M-health medical video communication systems: An overview of design approaches and recent advances
---
paper_title: Systematic review of studies of the cost-effectiveness of telemedicine and telecare. Changes in the economic evidence over twenty years

paper_content:

A systematic review of studies of the cost-effectiveness of telemedicine and telecare was undertaken from 1990 until September 2010. Twelve databases were searched, using economic evaluation terms combined with telemedicine terms. The search identified 80 studies which were classed as full economic evaluations; the majority (38) were cost-consequence analyses. There were 15 cost-effectiveness analyses (CEA) and seven cost-utility analyses (CUA). In the period January 2004 to September 2010 there were 47 studies. Eleven were CEA and seven were CUA. Economic tools are being increasingly used for telemedicine and telecare studies, although better reporting of the methodologies and findings of the economic evaluations is required. Nonetheless, the results of the review were consistent with previous findings, i.e. there is no further conclusive evidence that telemedicine and telecare interventions are cost-effective compared to conventional health care.
---
paper_title: An overview of recent end-to-end wireless medical video telemedicine systems using 3G

paper_content:

Advances in video compression, network technologies, and computer technologies have contributed to the rapid growth of mobile health (m-health) systems and services. Wide deployment of such systems and services is expected in the near future, and it's foreseen that they will soon be incorporated in daily clinical practice. This study focuses in describing the basic components of an end-to-end wireless medical video telemedicine system, providing a brief overview of the recent advances in the field, while it also highlights future trends in the design of telemedicine systems that are diagnostically driven.
---
paper_title: 4G Wireless Video Communications

paper_content:

A comprehensive presentation of the video communication techniques and systems, this book examines 4G wireless systems which are set to revolutionise ubiquitous multimedia communication.4G Wireless Video Communications covers the fundamental theory and looks at systems descriptions with a focus on digital video. It addresses the key topics associated with multimedia communication on 4G networks, including advanced video coding standards, error resilience and error concealment techniques, as well as advanced content-analysis and adaptation techniques for video communications, cross-layer design and optimization frameworks and methods. It also provides a high-level overview of the digital video compression standard MPEG-4 AVC/H.264 that is expected to play a key role in 4G networks. Material is presented logically allowing readers to turn directly to specific points of interest. The first half of the book covers fundamental theory and systems, while the second half moves onto advanced techniques and applications. This book is a timely reflection of the latest advances in video communications for 4G wireless systems. One of the first books to study the latest video communications developments for emerging 4G wireless systems Considers challenges and techniques in video delivery over 4G wireless systems Examines system architecture, key techniques and related standards of advanced wireless multimedia applications Written from both the perspective of industry and academia
---
paper_title: Comparison of the Coding Efficiency of Video Coding Standards—Including High Efficiency Video Coding (HEVC)

paper_content:

The compression capability of several generations of video coding standards is compared by means of peak signal-to-noise ratio (PSNR) and subjective testing results. A unified approach is applied to the analysis of designs, including H.262/MPEG-2 Video, H.263, MPEG-4 Visual, H.264/MPEG-4 Advanced Video Coding (AVC), and High Efficiency Video Coding (HEVC). The results of subjective tests for WVGA and HD sequences indicate that HEVC encoders can achieve equivalent subjective reproduction quality as encoders that conform to H.264/MPEG-4 AVC when using approximately 50% less bit rate on average. The HEVC design is shown to be especially effective for low bit rates, high-resolution video content, and low-delay communication applications. The measured subjective improvement somewhat exceeds the improvement measured by the PSNR metric.
---
paper_title: Overview of the High Efficiency Video Coding (HEVC) Standard

paper_content:

High Efficiency Video Coding (HEVC) is currently being prepared as the newest video coding standard of the ITU-T Video Coding Experts Group and the ISO/IEC Moving Picture Experts Group. The main goal of the HEVC standardization effort is to enable significantly improved compression performance relative to existing standards-in the range of 50% bit-rate reduction for equal perceptual video quality. This paper provides an overview of the technical features and characteristics of the HEVC standard.
---
paper_title: A Tutorial for Emerging Wireless Medical Video Transmission Systems [Wireless Corner]

paper_content:

