Session Medical Workshop
Chair Shuji Shimizu (Kyushu University Hospital, Japan)
Ho-Seong Han (Seoul National University Bundang Hospital, Korea)
Objective Our goal is to establish a medical network with high-quality moving image on a broadband Internet in all Asia-Pacific regions.
In order to expand our WG, it is essential for both medical and engineering people to get together on site and discuss our next strategy. At the same time, we will demonstrate our new and developing systems to our members.
Target Audience Medical doctors/Co-medicals /Engineers/Researchers
Program Details Session Chairs: Shuji Shimizu (Kyushu University Hospital, Japan)
Ho-Seong Han (Seoul National University Bundang Hospital, Korea)
Colin Carati (Flinder's University Hospital, Adelaide, Australia)
Lim Sew Hoo (National University of Singapore, Singapore)

Live Surgery / Endoscopy Demonstration at APAN-Hawaii (Live Demo)
Date: Jan 23th (Wed) Hawaii 14:00-17:30, California 16:00-19:30
           Jan 24th (Thr) Japan, Korea 9:00-12:30, China 8:00-11:30

Scheduled Procedures:
1. Robotic distal gastrectomy (Yonsei University, Korea)
2. Diagnostic gastroscopy (Kyusu University, Japan)

Connecting Stations:
1. University of Hawaii, USA [Chairperson: Shimizu S, Han HS]
2. Yonsei Univeristy Medical Center, Seoul, Korea [Operator: Hyung WJ]
3. Kyushu University, Fukuoka, Japan [Operators: Yoshinaga, Itaba:       Moderators: Yada S, Nagai E]
4. Shanghai Jiaotong University, Shanghai, China [ Moderators: Qiu, Huang, Wan]
5. North Shore Private Hospital, Sydney, Australia [ Moderator: Smith G]
6. University of California Irvine, Irvine, USA [ Moderators: Chang K, Clayman R ]

13:00- (UCI 15:00- , CN 7:00- , KR/JP 8:00- ) Surgery starts after robot set-up at Yonsei U in Korea

14:00-14:05 (UCI 16:00- , CN 8:00- , KR/JP 9:00- ) Official opening remarks: Shimizu S

14:05-14:10 (UCI 16:05- , CN 8:05- , KR/JP 9:05- ) Greeting from Yonsei U

14:10-14:30 (UCI 16:10- , CN 8:10- , KR/JP 9:10- ) Greetings and staff introduction from all stations

14:30-14:40 (UCI 16:30- , CN 8:30- , KR/JP 9:30- ) Case presentation: Yonsei U

14:40-15:30 (UCI 16:40- , CN 8:40- , KR/JP 9:40- ) Operation and discussion

15:30-16:00 (UCI 17:30- , CN 9:30- , KR/JP 10:30- ) Coffee break; Operation can be seen continuously.

16:00-16:15 (UCI 18:00- , CN 10:00- , KR/JP 11:00- ) Network explanation by Prof Okamura and Mr A Howard

16:15-16:45 (UCI 18:15- , CN 10:15- , KR/JP 11:15- ) Endoscopic demonstration from Kyushu U

16:45-17:15 (UCI 18:45- , CN 10:45- , KR/JP 11:45- ) Discussion about endoscopy (and about operation in between)

17:15-17:25 (UCI 19:15- , CN 11:15- , KR/JP 12:15- ) Good-bye messages from all stations

17:25-17:30 (UCI 19:25- , CN 11:25- , KR/JP 12:25- ) Closing remarks: Han HS

17:30 (UCI 19:30, CN 11:30, KR/JP 12:30) Adjourn

Medical WG day-2: 2008.1.24 (Thr) version 2
9:00-10:30 (Local time) Session 1: Network and technology update for medical activity
Chairperson: Lim Sew Hoo (NUS/SN)

1.Network situation in Brazil Abstract & Biographydownload
Luiz Ary Messina/RUTE [By Polycom (4pm at Rio de Janeiro)]

