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Shengwang X Remote Ultrasound: Real-time audio and video solve the problem of "difficult to see a doctor" at the grassroots level, and promote the equalization of medical resources

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Like tentacles, the real-time Internet extends through the sharing of scenarios, linking our offline and online lives, forming an indivisible network. As social live streaming, online education, and video conferencing have become an indispensable part of public life, more new scenarios such as smart watches, smart work lights, video dual recording, video underwriting, and remote consultations are constantly emerging.

In our view, the process of exploring the future scenarios of the real-time Internet is like a process of "seeing a glimmer of light". Therefore, Acoustic Network launched a series of plans for the "Journey of Catching "Light", hoping to share new real-time interactive scenes from the perspective of the combination of scenes, business and technology, and see how they "see" and "seize" the future of the real-time Internet Light.

"Famous doctors at the grassroots level" has always been regarded as one of the best ways to solve the imbalance of medical resources. However, real-time audio and video can allow famous doctors to go to the grassroots at a high frequency and solve the imbalance of medical resources remotely.

In recent years, with the country’s vigorous development of digital medical care, some video consultation scenes that require medical equipment, such as “remote ultrasound”, “surgery teaching”, and “remote operation training” are also entering grassroots hospitals to promote quality The sinking of medical resources. [The Journey of Catching the Light] In the seventh issue of the article, let’s talk about how to achieve remote ultrasound inspections in the medical industry with the help of real-time audio and video technology, and solve the problem of "difficult to see a doctor" at the grassroots level.

Beginning in November 2020, in a county in Gansu Province, township health centers, community hospitals, and county hospitals throughout the county have successively launched remote real-time ultrasound inspection systems, providing remote inspection services for patients in grassroots communities and remote mountainous areas. It was after the snow and road closures in the mountainous areas at the beginning of this year that basic-level patients were unable to go out of the mountain to see a doctor in the county. The remote ultrasound system also provided multiple emergency patients with ultrasound examination and treatment advice in a timely manner. Such medical scenes are also being implemented simultaneously in primary hospitals in many counties across the country, such as Hebei and Xinjiang. Behind this, the remote consultation system from Guangzhou Irido and the real-time audio and video technology of Shengwang are playing an important role.

Guangzhou Yidu is a company that focuses on the construction of medical consortia and provides telemedicine information service solutions for various medical institutions. In the remote ultrasound scenario, sonographers in county hospitals are connected through the "Yidi" remote consultation system. Physicians at a primary health center located 100 kilometers away conducted an online “face-to-face” ultrasound consultation with multiple patients. Throughout the consultation process, with the help of the real-time audio and video technology of SonicNet, the remote consultation system can realize high-definition medical ultrasound images. Real-time transmission, doctors then diagnose the patient in real time based on real-time ultrasound images. The diagnosis process can achieve ultra-low latency and high smoothness.

Data from "Iridium" shows that in a county in Gansu, the number of patients diagnosed by the remote ultrasound system per month has grown from 5-10 cases per month when it was launched to 50-80 cases per month at present. All primary health care The doctors of the hospital have quickly mastered the use of the system. With the strong cooperation of the county hospital, remote ultrasound examination has become the normal service of grassroots telemedicine.


Figure: A doctor in a county in Gansu uses a remote ultrasound system to diagnose patients in real time

Nie Zhengxue, product director of Agora's medical and financial industry, said that compared with ordinary video consultation, remote ultrasound examination puts forward higher requirements for remote consultation system, real-time image transmission, and real-time audio and video interaction. For example, the "Iridium" remote consultation system needs to include remote ultrasound software, remote imaging and other functions, and is deeply integrated with the electronic medical record. For the acoustic network, it will also face the guarantee of ultrasound images in the process of real-time ultrasound image transmission and real-time diagnosis. A series of technical difficulties such as high image quality and complex network environment of primary hospitals. At present, the remote ultrasound technology solutions provided by Acoustic Network for platforms such as "Iridium" have five core advantages in the industry:

1. Provide multi-stream real-time transmission: ultrasound real-time image + video stream + audio stream

In the online mode of remote real-time ultrasound examination, Shengwang provides real-time simultaneous transmission of three streams of ultrasound real-time image + video stream + audio stream, and supports real-time scanning by doctors + real-time ultrasound images for simultaneous presentation of two channels of video, which effectively guarantees While observing ultrasound dynamic images, ultrasound scanning techniques and body positions in real time, doctors in county hospitals can also simultaneously guide grassroots doctors to correctly operate ultrasound equipment, conduct real-time audio and video communication, and achieve the best remote scanning results.