The wireless transmission of medical video is expected to see significant growth in the coming years. This is primarily due to the expected availability of significant bandwidth in the next-generation of wireless communications networks, and the emergence of effective wireless video-compression standards. The design of wireless medical video transmission systems presents unique requirements for error-resilience and clinical validation. We present a tutorial introduction to the most important components of a wireless medical video transmission system. We focus on video-encoding requirements for error resilience, quality-of-service transmission, and diagnostic validation. Whenever possible, we give references to open-source software and provide references to the literature. We demonstrate the basic principles through the use of simple examples of stroke ultrasound videos.
---
paper_title: Wireless Telemedicine Systems: An Overview

paper_content:

Rapid advances in information technology and telecommunications - and, more specifically, wireless and mobile communications - and their convergence ("telematics") are leading to the emergence of a new type of information infrastructure that has the potential of supporting an array of advanced services for healthcare. The objective of this paper is to provide a snapshot of the applications of wireless telemedicine systems. A review of the spectrum of these applications and the potential benefits of these efforts is presented, followed by successful case studies in electronic patient record, emergency telemedicine, teleradiology, and home monitoring. It is anticipated that the progress carried out in these efforts and the potential benefits of emerging mobile technologies will trigger the development of more applications, thus enabling the offering of a better service to the citizen.
---
paper_title: An overview of recent end-to-end wireless medical video telemedicine systems using 3G

paper_content:

Advances in video compression, network technologies, and computer technologies have contributed to the rapid growth of mobile health (m-health) systems and services. Wide deployment of such systems and services is expected in the near future, and it's foreseen that they will soon be incorporated in daily clinical practice. This study focuses in describing the basic components of an end-to-end wireless medical video telemedicine system, providing a brief overview of the recent advances in the field, while it also highlights future trends in the design of telemedicine systems that are diagnostically driven.
---
paper_title: A Tutorial for Emerging Wireless Medical Video Transmission Systems [Wireless Corner]

paper_content:

The wireless transmission of medical video is expected to see significant growth in the coming years. This is primarily due to the expected availability of significant bandwidth in the next-generation of wireless communications networks, and the emergence of effective wireless video-compression standards. The design of wireless medical video transmission systems presents unique requirements for error-resilience and clinical validation. We present a tutorial introduction to the most important components of a wireless medical video transmission system. We focus on video-encoding requirements for error resilience, quality-of-service transmission, and diagnostic validation. Whenever possible, we give references to open-source software and provide references to the literature. We demonstrate the basic principles through the use of simple examples of stroke ultrasound videos.
---
paper_title: Cross-Layer Design for Optimized Region of Interest of Ultrasound Video Data Over Mobile WiMAX

paper_content:

The application of advanced error concealment techniques applied as a postprocess to conceal lost video information in error-prone channels, such as the wireless channel, demands additional processing at the receiver. This increases the delivery delay and needs more computational power. However, in general, only a small region within medical video is of interest to the physician and thus if only this area is considered, the number of computations can be curtailed. In this paper, we present a technique whereby the region of interest specified by the physician is used to delimit the area where the more complex concealment techniques are applied. A cross-layer design approach in mobile worldwide interoperability for microwave access wireless communication environment is adopted in this paper to provide an optimized quality of experience in the region that matters most to the mobile physician while relaxing the requirements in the background, ensuring real-time delivery. Results show that a diagnostically acceptable peak signal-to-noise-ratio of about 36 dB can still be achieved within reasonable decoding time.
---
paper_title: SPIHT-Based Echocardiogram Compression: Clinical Evaluation and Recommendations of Use

paper_content:

This paper describes an echocardiogram coding method that takes into account the visualization modes in order to compress efficiently the echocardiogram, a methodology to evaluate compressed echocardiograms and the evaluation of the compression method using the proposed evaluation methodology. The compression method takes advantage of the particular characteristics of each visualization mode and uses different compression techniques for each mode to compress efficiently the echocardiogram. A complete evaluation has been designed in order to recommend a minimum transmission rate for each operation mode that guarantees sufficient clinical quality. The evaluation of the echocaradiograms compressed with the proposed method has been carried out. The recommended transmission rates have been established as the following: 200 kbps for the 2D and the color Doppler modes, and 40 kbps for the M and the pulsed/continuous Doppler modes. These rates, especially the latter, are very low compared to previous results. These recommendations are valid for all devices and images compressed with the proposed method. The evaluation process can be applied to any compression method.
---
paper_title: Enhanced Protocol for Real-Time Transmission of Echocardiograms Over Wireless Channels

paper_content:

