A Voice Activated Video Communication System for Nurses to Communicate with COVID19 Inpatients: Notes from the Field (Preprint)

UNSTRUCTURED With the relaxing of telehealth regulations from the HIPAA Waiver for Telehealth Remote Communications during the COVID-19 Nationwide Public Health Emergency notification, our organization had the opportunity to pilot an innovative virtual care solution using a modified consumer grade system (Amazon Echo Show) within one inpatient COVID-19 unit. In this brief report, we describe our experiences with implementing the system, general feedback from clinicians, and discuss areas for future development required to enable future scaling of this solution.

Emulating Software-Defined Disaggregated Optical Networks in a Containerized Framework

Telecom operators’ infrastructure is undergoing high pressure to keep the pace with the traffic demand generated by the societal need of remote communications, bandwidth-hungry applications, and the fulfilment of 5G requirements. Software-defined networking (SDN) entered in scene decoupling the data-plane forwarding actions from the control-plane decisions, hence boosting network programmability and innovation. Optical networks are also capitalizing on SDN benefits jointly with a disaggregation trend that holds the promise of overcoming traditional vendor-locked island limitations. In this work, we present our framework for disaggregated optical networks that leverages on SDN and container-based management for a realistic emulation of deployment scenarios. Our proposal relies on Kubernetes for the containers’ control and management, while employing the NETCONF protocol for the interaction with the light-weight software entities, i.e., agents, which govern the emulated optical devices. Remarkably, our agents’ structure relies on components that offer high versatility for accommodating the wide variety of components and systems in the optical domain. We showcase our proposal with the emulation of an 18-node European topology employing Cassini-compliant optical models, i.e., a state-of-the-art optical transponder proposed in the Telecom Infrastructure Project. The combination of our versatile framework based on containerized entities, the automatic creation of agents and the optical-layer characteristics represents a novel approach suitable for operationally complex carrier-grade transport infrastructure with SDN-based disaggregated optical systems.

OPPNets and Rural Areas: An Opportunistic Solution for Remote Communications

Many rural areas along Spain do not have access to the Internet. Despite the huge spread of technology that has taken place during recent years, some rural districts and isolated villages have a lack of proper communication infrastructures. Moreover, these areas and the connected regions are notably experiencing a technological gap. As a consequence of this, the implementation of technological health solutions becomes impracticable in these zones where demographic conditions are especially particular. Thus, inhabitants over 65 suppose a large portion of such population, and many elderly people live alone at their homes. These circumstances also impact on local businesses which are widely related to the agricultural and livestock industry. Taking into account this situation, this paper proposes a solution based on an opportunistic network algorithm which enables the deployment of technological communication solutions for both elderly healthcare and livestock industrial activities in rural areas. This way, two applications are proposed: a presence detection platform for elderly people who live alone and an analytic performance measurement system for livestock. The algorithm is evaluated considering several simulations under multiple conditions, comparing the delivery probability, latency, and overhead outcomes with other well-known opportunistic routing algorithms. As a result, the proposed solution quadruples the delivery probability of Prophet, which presents the best results among the benchmark solutions and greatly reduces the overhead regarding other solutions such as Epidemic or Prophet. This way, the proposed approach provides a reliable mechanism for the data transmission in these scenarios.

Remote Medical Education in Indonesia: Analysis of 10 Years of Activities

Introduction: With ongoing development of technology, and especially amid the current COVID-19 pandemic, there is rapidly increasing need for remote communications, including in the field of medical education. This study aimed to evaluate our telemedicine activities between Japan and Indonesia. Methods: We retrospectively analysed the data acquired for the period 2010–2019 inclusive, looking at number of programmes, content, participating sites, and videoconferencing systems. We also digitally sent questionnaires to attendees to request their evaluation of image quality and programmes. Results: There were a total 135 programmes, with 29 participating institutions in Indonesia. The number of programmes increased rapidly in 2017, following a rapid increase of participating sites in 2016. Programmes included endoscopy (50 programmes, 37%), neurology (25, 19%), and dentistry (12, 9%). Between 5 and 10 sites connected with 81 programmes (60% of all), and more than 10 sites with 33 (24%). The most commonly used videoconferencing system was Vidyo (108, 80%), followed by Zoom (15, 11%). Participating institutions were located among 19 cities on the five major islands. Image quality received a favourable evaluation from 98% (504/516) of questionnaire respondents, with 100% (400/400) holding a favourable view of the programmes. Conclusion: Remote medical education expanded in Indonesia in the 10 years under review. This expansion is expected to continue to foster more specialists and it is anticipated to improve medical care nationwide.