2. CESNET Activities for Czech Medicine download
Jiri Navratil/CESNET | Abstract & Biography

3. Network situation in Trans-Pacific and in Seattle Abstract & Biographydownload
David Sinn/UW/Seattle

4. Communication XP download
Lee Sung Lim/KT | Abstract & Biography

5.Annotation technology Abstract & Biographydownload

6.International standardization of telemedicine system using DVTS) download

11:00-12:30 Session 2: Activity report and business meeting
Chairperson: Shuji Shimizu (Kyushu University)

1. Report from Asia Telemedicine Symposium Abstractdownload

2.Report from Audio-Visual team of Medical WG: Standardization of local set-up and data-sharing using APAN homepage
Nopphol/TH Abstract & Biographydownload | download

3.Rural medicine in Indonesia: Activity report and possible plans

4.Experience of 3-demension High Definition Eye Surgery Distance Live Demonstration in 600-participant lecture theater.
Pornarong C/ChulalonglornU/Bangkok)

5.Activity report in Australia and plan in New Zealand download
Colin/AU By Polycom (7:30am in Adelade)

6.Discussion about next APAN in New Zealand
      Healthcare education (YS Lee/Nakashima)
      Live surgery (Shimizu)
      Local technical issue

12:30-14:00 Lunch

14:00-15:30 Healthcare education 1 (Teleconference)

Chairperson: YS Lee (CBNU/KR) & Sakurai (Mie/JP)
Stations: Hawaii -California- Cheongju-Fukuoka

16:00-17:30 Healthcare education 2 (Teleconference)
Chairperson: Parvati (Stanford U/CA), YS Lee (CBNU/KR)
Stations: Hawaii -California-Wisconsin-Mumbai- Cheongju-Fukuoka

Healthcare 1 Teleconference ver 1.1
Date: Jan 24th (Thr) Hawaii 14:00-15:30, California 16:00-17:30
           Jan 25th (Fri) Korea and Japan 9:00-10:30

Program Organizer: Nakashima N (Kyushu U/JP) and Lee YS (Chungbuk NU/KR)

Connecting stations:
1. University of Hawaii, USA
[Chairperson: Lee YS/Sakurai S]
2. Stanford University, California, USA [ Moderator: Cammy Huang/Piya Sorcar]
3. Chungbuk National University, Cheongju, Korea [ Moderator: KyeongSoo Lee]
4. Kyushu University, Fukuoka, Japan [ Moderator: Nakashima N]

Opening remarks: YS Lee
1. Hawaii venue

      1) Shinobu Sakurai: The new health checkup system in Japan for Metabolic Syndrome Abstract & Biography (10min)download
      2) Young Sung Lee: Tele-medical activities in S. Korea Abstract & Biography (10min) download
      3) Hiroshi Mizushima: Ubiquitous medical system for home and hospital tele-care. Abstract & Biography (10min)

2. Stanford University
      1) Cammy Huang: Building Healthy Communities, Knowledge Is Infectious Abstract & Biography (10min)download
      2) Piya Sorcar:Interactive Teaching AIDS: Culturally Appropriate and Effective HIV/AIDS Education Abstract & Biography (10min)

3. Chungbuk National Uiversity Korea
      1) Kyeongsoo Lee: Strategy for Hypertension and DM in S.Korea Abstract & Biography(10min)
      2) JongKoo Lee; AI Experience In Republic of Korea: Status and Response Abstract & Biography(10min)

4. Kyushu University,
      Naoki Nakashima: A Japanese model of disease management for diabetes mellitus from primary to tertiary preventionAbstract & Biography (15min) download

5. Discussion between 4 stations (15min)
Closing Remarks: Shinobu Sakurai

Healthcare2 Teleconference ver 1.1
Date: Jan 24th (Thr) Hawaii 16:00-17:30, California 18:00-19:30, Wisconsin 20:00-21:30
           Jan 25th (Fri) India 7:30-9:30, Korea and Japan 11:00-12:30

Program organizer: Parvati D (Stanford U, US) & Young Sung Lee (Chungbuk National University, KR)

Connecting stations and presentations:
1. University of Hawaii, USA,
     Chairpersons: Parvati Dev/Lee YS
     Parvati Dev: Introduction to global online learning environments (10min) Abstract & Biographydownload
     W. LeRoy Heinrichs: Serious Virtual Worlds as Networked Learning Environments (10min) Abstract & Biographydownload