2. Support dynamic + static image acquisition, real-time recording + playback

In the process of real-time observation of ultrasound images by doctors, images of a certain part are often collected in real time for real-time diagnosis and later expert analysis. With the help of Acoustic Network, Iridium's remote real-time ultrasound inspection system can support dynamic + static image acquisition to meet the diverse diagnosis and treatment needs of doctors. At the same time, Shengwang also has the industry's leading real-time recording function, which can realize the recording of real-time ultrasound images and real-time audio and video diagnosis process in ultrasound examinations, and help doctors conduct secondary analysis and learning of the ultrasound examination process through playback.

3. Real-time transmission of high-definition ultrasound images, providing annotations for ultrasound screenshots

In the process of remote ultrasound examination, the clarity of the ultrasound image will greatly affect the doctor's diagnosis of the image results, and the sound network can achieve real-time transmission of high-definition ultrasound images, which can support up to 1080P 60fps high-definition image quality. At the same time, Shengwang's solution also supports doctors to mark the questionable image parts in real time after receiving the patient's ultrasound images, and provides image enhancement and non-destructive magnification functions for ultrasound screenshots.

4. Support cross-border consultations and resist weak network transmission

With the support of Shengwang's real-time interactive technology, remote ultrasound examinations can also achieve cross-border consultations, introducing foreign medical expert resources, and Shengwang's self-built SD-RTN™ software-defined real-time network covering 200+ countries and regions around the world can be done The global end-to-end high-quality transmission rate is >99%, the global end-to-end network delay is less than 400ms, and the median delay is 76ms, which effectively guarantees the ultra-low delay experience of the audio and video interaction between doctors and patients in multinational consultations.

At the same time, in the process of remote ultrasound landing in grassroots hospitals, you will generally face the complex network conditions of remote mountainous hospitals. For the audio and video interaction under weak network conditions, the sound network has a set of anti-weak network transmission and anti-packet loss algorithms, combined with network detection (Such as delay estimation, bandwidth estimation, packet loss estimation, etc.), anti-packet technology (such as ARQ, FEC, etc.), adaptive jitter buffer, network congestion control strategy, etc., can achieve 70% packet loss smooth video call, 80% % Voice calls are smooth under packet loss.

5. XLA Experience Quality Assurance

While providing customers with stable and reliable real-time interactive technology, Shengwang also provides unique XLA experience quality assurance in the industry.

In July 2020, Shengwang Design defined and launched XLA, the first experience quality standard in the real-time interactive industry. Different from SLA, XLA not only cares about the availability and service quality of real-time interaction, but also the user experience quality. It is the first quantifiable, verifiable, and compensable experience quality standard and guarantee established around the actual user experience. XLA is committed to providing high-quality real-time interactive experience quality assurance. Through the standardization of experience quality, it promotes real-time interaction from "available" to "easy to use", and makes "easy to use" a "standard".

Through XLA, customers can get the real-time interactive experience quality promise and guarantee on multiple dimensions such as login success rate, end-to-end delay, audio and video stall rate, etc., for free. With regard to the quality of experience of end-users, we can truly use them with confidence and satisfaction!

The person in charge of related technologies from "Iridium" said: "With the strong support of sound network technology, the remote ultrasound inspection system is based on low-latency video calls and high-fidelity transmission of ultrasound images under ordinary fiber optic broadband (100M bandwidth). To better meet the telemedicine needs in rural areas, we avoid a large amount of hardware investment. At the same time, doctors can quickly adapt to the browser method based on the B/S architecture (ie, browser/server mode). For flexible multi-channel audio The integrated transmission of video and medical professional images is convenient and can quickly solve their professional communication needs."

Nie Zhengxue also said that the technical value of real-time interaction goes beyond helping developers quickly build stable and smooth online interactive scenes. It also continues to play social value in the medical, financial, and government fields. For example, scenarios such as remote ultrasound and surgical teaching can effectively sink high-quality expert resources to primary hospitals to solve the problem of equalization of medical resources. At the same time, remote consultations can also improve the inspection and diagnosis capabilities of primary doctors, making it more convenient for rural areas. The patient's timely medical treatment. In addition, in medical insurance scenarios that are closely related to the people’s livelihood, with the support of real-time interactive technology, medical insurance bureaus in various places have successively launched the medical insurance system video remote service platform. Face recognition technology can quickly apply for medical insurance.

In the future, as the country vigorously develops a digital economy, RTE real-time interaction will continue to contribute more social value in the digitalization of life and the digitalization of grassroots governance.

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