Changes in the office for civil rights enforcement policy on telehealth remote communications in response to COVID-19

The novel coronavirus, the cause of COVID-19, has sent shockwaves throughout the world, shuttered many businesses essentially overnight, and has left billions living worldwide in quarantine. Not surprisingly, the health care industry has been significantly affected by the COVID-19 pandemic. This article focuses on how COVID-19 has influenced the Office for Civil Rights’ (OCR’s) enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules as they relate to telehealth remote communications, and opines about whether the COVID-19-related changes to HIPAA Privacy Rule and Security Rule enforcement might last beyond the current crisis.

La “fortezza invisibile”: il telegrafo ottico Chappe nella Francia napoleonica

The “invisible fortress”: the Chappe optical telegraph in the Napoleonic FranceEven in the defensive and fortifying processes, two aspects can be found: the material component and the immaterial one. If all the constructive, material and structural procedures are the first, for example, all that concerns remote communications (maximum optics) belongs to the second, an indispensable tool to complete an optimal strategy for offensive and/or defensive operations. Remote optical transmissions are closely connected to the management of defensive systems: this is also what happens with the optical telegraph of Claude Chappe, conceived during the French Revolution and adopted by Napoleon for the potential inherent in the strategic and territorial logic, as for the organization, structuring and sending of encrypted messages (which since the sixteenth century had also seen the interest of Leon Battista Alberti. The densest part of the network spreads to France, from Paris to the borders of the nation. In Europe, you will see achievements in Spain, up to Russia. The Lyon-Paris-Venice line also led to the construction of a Lombard-Piedmontese section. The present contribution stems from a conspicuous research, founded on the twenty-year collaboration of Marotta with the FNARH (Fédération Nationale des Associations de Recherche Historique sur la Poste et les Télécommunications). The system included the installation in high positions (hills, towers or bell towers) of a mechanical device, which could be reached at a distance of kilometers. On top of a fixed pole of about 5 m, the apparatus consisted of a central axis (ordinateur) at the ends of which two mobile arms (indicateurs) were fixed which allowed (in the variation of the reciprocal positions and inclinations) to realize multiple signals, at the base of an entire encrypted visual alphabet, arrived in 1841 up to 61000 messages. Multiple types of models made. The contribution will return the chronological developments of the system, in time and space of territories involved, with the relative comparisons of types, models and languages, also through 3D modeling.

Telemental Health

The Internet and advances in technology are substantially increasing our ability to communicate. Those remote audio and video communications technologies offer mental healthcare professionals with the opportunity to clinically engage with patients outside of the traditional office setting. However, with those opportunities come new challenges. Clinicians interested in utilizing remote communications technology to treat patients, telemental health, should carefully consider new legal exposures inherent in treating patients outside the office before incorporating telemental health into their practices. Telemental health raises new issues for mental healthcare professionals in the context of malpractice claims, personal jurisdiction, informed consent, licensing, and compliance with the Health Insurance Portability and Accountability Act (HIPAA). This chapter identifies the new and sometimes subtle problematic issues associated with telemental health, exploring the nature of the risks to the telemental health clinician and discussing a practical approach to minimizing the exposures.

Attitudes of the Public to Receiving Medical Care during Emergencies through Remote Physician–Patient Communications

Providing health services through remote communications for sub-acute health issues during emergencies may help reduce the burden of the health care system and increase availability of care. This study aimed to investigate the attitudes of the public towards receiving medical services and providing medical information through remote communication in times of emergencies. During the pandemic outbreak of the novel coronavirus (COVID-19), pandemic outbreak, 507 participants answered a structured online survey, rating their mean willingness to receive medical care and provide medical information, on a four-point Likert scale. Furthermore, demographic characteristics, social media use, and trust in data protection was collected. The mean willingness to receive medical services was 3.1 ± 0.6 and the mean willingness to provide medical information was 3.0 ± 0.7, with a strong significant correlation between the two (r = 0.76). The multiple regression model identified higher trust in data protection, level of education, and social media use as statistically significant predictors for a higher willingness to receive medical information while the first two predicted willingness to provide information. The findings suggest an overall positive attitude to receive medical care through remote communications.

Acoustic Coupled Disaster & Remote Communications Systems

Following disasters, and in other infrastructure-deprived settings, such as remote areas, the need for communications is profound. However, the ability to provide communications solutions in such situations is extremely difficult because of the lack of functional infrastructure, and the logistical difficulty or impossibility of bringing in additional hardware. Therefore it is important to create communications solutions that can operate using existing locally available hardware. In this paper we describe one possible solution based on acoustic coupling of mobile telephones with existing two-way radios, such as are often carried in remote areas of Australia, and are fitted to many vehicles that are used in such areas. We describe a number of related software systems and some simple experiments that demonstrate the feasibility of the general concept, before describing a possible integration of such technologies with the secure digital communications capabilities offered by the open-source Serval Mesh software. We argue that such an integration is not only possible, but also has the potential to allow secure digital communications in a variety of scenarios, without the need for any new or additional hardware.