MINCS-UH

Medical Information Network by Communications Sattelite for University Hospitals

Overview of the MINCS-UH systems

MINCS-UH was introduced to eight national university hospitals in 1996 for the purpose of clinical conferences and joint lectures among distant university hospitals [3]. Then it was introduced to three additional university hospitals in 1998, eight more in April 1999, and a further eleven in November 1999. All the MINCS-UH sites have essentially the same broadcasting equipment, i.e., a parabolic antenna, an electronic wave transmitter/receiver, MPEG2 encoder/decoder for data compression/decompression, an encryption encoder/decoder for data encryption/decryption, analog-digital converters and their control equipment, etc. Its equipment cost is about 300 million (2.4 million US dollars) yen for each university hospital, and 9 billion yen (72 million US dollars) in total. Major characteristics of MINCS-UH is as follows:

1)Digitalized HDTV MINCS-UH is the first state-of-the-art digital HDTV broadcasting system in the world. The purpose of the digitalization is to use digital cipher technology for security protection. In order to reduce equipment cost, analog-based HDTV monitors and cameras are used. Using hardware-based analog-digital encoder/decoders, analog-based signals are converted into digital ones and vice versa.

2)Bi-directional communications Two satellite circuits for HDTV and NTSC are used to make bi-directional communications possible. Usually a lecturer presents his or her lecture through the HDTV circuit and the audience asks questions though the NTSC one. The lecturer has control over both circuits and can switch the NTSC circuit to another site on request by the audience. Thus, all the audience in all the sites can ask questions to the lecturer.

3)Strong digital encryption MULTI2, 128-bit strong digital encryption algorithm developed in Japan, is used for encryption. At the time of the MINCS-UH development, it was impossible to use a foreign encryption algorithm with more than 40 bits key length because of the U.S. export restriction.

4)Easy operability MINCS-UH is designed so that regular university hospital staff, rather than specialists, can carry out all the regular operations. It takes only a few hours to master its operations.

Usages of MINCS-UH

The Steering Committee of MINCS-UH was established in 1996 and, since then, it has discussed the management and operations of MINCS-UH and organized collaborative broadcasting programs. It also prepares promotional brochures, and its members earnestly explain the significance and usage of MINCS-UH to local staff in each university hospital many times over.

At the beginning of its operation, the number of programs broadcast was limited in number (Fig. 3). But the number of programs has gradually increased, and it is now more than one hundred a year. In many programs, diagnostics images such as X-ray films and pathohistological specimens are presented. From the experience of using MINCS-UH, staff in each university hospital have come to realize the significance and usage of bi-directional distant communications with high quality moving images, and have learned how to make better use of the facilities, including creation of new programs and collaborative program planning.

Discussion

MINCS-UH was the first state-of-the-art digital HDTV broadcasting system in the world at the time of its development. There are reasons why such a system was developed for clinical medicine. In order to protect critical patient privacy, analog-based scrambling technology is insufficient and strong digital encryption technology should be used. Thus, digitalization is essential. In clinical care, numerous diagnostic images are routinely used, and NTSC-level image quality is by no means sufficient for clinical conferences, because the diagnostics and treatment depend on the quality of images. Recently, the broadbandization of the Internet is rapidly progressing. The immediate target of image quality for the Internet is that of NTSC-based television. When the idea of the MINCS-UH was conceived in the early 1990s, the communication speed of the Internet backbone was measured using kbps units. The speed was measured using Mbps and Gbps units in the middle and late 1990s, respectively. Considering such rapid progress, HDTV-level high quality moving images can be used within the Internet in the not-so-distant future. Then MINCS-UH will make way for Internet-based distant image communications. Thanks to MINCS-UH, Japanese medical professionals have learned to make better use of bi-directional distant communications with high quality moving images. This experience will also contribute to making the best use of the Internet-based, HDTV-level image communications in the future. However, it seems questionable whether MINCS-UH pays off from the view of cost-benefit evaluation. It should be noted that, for the evaluation, one should consider that the development of the MINCS-UH is partly due to the strategic industrial policy of the Japanese government. It may pay off if the Japanese electronic industry will lead the digital HDTV market in the world.

Literature

[1] Kiuchi T. MINCS-UH - Medical Information Network by Communications Satellite for University Hospitals. Look Japan, 1997

[2] Kiuchi T, Takahashi T. High Speed Digital Circuits for Medical Communication; the MINCS-UH Project. Methods of Information in Medicine 39:353-5, 2000