Development and Installation of

a Telemedicine Mobil Station

Argentina
Facultad de Ciencias Mdicas - UNR
rea de Informtica Mdica y Telemedicina
I.

Background information

The inspiring events that preceded the development of the initiative

presented here were several natural disasters that devastated the
Americas Region during the first half of 2010. All these disasters
revealed the fragility of the mechanisms for medical assistance response
when communications are truncated or health care needs arise in
inaccessible areas.
But beyond these unpredictable, although at some way expected
circumstances, the ultimate goal in the development of new
technological tools should be reducing inequities in access to qualified
health care that the daily reality makes it evident in unprotected
environmental settings, and vulnerable social and cultural scenarios of
many countries.
The Telemedicine Mobil Station Project endorses its objectives concerned
with the benefits to peoples health through a national industry, low cost
solution.
With the antecedent of the book Telehealth in the Americas (Telesalud
en las Amricas-CCP.I/CITEL/OEA, UIT/BDT, PAHO y AHCIET) edited by
CITEL (1) with the collaboration of Prof. Marcelo Petrich, member of the
network Telehealth in the Americas, in December 2003, which
concludes the need to develop this type of technology solutions.
II.

Goals & timeframe

To develop a transportable telemedicine base to be applied both in

situations of natural disasters and to facilitate specialized medical care
in distant geographical areas.
This telemedicine base should meet the following requirements:
a. Connectivity anywhere in the world and under
circumstances.

any

Page 1 of 8

b. Portability for any land, air or river environment.

c. Autonomy in energy supply.
d. Versatility in the composition of medical peripherals
appropriate to each situation.
e. Sustainability in scientific-academic medical specialties
consulting staff.
f. Adaptability to local health policies and regional economic
reality.
g. Cost savings of implementing.
Project Design
The planning agenda included the generation of a collaborative
consortium between national universities, NGOs and private companies,
under the auspices of international organizations, which addressed the
different aspects of construction, operation and connectivity of a
telemedicine mobile station, as well as provision of academic solutions.
This work included in a successive way: (a) construction of agile,
practical and transportable container box; (b) selecting and adapting
medical peripherals to be included; (c) development of information unit,
software, and supporting systems; (d) selection of media and satellite
connectivity protocols; (e) designation of academic professionals to
provide remote specialized assistance; (f) testing the operability of
equipment in extreme conditions; (g) presentation and demonstrations
at scientific-technological national and international events and to the
general public through dissemination medias; (h) installation of the first
prototype in a geographic area of catastrophes and socio-health need.
Results
1. Collaborative consortium
The consortium was composed from agreements signed between the
National University of Rosario-Faculty of Medical Sciences (FCM-UNR),
the Digital Era Foundation (2) and EXO S.A.(3). The project has the
support and sponsorship of the Telehealth Network of the Americas (4, 5)
of the Inter-American Telecommunication Commission of the
Organization of American States (CITEL-OAS) and of the Government of
Argentina Communication Secretariat and Ministry of Defense.
2. Development of the Mobile Telemedicine Station
In its previous version (Version 2.0 - WiP / December 2013) the mobile
telemedicine station is composed of several modules which may be
selected by the user for their actual incorporation to box:

Page 2 of 8

 Basic Telemedicine module: composed of a workstation with 14

monitor, Bluetooth keyboard and mouse, a communications router, a
specific telemedicine software, cabling and integration.
Cardio-Respiratory module: composed of vital signs monitor, blood
pressure device, 12-lead electrocardiograph, digital spirometer and
digital stethoscope.
Imaging module: composed of a camera for visual surface
exploration, portable ultrasound transducers, light table, and direct
light microscope (optional).
Medical Digital Peripherals: white light source, dermatoscope,
ophthalmoscope, otoscope and laryngoscope.
Power supply: deployable solar panels, batteries, electric generator.
Satellite connection unit
Transportation Container: storage box for telemedicine equipment
provided with wheels and convertible into desktop for working place.
3. Consulting staf
A group of experts encompassing most disciplines and medical
specialties, with recognized expertise in the diagnosis, management and
treatment of different situations that could arise in the very different
circumstances of use, was selected from the list of Professors of the
FCM-UNR and the Heads of the specialized services of its University
Hospitals (6).
4. System operability
To test the operation in extreme conditions, a group of physicians and
technicians moved to the southernmost region of the world, transporting
the container box with the telemedicine equipment by regular air flight
to the city of Ushuaia, in Tierra del Fuego Province, Argentina. Satellite
deployed multipoint connection was established with a base held in the
city of Ushuaia, where representatives of CITEL, SECOM authorities (7)
and delegates from the PCC.I of different countries of the OAS (8) were
gathered, as well as with the Situation Room of the Telehealth Network
of the Americas, located at the FCM-UNR in the city of Rosario.
5. Presentation of equipment and dissemination of the initiative
The presentation of the equipment takes place within the scope of the
Permanent Consultative Committee (PCC.I) and the Telehealth Network
of the Americas of CITEL. Also, in International Conventions and
Symposiums in Mexico, Colombia, France, Peru, among others.
The development of this mobile telemedicine station as a tool for distant
medical assistance during natural disasters reached a remarkable
Page 3 of 8