2. Stanford University, California, USA [Moderator: Shyh-Yuan Kung]
      Paul Kim: E-PBL for Medical Education over the intercontinental high speed networks Abstract & Biography(10min)

3. University of Wisconsin, USA
      Moderator: Steven Senger(LaCrosse):Online digital anatomy Abstract & Biography(10 min)]

4. Tata Memorial Medical Center, Mumbai, India (via the ERNET facility office)
      Moderator: Parul Shukla: Education over telemedicine networks (10min)]

5. Chungbuk National University, Cheongju, Korea
      Moderator: ChanHoh Hwang (10 min)]

6. Kyushu University, Fukuoka, Japan
      Moderator: Nakashima N: Online support system of disease management for primary prevention of lifestyle diseases Abstract & Biography(10 min)]

7. MedicVision, Melbourne, Australiadownload
      Moderator: Ross Horley; Implementation of simulation centers Abstract & Biography(10 min)]]

8. Discussion among 7 stations (20min)
      Closing Remarks: Parvati Dev

Abstracts and Biographies

CESNET Activities for Czech Medicine
Jiri Navratil/CESNET






Abstract: CESNET, was established by all Czech universities and the Czech Academy of Science to operate as Czech NREN. CESNET network connects all academic institutes in the country. Current network is based on DWDM technology that opens wide possibilities for network services. CESNET is part of European academic network GÉANT2 and member of GLIF.

CESNET as research organization is active in development and implementation of new network technologies and applications. We support applications that requesting exchange large volume of data, high transmission speed, defined response time or high level of privacy. CESNET creates independent E2E paths, private and virtual network on different level of protocols for different groups of users (grid, data centers, hospitals, digital libraries, etc.). Currently, we focus mainly on applications from the area of medicine and particle physics.

In the field of medicine we support several applications that connecting university and research hospitals for DICOM data exchange. In collaboration with the universities and several clinics we are developing tools for interactive 3D collaboration environment. We support multimedia services using standard signaling protocols (H.323, SIP, SS7), MCU for multipoint live surgery, etc. CESNET research group also work on the multipoint wide area transmission of uncompressed HD video. We operate streaming servers used by the whole academic community and we are trying to increase availability of the HD (compressed) streaming for the distance community (DVTS). Several examples of applications from the medical field will be presented.
AI Experience In Republic of Korea: Status and Response 
Lee, Jong-Koo, MD., MPH, Deputy Minister of Korea, CDC

Biography: Dr. JK Lee has a Ph.D. in medical management with completion of residency in family medicine from Seoul National University hospital.  After graduation, he studied medical management and local medical problems.  In the Ministry of Health & Welfare, he has been in charge of medical treatment for rural areas and also has been responsible for health cares and medical administrative tasks.  Now, he is the deputy minister of Korea Centers for Disease Control & Prevention. 
Abstract: AI has been prevalent in 2003 and 2006, Korea.   Korea has made on intensive effort to prevent human infection by investigating the aspect of prevalence and the source of infection.  In doing so, Korean government could eradiate prevalence of AI without human infection.

This presentation will introduce prevalence of AI using satellite photographs about Korean experiences of AI and procedure for AI incidence.  

A Japanese model of disease management for diabetes mellitus from primary to tertiary prevention
Naoki Nakashima MD, PhD
Assistant Professor Department of Medical Informatics Kyushu University Hospital, Japan







Bio: Dr. Nakashima has been a diabetes specialist for 18 years and he has studied about disease management for diabetes mellitus in Japan for 5 years. He is a councillor member of Japanese Society of Diabetes Mellitus and a director of general affairs of Japanese Association of Medical Informatics. Especially he is interested in standardization of medical information and medical procedure of life style diseases. He is also promoting a project of broad band telemedicine network in Asia Pacific area.