This paper presents a methodology to transmit clinical video over wireless networks in real-time. A 3-D set partitioning in hierarchical trees compression prior to transmission is proposed. In order to guarantee the clinical quality of the compressed video, a clinical evaluation specific to each video modality has to be made. This evaluation indicates the minimal transmission rate necessary for an accurate diagnosis. However, the channel conditions produce errors and distort the video. A reliable application protocol is therefore proposed using a hybrid solution in which either retransmission or retransmission combined with forward error correction (FEC) techniques are used, depending on the channel conditions. In order to analyze the proposed methodology, the 2-D mode of an echocardiogram has been assessed. A bandwidth of 200 kbps is necessary to guarantee its clinical quality. The transmission using the proposed solution and retransmission and FEC techniques working separately have been simulated and compared in high-speed uplink packet access (HSUPA) and worldwide interoperability for microwave access (WiMAX) networks. The proposed protocol achieves guaranteed clinical quality for bit error rates higher than with the other protocols, being for a mobile speed of 60 km/h up to 3.3 times higher for HSUPA and 10 times for WiMAX.
---
paper_title: High-Resolution, Low-Delay, and Error-Resilient Medical Ultrasound Video Communication Using H.264/AVC Over Mobile WiMAX Networks

paper_content:

In this study, we describe an effective video communication framework for the wireless transmission of H.264/AVC medical ultrasound video over mobile WiMAX networks. Medical ultrasound video is encoded using diagnostically driven, error resilient encoding, where quantization levels are varied as a function of the diagnostic significance of each image region. We demonstrate how our proposed system allows for the transmission of high-resolution clinical video that is encoded at the clinical acquisition resolution and can then be decoded with low delay. To validate performance, we perform OPNET simulations of mobile WiMAX medium access control and physical layers characteristics that include service prioritization classes, different modulation and coding schemes, fading channel's conditions, and mobility. We encode the medical ultrasound videos at the 4CIF (704×576) resolution that can accommodate clinical acquisition that is typically performed at lower resolutions. Video quality assessment is based on both clinical (subjective) and objective evaluations.
---
paper_title: Flexible Macroblock Ordering for Context-Aware Ultrasound Video Transmission over Mobile WiMAX

paper_content:

The most recent network technologies are enabling a variety of new applications, thanks to the provision of increased bandwidth and bettermanagement of Quality of Service. Nevertheless, telemedical services involving multimedia data are still lagging behind, due to the concern of the end users, that is, clinicians and also patients, about the low quality provided. Indeed, emerging network technologies should be appropriately exploited by designing the transmission strategy focusing on quality provision for end users. Stemming from this principle, we propose here a context-aware transmission strategy for medical video transmission over WiMAX systems. Context, in terms of regions of interest (ROI) in a specific session, is taken into account for the identification of multiple regions of interest, and compression/transmission strategies are tailored to such context information. We present a methodology based on H.264 medical video compression and Flexible Macroblock Ordering (FMO) for ROI identification. Two different unequal error protection methodologies, providing higher protection to the most diagnostically relevant data, are presented.
---
paper_title: Cross-Layer Ultrasound Video Streaming Over Mobile WiMAX and HSUPA Networks

paper_content:

It is well known that the evolution of 4G-based mobile multimedia network systems will contribute significantly to future mobile healthcare (m-health) applications that require high bandwidth and fast data rates. Central to the success of such emerging applications is the compatibility of broadband networks, such as mobile Worldwide Interoperability For Microwave Access (WiMAX) and High-Speed Uplink Packet Access (HSUPA), and especially their rate adaption issues combined with the acceptable real-time medical quality of service requirements. In this paper, we address the relevant challenges of cross-layer design requirements for real-time rate adaptation of ultrasound video streaming in mobile WiMAX and HSUPA networks. A comparative performance analysis of such approach is validated in two experimental m-health test bed systems for both mobile WiMAX and HSUPA networks. The experimental results have shown an improved performance of mobile WiMAX compared to the HSUPA using the same cross-layer optimization approach.
---
paper_title: Enhanced Protocol for Real-Time Transmission of Echocardiograms Over Wireless Channels

paper_content:

This paper presents a methodology to transmit clinical video over wireless networks in real-time. A 3-D set partitioning in hierarchical trees compression prior to transmission is proposed. In order to guarantee the clinical quality of the compressed video, a clinical evaluation specific to each video modality has to be made. This evaluation indicates the minimal transmission rate necessary for an accurate diagnosis. However, the channel conditions produce errors and distort the video. A reliable application protocol is therefore proposed using a hybrid solution in which either retransmission or retransmission combined with forward error correction (FEC) techniques are used, depending on the channel conditions. In order to analyze the proposed methodology, the 2-D mode of an echocardiogram has been assessed. A bandwidth of 200 kbps is necessary to guarantee its clinical quality. The transmission using the proposed solution and retransmission and FEC techniques working separately have been simulated and compared in high-speed uplink packet access (HSUPA) and worldwide interoperability for microwave access (WiMAX) networks. The proposed protocol achieves guaranteed clinical quality for bit error rates higher than with the other protocols, being for a mobile speed of 60 km/h up to 3.3 times higher for HSUPA and 10 times for WiMAX.
---
paper_title: Flexible Macroblock Ordering for Context-Aware Ultrasound Video Transmission over Mobile WiMAX

paper_content:

The most recent network technologies are enabling a variety of new applications, thanks to the provision of increased bandwidth and bettermanagement of Quality of Service. Nevertheless, telemedical services involving multimedia data are still lagging behind, due to the concern of the end users, that is, clinicians and also patients, about the low quality provided. Indeed, emerging network technologies should be appropriately exploited by designing the transmission strategy focusing on quality provision for end users. Stemming from this principle, we propose here a context-aware transmission strategy for medical video transmission over WiMAX systems. Context, in terms of regions of interest (ROI) in a specific session, is taken into account for the identification of multiple regions of interest, and compression/transmission strategies are tailored to such context information. We present a methodology based on H.264 medical video compression and Flexible Macroblock Ordering (FMO) for ROI identification. Two different unequal error protection methodologies, providing higher protection to the most diagnostically relevant data, are presented.
---
paper_title: Cross-Layer Design for Optimized Region of Interest of Ultrasound Video Data Over Mobile WiMAX

paper_content:

The application of advanced error concealment techniques applied as a postprocess to conceal lost video information in error-prone channels, such as the wireless channel, demands additional processing at the receiver. This increases the delivery delay and needs more computational power. However, in general, only a small region within medical video is of interest to the physician and thus if only this area is considered, the number of computations can be curtailed. In this paper, we present a technique whereby the region of interest specified by the physician is used to delimit the area where the more complex concealment techniques are applied. A cross-layer design approach in mobile worldwide interoperability for microwave access wireless communication environment is adopted in this paper to provide an optimized quality of experience in the region that matters most to the mobile physician while relaxing the requirements in the background, ensuring real-time delivery. Results show that a diagnostically acceptable peak signal-to-noise-ratio of about 36 dB can still be achieved within reasonable decoding time.
---
paper_title: An overview of recent end-to-end wireless medical video telemedicine systems using 3G

paper_content:

Advances in video compression, network technologies, and computer technologies have contributed to the rapid growth of mobile health (m-health) systems and services. Wide deployment of such systems and services is expected in the near future, and it's foreseen that they will soon be incorporated in daily clinical practice. This study focuses in describing the basic components of an end-to-end wireless medical video telemedicine system, providing a brief overview of the recent advances in the field, while it also highlights future trends in the design of telemedicine systems that are diagnostically driven.
---
paper_title: Cross-Layer Design for Optimized Region of Interest of Ultrasound Video Data Over Mobile WiMAX

paper_content:

The application of advanced error concealment techniques applied as a postprocess to conceal lost video information in error-prone channels, such as the wireless channel, demands additional processing at the receiver. This increases the delivery delay and needs more computational power. However, in general, only a small region within medical video is of interest to the physician and thus if only this area is considered, the number of computations can be curtailed. In this paper, we present a technique whereby the region of interest specified by the physician is used to delimit the area where the more complex concealment techniques are applied. A cross-layer design approach in mobile worldwide interoperability for microwave access wireless communication environment is adopted in this paper to provide an optimized quality of experience in the region that matters most to the mobile physician while relaxing the requirements in the background, ensuring real-time delivery. Results show that a diagnostically acceptable peak signal-to-noise-ratio of about 36 dB can still be achieved within reasonable decoding time.
---
paper_title: SPIHT-Based Echocardiogram Compression: Clinical Evaluation and Recommendations of Use

paper_content:

This paper describes an echocardiogram coding method that takes into account the visualization modes in order to compress efficiently the echocardiogram, a methodology to evaluate compressed echocardiograms and the evaluation of the compression method using the proposed evaluation methodology. The compression method takes advantage of the particular characteristics of each visualization mode and uses different compression techniques for each mode to compress efficiently the echocardiogram. A complete evaluation has been designed in order to recommend a minimum transmission rate for each operation mode that guarantees sufficient clinical quality. The evaluation of the echocaradiograms compressed with the proposed method has been carried out. The recommended transmission rates have been established as the following: 200 kbps for the 2D and the color Doppler modes, and 40 kbps for the M and the pulsed/continuous Doppler modes. These rates, especially the latter, are very low compared to previous results. These recommendations are valid for all devices and images compressed with the proposed method. The evaluation process can be applied to any compression method.
---
paper_title: Enhanced Protocol for Real-Time Transmission of Echocardiograms Over Wireless Channels

paper_content:

This paper presents a methodology to transmit clinical video over wireless networks in real-time. A 3-D set partitioning in hierarchical trees compression prior to transmission is proposed. In order to guarantee the clinical quality of the compressed video, a clinical evaluation specific to each video modality has to be made. This evaluation indicates the minimal transmission rate necessary for an accurate diagnosis. However, the channel conditions produce errors and distort the video. A reliable application protocol is therefore proposed using a hybrid solution in which either retransmission or retransmission combined with forward error correction (FEC) techniques are used, depending on the channel conditions. In order to analyze the proposed methodology, the 2-D mode of an echocardiogram has been assessed. A bandwidth of 200 kbps is necessary to guarantee its clinical quality. The transmission using the proposed solution and retransmission and FEC techniques working separately have been simulated and compared in high-speed uplink packet access (HSUPA) and worldwide interoperability for microwave access (WiMAX) networks. The proposed protocol achieves guaranteed clinical quality for bit error rates higher than with the other protocols, being for a mobile speed of 60 km/h up to 3.3 times higher for HSUPA and 10 times for WiMAX.
---
paper_title: High-Resolution, Low-Delay, and Error-Resilient Medical Ultrasound Video Communication Using H.264/AVC Over Mobile WiMAX Networks

paper_content:

In this study, we describe an effective video communication framework for the wireless transmission of H.264/AVC medical ultrasound video over mobile WiMAX networks. Medical ultrasound video is encoded using diagnostically driven, error resilient encoding, where quantization levels are varied as a function of the diagnostic significance of each image region. We demonstrate how our proposed system allows for the transmission of high-resolution clinical video that is encoded at the clinical acquisition resolution and can then be decoded with low delay. To validate performance, we perform OPNET simulations of mobile WiMAX medium access control and physical layers characteristics that include service prioritization classes, different modulation and coding schemes, fading channel's conditions, and mobility. We encode the medical ultrasound videos at the 4CIF (704×576) resolution that can accommodate clinical acquisition that is typically performed at lower resolutions. Video quality assessment is based on both clinical (subjective) and objective evaluations.
---
paper_title: Flexible Macroblock Ordering for Context-Aware Ultrasound Video Transmission over Mobile WiMAX

paper_content:

The most recent network technologies are enabling a variety of new applications, thanks to the provision of increased bandwidth and bettermanagement of Quality of Service. Nevertheless, telemedical services involving multimedia data are still lagging behind, due to the concern of the end users, that is, clinicians and also patients, about the low quality provided. Indeed, emerging network technologies should be appropriately exploited by designing the transmission strategy focusing on quality provision for end users. Stemming from this principle, we propose here a context-aware transmission strategy for medical video transmission over WiMAX systems. Context, in terms of regions of interest (ROI) in a specific session, is taken into account for the identification of multiple regions of interest, and compression/transmission strategies are tailored to such context information. We present a methodology based on H.264 medical video compression and Flexible Macroblock Ordering (FMO) for ROI identification. Two different unequal error protection methodologies, providing higher protection to the most diagnostically relevant data, are presented.
---
paper_title: A clinical distortion index for compressed echocardiogram evaluation: recommendations for Xvid codec.

paper_content:

This paper introduces a new clinical distortion index able to measure the decrease in diagnostic content in compressed echocardiograms. It is calculated using cardiologists' answers to a clinical testbed composed of two types of tests: one blind and the other semi-blind. This index may be used to compare clinical performance among video codecs from a clinical perspective. It can also be used to classify compression rates into useful and useless ranges, thus providing recommendations for echocardiogram compression. A study carried out in order to illustrate its use with Xvid video codec is also presented. The results obtained showed that, for 2D and M modes, the transmission rate should be at least 768 kbit s−1 and for color Doppler mode and pulsed/continuous Doppler, 256 kbit s−1.
---
paper_title: Cross-Layer Ultrasound Video Streaming Over Mobile WiMAX and HSUPA Networks

paper_content:

It is well known that the evolution of 4G-based mobile multimedia network systems will contribute significantly to future mobile healthcare (m-health) applications that require high bandwidth and fast data rates. Central to the success of such emerging applications is the compatibility of broadband networks, such as mobile Worldwide Interoperability For Microwave Access (WiMAX) and High-Speed Uplink Packet Access (HSUPA), and especially their rate adaption issues combined with the acceptable real-time medical quality of service requirements. In this paper, we address the relevant challenges of cross-layer design requirements for real-time rate adaptation of ultrasound video streaming in mobile WiMAX and HSUPA networks. A comparative performance analysis of such approach is validated in two experimental m-health test bed systems for both mobile WiMAX and HSUPA networks. The experimental results have shown an improved performance of mobile WiMAX compared to the HSUPA using the same cross-layer optimization approach.
---
paper_title: 3D medical video transmission over 4G networks

paper_content:

Enabling 3D video in e-health applications results in the provision of more natural viewing conditions and improved diagnosis. Recent advances in wireless communications, network technologies and 3D video capture/display mechanisms enable the replacement of 2D video applications of current healthcare services with 3D video, to provide improved perception and diagnosis. Remote surgery and surgery training can benefit in particular from 3D video due to the added dimension of depth. This paper envisages a wireless health system which transmits 3D surgical video over a 3GPP LTE network. The quality of the received 3D video is measured both objectively and subjectively for several packet sizes.
---
paper_title: Open-Source Telemedicine Platform for Wireless Medical Video Communication

paper_content:

An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings.
---
paper_title: Region-of-interest video coding for enabling surgical telementoring in low-bandwidth scenarios

paper_content:

Surgical telementoring can prove very effective in a military surgical paradigm where less experienced surgeons deployed at forward sites can be mentored by more experienced specialists from a rearward remote site, thus enhancing intheater surgical options by bringing scarce expertise into play. However, lack of sufficient bandwidth in active military theaters limit the ability to implement real-time video communication capability, and hence render such clinically beneficial programs undeliverable. Region-of-interest (ROI) video-coding presents a possible solution to this problem. By allocating more bits to the ROI as compared to the rest of the frame (also known as background (BG)), ROI encoding of surgical videos can increase the bandwidth perceived by the telementoring application. In this paper, we introduce a flexible and interactive ROI in a low-complexity, H.264-compliant and diagnostically lossless (DL) fashion to enable remote mentoring of surgical procedures in very low-bandwidth scenarios. Further, subjective evaluations by surgeons indicate that ROI-encoded videos are preferred over the uniformly-encoded videos for the purpose of surgical evaluation and telementoring.
---
paper_title: High efficiency video coding for ultrasound video communication in m-health systems

paper_content:

Emerging high efficiency video compression methods and wider availability of wireless network infrastructure will significantly advance existing m-health applications. For medical video communications, the emerging video compression and network standards support low-delay and high-resolution video transmission, at the clinically acquired resolution and frame rates. Such advances are expected to further promote the adoption of m-health systems for remote diagnosis and emergency incidents in daily clinical practice. This paper compares the performance of the emerging high efficiency video coding (HEVC) standard to the current state-of-the-art H.264/AVC standard. The experimental evaluation, based on five atherosclerotic plaque ultrasound videos encoded at QCIF, CIF, and 4CIF resolutions demonstrates that 50% reductions in bitrate requirements is possible for equivalent clinical quality.
---
paper_title: Ultrasound video despeckle filtering for High Efficiency Video Coding in m-health systems

paper_content:

Mobile-Health (m-health) medical video communication systems need to communicate ultrasound video of adequate diagnostic quality for remote diagnosis and care. In this study, we demonstrate how ultrasound video noise reduction, employed as a pre-processing step, used in conjunction with High Efficiency Video Coding (HEVC), can significantly improve diagnostic quality at considerably lower bitrate demands than conventional H.264/AVC source encoding. Three video despeckle filters were investigated, namely: linear filtering (DsFlsmv), hybrid median filtering (DsFhmedian), and speckle reducing anisotropic diffusion (DsFsrad). The methods were tested using ten atherosclerotic plaque ultrasound videos. Speckle filtering was applied at a frame-level basis. Experimental results were obtained using both subjective (by two clinical experts) and objective video quality assessment. The best achieving despeckle filter was DsFlsmv followed closely by DsFhmedian. In both cases, the filters provided for increased clinical performance while associated with significant bitrate demands reductions.
---
paper_title: Wireless Telemedicine Systems: An Overview

paper_content:

Rapid advances in information technology and telecommunications - and, more specifically, wireless and mobile communications - and their convergence ("telematics") are leading to the emergence of a new type of information infrastructure that has the potential of supporting an array of advanced services for healthcare. The objective of this paper is to provide a snapshot of the applications of wireless telemedicine systems. A review of the spectrum of these applications and the potential benefits of these efforts is presented, followed by successful case studies in electronic patient record, emergency telemedicine, teleradiology, and home monitoring. It is anticipated that the progress carried out in these efforts and the potential benefits of emerging mobile technologies will trigger the development of more applications, thus enabling the offering of a better service to the citizen.
---

Title: M-Health Medical Video Communication Systems: An Overview of Design Approaches and Recent Advances

Section 1: INTRODUCTION
Description 1: Introduce the significance of m-health systems, recent advancements in video coding standards and wireless networks, and an overview of the paper’s structure.

Section 2: M-HEALTH MEDICAL VIDEO COMMUNICATION SYSTEMS DESIGN APPROACHES
Description 2: Highlight design trends in m-health medical video communication systems, focusing on diagnostically driven encoding and transmission techniques.

Section 3: Diagnostically Relevant Encoding
Description 3: Discuss methods that improve coding efficiency through diagnostically relevant encoding approaches.

Section 4: Diagnostically Robust Transmission
Description 4: Describe adaptive algorithms used for robust transmission of medical videos over wireless networks.

Section 5: Diagnostically Resilient Encoding and Decoding
Description 5: Explain techniques that enhance error resilience and concealment to ensure the diagnostic quality of medical video communications.

Section 6: RECENT ADVANCES IN M-HEALTH MEDICAL VIDEO COMMUNICATION SYSTEMS
Description 6: Summarize recent studies and categorize them based on diagnostically driven and non-diagnostically driven approaches.

Section 7: Diagnostically Driven M-Health Systems
Description 7: Discuss recent studies on the use of diagnostically driven techniques in m-health systems.

Section 8: Non-Diagnostically Driven M-Health Systems
Description 8: Cover advancements in m-health systems that do not use diagnostic information for video encoding and transmission.

Section 9: DISCUSSION AND CONCLUDING REMARKS
Description 9: Provide a summary of the major trends and future directions in m-health medical video communication systems, emphasizing the potential of new video coding standards and wireless networks.