national and international popular diffusion through CITEL, graphic and

TV media (13-15). And now that the National University of Rosario has
become an Academia Associate member of ITU, its planned to present
the initiative to ITU-D, Study Group 2, for dissemination as a best
practice for other development countries. (9-11).
6. Installation and commissioning of the first prototype
In early 2014, Argentine Defense Minister (12) oversaw the launch of a
transportable telemedicine station in Port au Prince, Haiti. This
equipment was specially designed to meet medical assistance
necessities during natural disasters and extreme situations, enabling
second medical opinion request to any center in the world. The HMR is
the only second level medical facility in Haiti and it is fully operated by
members of the Argentine armed forces integrating peacekeeping
mission set by the United Nations since 2004 in the Caribbean country.
Teleconferences between the Director of the HMR in Haiti and the second
medical opinion staff from the FCM-UNR in Rosario formally started on
March 2014 (13).
7. Development the second prototype Mobile Telemedicine Station
In October 2014 the collaboration agreement between FCM-UNR and
EXO S. A. was carried out. This agreement with Argentinean company
with national capital, promotes development of a new and more versatile
prototype Mobile Telemedicine Station, smaller in size, with a software
development oriented to the cloud.
In its latest version (Version 3.0 - WiP / October 2014) the mobile
telemedicine station is composed of several modules which may be
selected by the user for their actual incorporation to the box:

Basic Telemedicine module: composed of a two in one / Notebook

and tablet with 10 display touch, keyboard, mouse, webcam, Wifi,
Bluetooth, a communications router, cabling and integration.
Cardiorespiratory module: composed of vital signs monitor, blood
pressure device, 12-lead electrocardiograph, digital pulse oximeter
and digital thermometer.
Imaging module: composed of a camera for visual surface
exploration, portable ultrasound transducers, light table, and direct
light microscope (optional).
Medical Digital Peripherals: white light source, dermatoscope,
ophthalmoscope, otoscope and laryngoscope.
Page 4 of 8

Power supply: deployable solar panels, batteries, electric

generator.
Satellite connection unit (optional).
Transportation Container: Briefcase for telemedicine equipment
provided with wheels and convertible into desktop for working
place. The briefcase is armored, also water resistant and dust.

Telemedicine Software
For the prototype of mobile telemedicine station an important
development of specific software for its use had to be carried out.
In an easy and fast way, the medical specialist can diagnose the most
important vital signs:

Electrocardiograph (ECG) wave along with heart rate and

respiration rate. The software also helps the professional on
arrhythmia detection by analyzing the ECG wave.
O2 saturation and Pulse.
Blood Pressure.
Body temperature.

The telemedicine software is a Web Application that connects to the

Telemedicine Station through USB or bluethooth so it can be used
from any device with a browser.
Along with the vital sign monitoring, the software also has the
following features:

Medical studies storage: The health professional has the option to

save the data as a study for later analysis and diagnosis. The
study is stored securely encrypted and digital signed.
Medical studies sharing: The health professional can share the
saved study with another colleague in a secure way for remote
medical consultation preserving the patient's anonymity.
Live remote consultation: Through videoconferencing technology,
the health professional can make a live consultation to another
professional in a remote location.
Cloud sync: Saved studies are sync through a secure cloud based
on a zero knowledge framework. This way, the health professional
can see or share the studies on any device or location at any time.

8. Certification process and massive deployment of the Mobile

Telemedicine Station

Page 5 of 8

The certification for the Mobile Telemedicine Station is expected to be

done in 2015 before ANMAT (13) and ISO, in order to start its production
for the final product to be sold.
The permanent participation in the ITU Standarization and Development
Sectors guarantees that the certification process meets international
standards.
III.