Abstract: Disease Management has been developed in USA to improve medical quality, and has been spreading especially in tertiary prevention of chronic disease throughout the world. The Particular Health Check-Up System (PHCS), which will start from the spring 2008 by Japanese government, also has disease management logic as an institution. PHCS will greatly affect insurers because it will cover 57 million citizens (45% of entire Japanese population) and will involve all insurers. We have studied about a Japanese model of disease management in secondary/ tertiary prevention of diabetes mellitus and conducted a practical experiment since 2004. We also developed a primary prevention program implemented in relation to government’s program and ICT system to apply PHCS. We are now managing about 500 monitors in the primary prevention program.
The results of halfway analysis of our system shows that 2.3 cm decrease of waist and 1.5 kg decrease of weight on averages in primary prevention program (n=158). In secondary/ tertiary prevention (n=13) resulted 0.32% decrease of HbA1c (control (n=18); 0.16%), and achievement ratio of annual examination in the clinical guideline was 80.2% (control; 54.8%). In the presentation, we introduce topics about PHCS by Japanese government and our project (Carna project).

Online support system of disease management for primary prevention of lifestyle diseases (Talk in 2nd session)

Abstract: The Particular Health Check-Up System (PHCS) will start from the spring 2008 by Japanese government. PHCS includes not only annual health check-up but also health instruction for high risk people. The program of health instruction is finely ruled in PHCS. We have developed ICT system as an application service provider system to accept outsourcing health instruction provider from insurers. It consists of a data base application of results of health check up and health instruction, online appointment system for health instructors, and online navigation system for primary instruction (both for private instruction and group instruction) and for follow up instruction for 3 months at least. The DB application has an automatic stratification function and an analytical function. For example, implementation of this system has cut-down the primary instruction time by about two-third (from 60 min to 20 min). We have had many offers to use the system in PHCS from insurers. In the presentation, we introduce about the configuration and user interface of the system.

Interactive Teaching AIDS: The Development Process of Culturally Appropriate and Effective HIV/AIDS Education
Piya Sorcar, Ph.D Student


Bio: Piya Sorcar is a Ph.D. student at Stanford University in Learning Sciences & Technology Design and the executive director of Interactive Teaching AIDS, where she leads a team of interdisciplinary experts to develop animation-based curricula to teach HIV/AIDS awareness and prevention strategies. Based on original IRB-approved research, the applications target young adults to promote awareness despite cultural and social barriers present in many developing countries. The production versions were created with the Medical Research Information Center and funded by the South Korean Ministry of Science and Technology, Time Warner, among others, and are used in several countries including South Korea, India, Canada and England.

Abstract: One of the greatest public health challenges facing our world today is how to provide effective health education in Asia. With more than 60% of the world’s people residing in Asia, prevention and awareness of communicable diseases in this region has direct benefits of the rest of the world. Diseases such as HIV/AIDS that are transmitted sexually present significant challenges because social stigma often precludes such open discussion, especially in Asian countries. In fact, although India has one of the largest populations of HIV/AIDS sufferers, several states have recently banned sex education in schools, and with it HIV/AIDS education.

Interactive Teaching AIDS is a pedagogically-grounded and evidence-based animated tutorial aimed at teaching prevention strategies despite social and cultural barriers. Developed by an interdisciplinary team of experts, including education, communication and medical professionals, it is targeted towards young adults. The results of our recent study in India reveal significant increases in learning and students rapidly spreading prevention education through their peer networks.

Serious Virtual Worlds as Networked Learning Environments
Wm. LeRoy Heinrichs, MD, PhD
Professor Emeritus, Stanford School of Medicine


Abstract; Practicing life and death scenarios in a videogame-like world is now possible for our youth, from high schoolers through resident physicians and graduate nurses, and beyond. The clinical management of critically-injured virtual patients is becoming an accepted mode of experiential learning for basic medical emergencies and massive trauma events. Avatars in the world, both learners and patients are role-played by geographically-dispersed persons who communicate with headsets, and in-world radios. Rapidly-evolving, patho-physiological models for victim avatars allow for practicing standard clinical emergency management. Teams of ED personnel (four MD’s and seven RN’s) report high levels of engagement, and endorsed the worlds as being realistic.

