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Rapid advances in information technology and telecommunications, and in particular mobile and wireless communications, converge towards the emergence of a new type of “infostructure��? that has the potential of supporting a large spectrum of advanced services for healthcare and health. Currently the ICT community produces a great effort to drill down from the vision and the promises of wireless and mobile technologies and provide practical application solutions. Research and development include data gathering and omni-directional transfer of vital information, integration of human machine interface technology into handheld devices and personal applications, security and interoperability of date and integration with hospital legacy systems and electronic patient record. The ongoing evolution of wireless technology and mobile device capabilities is changing the way healthcare providers interact with information technologies. The growth and acceptance of mobile information technology at the point of care, coupled with the promise and convenience of data on demand, creates opportunities for enhanced patient care and safety. The developments presented in this section demonstrate clearly the innovation aspects and trends towards user oriented applications.

M-health: Emerging Mobile Health Systemspresents recent advances in this area and explores future trends in the applications of current and emerging wireless communication and network technologies for healthcare delivery and new wireless telemedical services. This work also evaluates the impact of the synergies between the 2.5G and 3G systems and beyond for healthcare applications and explores the augmentation of these technologies for the next generation of m-health services. M-health is commonly defined as the ‘emerging mobile communications and network technologies for healthcare systems’. M-health represents a new framework of research, blending innovative mobile communications, network technologies, and medical sensor and ubiquitous computing devices with medical and biological sciences for enhanced healthcare delivery mechanisms and services.

The concept behind the MobiHealth project (MobiHealth, 2002) was to bring together the technologies of Body Area Networks (BANs), wireless broadband communications and wearable devices to provide mobile healthcare services for patients and health professionals. For patients, these technologies enable remote patient care services such as management of chronic conditions and detection of health emergencies. For health professionals the technology offers access to information and communication services from a mobile device, thus enabling mobility for the individual professional and supporting the operation of distributed ‘virtual' healthcare teams (sensu Pitsillides, 1999).

It is well-known that speckle is a multiplicative noise that degrades the visual evaluation in ultrasound imaging. The recent advancements in ultrasound instrumentation and portable ultrasound devices necessitate the need of more robust despeckling techniques for enhanced ultrasound medical imaging for both routine clinical practice and teleconsultation. The objective of this work was to carry out a comparative evaluation of despeckle filtering based on texture analysis, image quality evaluation metrics, and visual evaluation by medical experts in the assessment of 440 (220 asymptomatic and 220 symptomatic) ultrasound images of the carotid artery bifurcation. In this paper a total of 10 despeckle filters were evaluated based on local statistics, median filtering, pixel homogeneity, geometric filtering, homomorphic filtering, anisotropic diffusion, nonlinear coherence diffusion, and wavelet filtering. The results of this study suggest that the first order statistics filter lsmv, gave the best performance, followed by the geometric filter gf4d, and the homogeneous mask area filter lsminsc. These filters improved the class separation between the asymptomatic and the symptomatic classes based on the statistics of the extracted texture features, gave only a marginal improvement in the classification success rate, and improved the visual assessment carried out by the two experts. More specifically, filters lsmv or gf4d can be used for despeckling asymptomatic images in which the expert is interested mainly in the plaque composition and texture analysis; and filters lsmv, gf4d, or lsminsc can be used for the despeckling of symptomatic images in which the expert is interested in identifying the degree of stenosis and the plaque borders. The proper selection of a despeckle filter is very important in the enhancement of ultrasonic imaging of the carotid artery. Further work is needed to evaluate at a larger scale and in clinical practice the performance of the proposed despeckle filters in the automated segmentation, texture analysis, and classification of carotid ultrasound imaging.

In this study we present a new automatic segmentation technique for detecting the intimamedia layer of the far wall of the common carotid artery in longitudinal ultrasound images, by applying snakes after image normalization and despeckling. We have tested and validated our segmentation technique on 100 images using the visual interpretation results and manual measurements by two vascular specialists. Results showed that no significant difference was found between the manual and the automatic segmentation measurements. Better segmentation results were obtained for the normalized despeckled images.

Emerging technologies in wireless and mobile telecommunication networks, combined with the simultaneous rapid advances in information technology, are leading to many new solutions in the field of telemedicine. As a result the opportunities for improving further existing and supporting new advanced services for healthcare are widened. The objective of this study is to carry out a practical evaluation of the performance of the GSM and GPRS systems in the transmission/reception of images and video as well as Patient Record and biosignals in emergency cases. The data transfer rate achieved with GPRS were in the range of 32 Kbps (while for GSM 9.6 kbps) with the download time for typical images of a file size of 200 Kbytes to the mobile device to be in the region of 60 seconds. Similar performance was also recorded in the case of a moving station (simulating the ambulance). In conclusion, the physicians were very pleased by the benefits offered by the system through the freedom of access, anywhere and anytime even in motion.

The unceasing emergence of new technologies in wireless and mobile telecommunication networks, combined with the simultaneous rapid advances in information technology, are leading to many new solutions in the field of telemedicine, thus offering more opportunities for improving further existing and supporting new advanced services for healthcare. The objective of this paper is to carry out a practical evaluation of the performance of the GSM and GPRS systems in the transmission/reception of X-ray images and video in emergency orthopedics cases. As expected, the performance of GPRS is superior to that of GSM. The data transfer rate achieved with GPRS were in the range of 32 Kbps with the download time for typical Xray images of a file size of 200 Kbytes to the mobile device to be in the region of 60 seconds. Similar performance was also recorded in the case of a moving station (simulating the ambulance) for the biggest part of the journey. In conclusion, although the medical imaging downloading timing was in the range of a few minutes, the physicians were very pleased by the benefits offered by the system through the freedom of access, anywhere and anytime even in motion.

The objective of this work was to develop six speckle reduction-filtering techniques and evaluate them together with texture analysis in the assessment of 240 ultrasound images of the carotid artery. The de-speckled filters are based on anisotropic diffusion, local statistics with higher moments, and geometric filtering. Results showed that some improvement in class separation (between symptomatic and asymptomatic plaques) of the images was evident after de-speckle filtering.

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.

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 mobile technology in healthcare. A brief review of the spectrum of these applications and the potential benefits of these efforts will be presented, followed by success 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.