Projects added value and importance start

Access to a better medical assistance with a broader health coverage for

the population, narrowing geographical, social, cultural and digital gaps.
Improves the communication among health professionals, facilitating the
access to leading reference centers. A m ore affordable and continuous
education, with better access to sanitary information.

In this sense, incorporating telemedicine workstations to Primary Health

Care strategies will increase the chance of secondary level referrals, the
access to medical specialist due to physicians and patient transfers,
actual reduction of costs and,, thus, avoiding saturation of central
hospitals.
IV.

Challenges

Access to healthcare, one of the major human rights to ensure adequate

life conditions for the population, is an inalienable responsibility of states
and societies to their citizens (1, 2) However, inequality in access to
health standards is still a hallmark feature for many deploying countries.
There is an urgent need to develop tools that allow implementing health
policies that enable efficient high quality medical care for geographically
remote or socioeconomically isolated populations of the continent, and
at affordable costs.
By taking benefit from ICT applied to health the digital gap that these
populations suffer can be reduced.
V.

Relevance of the project to the respective Action Line

The initiative shows the development of a national industry device with

low production costs and marketing, as a response to the fragility
showed by the health care system in situations of catastrophes and
natural disasters, Primary Health Care in remote locations, second
medical consult, care to isolated patients with transmissible infections,
such as Ebola, which reduces the constant contact between the patient
and health professionals and maintains the patients continuous control.

Page 6 of 8

Thus, the first, while ensuring portability, connectivity and energy

supply, incorporated only those medical devices appropriate to
emergency situations.
However, the reality of Latin American and Caribbean geography as well
as the socioeconomic conditions prevalent in many developing
countries, generates options for a wider usage of this mobile
telemedicine station, providing equitable access to high quality health
care regardless of these conditions. That's why the second prototype
also incorporates a modular system that allows adapting the equipment
composition to the specific needs of each case, contemplating economic
aspects and origin of the equipment.
VI.

Conclusion

The speed of progress in various areas of medical technology,

informatics and telecommunications raises the need to continue this
collaborative project incorporating those advances in order to improve
the performance and adaptability to future scenarios.
Finally, this equipment is not an isolated commercial product but a fully
integrated system which works linked to medical staff. There is an
urgent need to organize Schools of Medicine and University Hospitals of
Latin America, and other developing countries, to provide a
comprehensive educational and research network assistance to doctors
away from large urban centers.

Page 7 of 8

References
1.
2.
3.
4.

https://www.citel.oas.org/es/Paginas/default.aspx
https://karisma.org.co/derechos-humanos-en-la-era-digital
EXO S.A. company http://exo.com.ar/
Inter-American Telecommunication Commission. OAS. Resolution
CCP1 Creation of the Telehealth Network of the Americas.
Resolution PCC.I/RES.152 (XIV- 09).
5. Inter-American Telecommunication Commission. OAS. Resolution
CCP1 Denomination of the Telehealth Network of the Americas.
Resolution PCC.I/DEC.133 (XIX-11).
6. Crisci CD. Designation of the staff of specialists and experts for
second medical opinion program.
7. Organismo oficial regulador del sector de telecomunicaciones
(SECOM)http://www.secom.gov.ar/
8. Inter-American Telecommunication Commission. OAS. Sixteenth
CCP.I Meeting. Ushuaia, Argentina, 11-14 May 2010.
9. Telam. Telemedicine transportable station. Telam Audiovisual 2010.
In: http://www.youtube.com/watch?v=lxsHzjdRGYg
10.
TN. . Telemedicine. TN Ciencia. In:
http://www.youtube.com/watch?v=vrwn0W2qr0Q
11.
Aen. Mobil Telemedicine. aen. In:
https://www.youtube.com/watch?v=06gB4zpt0w4
12.
Argentina Joint Armed Forces. Videoconferencing
commissioning Telemedicine instrumental. Available in:
http://www.fuerzas-armadas.mil.ar/Video-ConferenciaTelemedicina.aspx
13.
Rossi A. Debemos trabajar para que Amrica Latina
disminuya la desigualdad social. InfoNews, February 26th, 2014.
14.
Administracin Nacional de Medicamentos, Alimentos y
Tecnologa mdica: http://www.anmat.gov.ar/

Page 8 of 8