Dr. Heinrichs is Professor (Emeritus) and Past Chair of Obstetrics and Gynecology at Stanford University where he practiced for 27 years, doing obstetric deliveries and performing and teaching laparoscopic surgery. He recognized the potential for teaching this type of surgery with Virtual Reality systems, modeled after flight simulators used by the aviation industry in training and maintaining skills of pilots. He retired to SUMMIT where he developed an anatomically correct, human 3D model (Lucy v.3.0) as the virtual anatomy for pelvic surgical simulators. Dr. Heinrichs also initiated a project with Immersion, Inc. for developing a hysteroscopy trainer, now a commercially available trainer. At SUMMIT where he has been Associate Director for over a decade, he and colleagues have developed anatomy and surgical simulation projects for distribution over Internet2. His designation in 2002, along with SUMMIT, for the 8th Annual Satava Award by the Medicine Meets Virtual Reality organization was for his leadership in the field of surgical simulation. He is PI on a Wallenberg Foundation project (March 31, 2008 completion; possible renewal) that implemented a 3D World for training of medical teams for crisis management of trauma, and another on CPR training. He and colleagues have recently developed a trainer for intracorporeal suturing. He serves (since 2004) as a Medical Advisor to Forterra Systems, Inc., with which he an colleagues have developed a MOS for mass disaster management training, released in May 2007. Dr. Heinrichs has served as a non-paid Chief Medical Officer for BioControl Systems, LLC (since 2000), and as a co-Principal in Innovation in Learning, Inc., (formed in 2008). During the Fall of 2007, he has assisted BioControl Systems adapt a micro-EMG sensor to subjects using a commercial Core Trainer. Dr. Heinrichs writes on the topics of Surgical Simulation and Team Training in Virtual Environments, and lectures internationally on these topics.

E-PBL for Medical Education over the intercontinental high speed networks
Paul Kim, Stanford University School of Education













Abstract: In the last few decades of research, the assessment strategies employed to measure the student performance in PBL (Problem-Based Learning) for medical education appear to focus only on the quantitative aspect (i.e., acquisition of knowledge and skills measured through essays, free recalls, standard patient simulations, etc.), but less on “deep learning aspects” such as self-reflecting, critical reasoning, or problem solving skills through identifying patterns of best practices (i.e., ability to clearly define the problems, generate and test hypotheses, explain anomalies, develop alternative perspectives, integrate scientific evidences, etc.) With the recent proliferation of ICT (Information and Communication Technologies) fueled by affordable high-performing computers and low-cost high-bandwidth networks, new opportunities are emerging to address some of the inherent shortfalls of PBL and expand the interaction model to include tutors or experts from remote locations. In the presentation, a newly developed E-PBL case integrated in a web-based group cognition space will be demonstrated. A special focus will be given to the ability to express and assess cognitive strategies of participants in a PBL case. Some of the cognition patterns for identifying anomalies, relating to clinical evidences, generating and testing hypotheses will be demonstrated with visual expressions using pointers, highlighters, and relation indicators. The presentation will involve multiple participants connected through high-speed intercontinental networks and medical images such as MRIs and X-Rays and videos such as endoscopy sessions and PET/CT animations.

Paul Kim Bio: As the Assistant Dean and CTO for Stanford University School of Education, he is responsible to provide leadership in all aspects of academic and innovative technology. He received his Ph.D. in Educational Technology from University of Southern California and has been collaborating with educational research and development institutes such as U.S. Satellite Laboratories, Medical Research & Information Center, and Korea Educational Research and Information Service. He has served as Vice President for Vatterott College, MO and Chairman of the Board for Intercultural Institute of California. He has taught EDUC392 - Enterprising Higher Education in the Digital Age, EDUC391- Web-Based Technologies for Learning, EDUC480 & 490 Directed Studies with topics such as Private Post-Secondary Education, Digital Portfolios, and Concept-Map-based Assessment. His recent publications include: Kim, P., Um, S., Sorcar, P., Chung, H., Lee, Y. (2007). Effects of episodic variations in web-based health education: Influence of fear and humor appeal on comprehension, retention, and behavior change. (To appear in Health Education Research), Kim, P. (2007). E-Learning: Moving beyond the "e," and into training strategies that promise long-term impact. Training Magazine, November issue. Also, his recent presentations include “Parallelism Paradox in Learning Technology Research & Development”, Invited Lecture, Hanyang University, Seoul, Korea, November, 2007, “Group Cognition in E-PBL for Medical Education”, Invited Lecture, Chungbuk National University, Cheongju, Korea, November, 2007, “E-Learning to M-Learning and educational access for the underserved”, Invited Lecture, CETYS University, Mexicali, Mexico, November, 2007, “E-Learning: Entrepreneurship, Investment, & Technology”, Panel Discussion with Mike Sandler (Eduventures) and Howard Block (Knowledge Investment Partners), Stanford University, Stanford, CA, November, 2007.

