence and transmission mode and can cause spread of local or species-specific diseasesOn average, one new human disease per year, of which 75% is from animal originDiseases can re-emerge after containment if the reservoir of the virus still exists (Ebola, SARS)Chikungunya in La Réunion island:
since March 2005 - More than 266 000 cases (InVS, 3/08/2006).
BioterrorismAnthrax (US, 2001)
+ Risk of epidemiological crises after natural or man-made disasters
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Needs
Need for an Outbreak Management System to prevent, predict and organize an optimized response.
Network of experts, decision-makers Tools:
To prevent or predict the outbreakTo issue early warningTo optimize the resources and the intervention to limit the extension of the crisis
Added value of satellite communications for health early warning in remote, isolate or prone to natural or man-made disaster areas.
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SATCOM in biological crises
Access to communication from any place in the world especially remote areas or areas with difficult access.
Data collection for electronic surveillance and early alertGeolocalisation of events related to the outbreak of epidemics (monitoring of movement of birds, localization of areas at risks…)
Communication for management of biological crisis. Satellite connectivity between experts, decision-making centers and coordination centers on the site of the crisis. Access to Internet from remote areas or mobile field unitsSatellite communications for mobile field units.
Post disaster monitoring for data collection.
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SAFE objectives
Specifications based on a close collaboration with end-users, in particular WHO and ECDC. Development of a European Outbreak management
system:InteroperableImplementing existing standardsBased on well recognized open source technologies.
To provide a standard tool usable by the maximum number of end-users.
To develop and demonstrate the added value of various satellite communication services for all the phases of a biological crisis including prevention,
early warning and crisis management.
To develop and demonstrate the added value of various satellite communication services for all the phases of a biological crisis including prevention,
early warning and crisis management.
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SAFE demonstrator (1)
Operation field
Local application server
Coordination van
Sat comm. Providerterrestrial gateway
Network equipment
InternetInternet
Data consulting on remote site
Video conferences users
Field agents
Data handling (consulting,meeting, reporting)
End users / Expert centers
SAFEremote
applicationserverField
laboratory
SAFE
Globalstar Gateway
Globalstar
Eutelsat
GPS
DVB-RCS
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SAFE demonstrator (2)
A network of expert centers and hospitals able to communicate by satellites and interoperable with other networks
A coordination van DVB-RCS capability Deployable Wi-Fi networkPortable terminals, satellite phones for mobile teams
A field laboratory or lab.van In-situ analyses
An information systemData collectionGIS for geolocalisation and visualization of epidemics evolution
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Network of expert centers
Satellite link to restore the communication
between the field and the overall network of epidemiological surveillance through Internet.
For SAFE demonstrations: DVB-RCS accessAccess through a communication platform offering:
Broadband satellite connectivity for high quality point to point and multipoint videoconference or broadcasting applications.Access to a network of already satellite powered sites (35 hospitals in various countries)
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Coordination van
Link with expert and decision makers:DVB-RCS connectionAccess to Internet
Link with mobile teams on the field:Local Wi-Fi networkSatellite phones for areas outside Wi-Fi coveragehandheld terminals for data collection by the mobile teams.
Equipped withSatcom antenna for DVB-RCS connection (2Mb/s)Application server with SAFE information system (data collection + GIS)Mobile terminals for the field agents: Tablet PC, PDA, GlobalStar Phones+ for the purpose of SAFE demonstrations: a lab. Kit.
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Lab van (Field laboratory)
To obtain and analyze:Environmental samples to evaluate the diffusion of the biological agent and the sources of contaminationBiological samples from asymptomatic people and for people demonstrating local or general symptoms of infection or intoxication
Series of preliminary tests Advices and expertise from remote expert centers (Possibility to send images and data) Rapid and preliminary information provided to hospitals and public health experts (care of
potentially infected/intoxicated people)
Link with the coordination van, remote expert centers
Equipped with Instruments and material to obtain biological and environmental samplesBasic microbiological kits to detect and presumptively identify the biological agentSAFE information systemLink with laboratories, hospitals, epidemiological centers, military and civil protection groups for the crisis management. Structures and instrumentation to protect people working in from the contaminating agent
To limit the costs, the lab van will be replaced by a lab kit included in the coordination van for most of SAFE demonstrations.
To limit the costs, the lab van will be replaced by a lab kit included in the coordination van for most of SAFE demonstrations.
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Data management system - MEDANY
Based on open source technologies (Eclipse eRCP namely supported by IBM, Nokia, Motorola)
Solution adapted to any type of situation, easy deployment, easy maintenance
Quick and easy configuration of collection formsEasy application deployment (concept of rich client) as easy as calling a URLeUpdate -> very easy maintenance
Configuration:Remote and local application servers for collecting, consolidating, storing an analyzing information Rich client deployed on mobile equipment
Maintenance facilitated (eUpdates). High portability on a great number of handheld devices (PDA, Smart Phones)
Website for data consultationInterface with laboratory equipment for the lab van. Security: secured access with user profiles.
Interoperability Export via web services for inter-system communicationExport to files (spreadsheet, Epi Info format…)Database with standard interfaces - integration of a data model defined in accordance with PHIN guidelines.
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GIS
Integration of information essential for the evaluation of the situation
Vegetation mapLand coverWater resources, water qualityWind blow and dust mapsLand surface temperatureMeteorological information layer. Integration of geopolitical informationIn-situ information all along the crisis
Points of sample collectionSituation of the different components/people of the in-situ unitsAreas covered by mobile teams.
Satellite images: Global analysis of the situation: Historical information and new acquired one to evaluate damage.
Digital elevation maps
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Demontrations
Objective:To validate SAFE approach with end-users.
Different types of demonstrations:End-to-end case of early warning at the onset of an epidemic based on a post disaster scenario.
Itinerant and On-demand demonstrations
Inclusion of a scenario on the avian flu risk defined with experts from WHO. Evaluation of SAFE solution for radiological risks. Others to be defined, all over Europe, on demand of users.
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Sustainability
Objective of the consortium:To provide a sustainable system for Health Early Warning, using international standards and relying on advanced satcom services.
Promotion towards end-usersParticipation to workshopsPromotion of a users groupOrganization of the itinerant on demand demonstrations
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Other perspectives and recommendations
Conditions for acceptability of space based products by the usersLegal aspects of sharing health related data
Access and property rights on transnational dataRules for publishing transnational sensitive data
Standardization of health data for efficient exchanges in the European region.
Discussion with decision makers:Possibility to issue an open source version of a basic SAFE information system for data collection in collaboration with decision makers.
Initial investment to be defined.
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Schedule
Duration: 18 months (07/2006 - 12/2007)July 2006 - December 2006:
Definition of users and requirementsFunctional analysis, system design
November 2006 - June 2007:Development and integration
July 2007-December 2007:DemonstrationsCost benefit and sustainability analysisPerspectives and recommendations.
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Partners
FORTHInstitute for Computer Science
FORTHInstitute for Computer Science
MicrobiologyUNIVERSITY of VERONA
MicrobiologyUNIVERSITY of VERONA
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Why becoming part of the users group
Participate in the specifications of the system.
Contribute to evaluate SAFE solution, for instance by including SAFE solution in one of your exercises
Get a prior access to SAFE results
Become a partner for the dissemination and the exploitation