Technical explanation
Next-Generation Telemedicine Solutions with a Smart Cyber Operating Theater and 5G

Overview

The demand for telemedicine has significantly increased due to the spread of infectious diseases. Advances in information and communication technology have led to major innovations in healthcare service delivery. NTT DOCOMO is leveraging its communication technologies to address social issues such as regional medical care disparities and disaster response, accelerating implementation in partnership with medical institutions.

Regional Disparities in Medical Care and Challenges in Disaster Medicine

Japan's healthcare system faces several challenges, including regional disparities between urban and rural areas, and difficulties in providing care during large-scale disasters. In remote islands and depopulated regions, severe shortages of doctors have created serious gaps in access to healthcare. When disasters occur, establishing a medical response system at the disaster site becomes urgent; however, the current systems are often insufficient. Additionally, as the population ages, there is a growing demand for home and mobile medical services, making these issues increasingly critical.

Overview of the Next-Generation Telemedicine Solution Using a Smart Cyber Operating Theater and 5G

• In collaboration with Tokyo Women's Medical University, NTT DOCOMO is developing an advanced telemedicine solution that integrates a “Smart Cyber Operating Theater^*1,” initially developed and clinically implemented at the university, with 5G communication.
• This solution consists of the “Mobile Smart Treatment Room,” a vehicle-based surgical unit equipped with smart cyber operating theater systems, and the “COBS Device”^*2 which transmits medical data from the vehicle to remote locations via 5G. Equipped with communication functions, it securely transmits real-time data from inside the vehicle — including medical images and device readings — via the commercial 5G network and cloud infrastructure (docomo MEC^®*3 and MEC Direct^®*4). Remote specialists can use the COBS Device to monitor patient conditions and support decision making, enabling the delivery of advanced and safe medical care.
• The Mobile Smart Treatment Room is designed for both normal times and emergencies. It conducts routine medical rounds in rural areas and provides emergency care at disaster sites. Medical data transmitted over 5G is stored and referenced in a secure cloud database, enabling use not only for support of diagnosis and treatment but also for reviewing past cases and training young doctors.

1. The Smart Cyber Operating Theater is a cutting-edge operating room utilizing IoT (Information of Technology) developed by Tokyo Women's Medical University in collaboration with Hiroshima University, Shinshu University, DENSO, Hitachi, and nine other organizations. By integrating IoT technology to connect various medical devices and equipment and introducing a centralized “strategy desk” to manage surgical workflow and patient conditions, the system aims to enhance surgical precision and safety.
2. COBS stands for Communication Business System for medical providers. It is a medical platform currently under development that utilizes 5G and cloud-based services.
3. docomo MEC is DOCOMO's cloud platform that incorporates key characteristics of MEC (Multi-access Edge Computing) required in the 5G era, including low latency and high security.
4. MEC Direct is a business solution provided by DOCOMO that enables secure and low-latency communication by directly linking devices to the cloud infrastructure, bypassing the public internet.

Technical Challenges

To enable remote support by transmitting medical information—such as diagnostic images, surgical images, and vital data—over communication networks, several technical hurdles must be addressed:

• Low-Latency Communication: It is essential to minimize communication delays between locations to ensure smooth data transmission and real-time supports for diagnosis and treatment in the Mobile Smart Treatment Room.
• High Bandwidth: The transmission of large medical data files, such as high-resolution surgical footage, requires high bandwidth.
• Robust Security: As the system handles sensitive patient data, strong cybersecurity measures are indispensable.

Our Technical Details

The advanced telemedicine solution utilizes the following technological assets:

• 5G Communication: By leveraging the high-speed and low-latency features of 5G, the system enables real-time transmission of high-resolution medical images and large-volume data. The solution can be used not only in hospitals but also at home or in remote locations within 5G service areas.
• docomo MEC: With multiple MEC servers directly connected to DOCOMO's network, this edge cloud platform supports low-latency services. It allows faster and more stable exchange of medical information compared to conventional internet-based transmission, enabling real-time remote support.
• MEC Direct Connection: This service establishes a private, closed network without going through the public internet, offering an additional layer of cyber protection and ensuring secure transmission of sensitive medical data.

Conclusion

This advanced telemedicine solution has the potential to significantly reduce regional disparities in medical access and strengthen disaster response capabilities. NTT DOCOMO will continue working with partners to accumulate evidence through demonstration trials, resolve remaining technical challenges, and promote early implementation into society.