Tele-medical activities in S. Korea  Professor, Chungbuk National University, College of Medicine 


Bio: Dr. Young Sung Lee, M.D. Ph.D. has been leading MedRIC (Medical Research Information Center), a Ministry of Science and Technology funded organization in S. Korea, focusing on research and development in medical informatics, medical data visualization, telematics, Virtual Reality-based medical training, and health communication and promotion policies and programs. Dr. Lee is Professor of College of Medicine at Chungbuk National University and a visiting scholar at Stanford University Medical Media and Information Technology. He has lead many global health literacy initiatives covering diseases such as AIDS, Avian Influenza, cancer series (e.g., lung, colon, and breast cancer), and other diseases such as pneumonia, malaria, tsutsugamushi fever, haemorrhagic fever, and leptospirosis). He is currently serving as a board member of the Korean Society of Medical Informatics.  
Abstract: Korea has the most innovating information infrastructure in the world.  For the last 10 years, broad-bandwidth network has been set up nationwide in the name of  'e-government and e-science'. These infrastructure can enable study, education and policy discussion in public health and health promotion field in correlation with 250 national health centers.  These presentation will suggest review of these possibility and cases using experiences in public health and health promotion field of Korea for the time being.  Through these cases, in cooperation with Korea, Asia-Pacific area and the world furthermore,  e-research environment for public health will be encouraged and know-how to disseminate this and factors for barriers and organizational problems will be discussed.  

Communication XP
SL Lee 

ConferenceXP is an open research project from Microsoft on video conferencing and remote cooperation. The ConferenceXP video conferencing application runs on Microsoft Windows to provide the features such as video and audio communication, document sharing, white board and chatting. The software is quite stable and flexible, when used with the webcam or the camcorder with inter-frame compression, which is the common usage in the public. In the special case of using high quality uncompressed DV image for the conferencing, however, there are some problems, mainly because the ConferenceXP is originally designed as a distributed system based on the multicast network. DV/CXP is being developed to address this situation. DV/CXP takes a centralized approach while still using the existing ConferenceXP client application, to provide efficient video mixing and control for DV image transfer over the unicast network.

The new health checkup system in Japan for Metabolic Syndrome
Shinobu Sakurai, M.N., R.N, P.H.N. Professor in Community Nursing Faculty of Medicine, School of Nursing, Mie University

Shinobu Sakurai is Professor who graduated from St Luke's Nursing University at Tokyo and study in University of California San Francisco. She worked as a Public health nurse at school based setting and occupational health setting for years in Japan, and continued her research and educate in Community nursing in Mie. Currently, she conducts many projects in making community health service, health organization, health promotion and disaster risk management in rural area, and evaluate health & welfare service in city government. Also, she is the main lecture in public health nursing on the job training course in Mie prefecture.

The health checkup system of Japan changes greatly in April, 2008. To decrease incidence rate with the lifestyle disease, and to reduce the medical treatment expense, It makes it to the content to which power improves giving priority to the Metabolic Syndrome prevention. The health guidance with the main transmission of the medical examination result will change dramatically. The doctor and the public health nurse and the dietitian support "The lifestyle is changed" spending time in the person for whom the support is necessary. The object person of the medical examination provisionally calculates the Ministry of Health, Labor and Welfare and about 50 million people the object person of the health guidance is calculating to reach 14 million people provisionally. It introduces this epoch-making system and the mechanism in this session.

Strategy for Hypertension and DM in S. Korea
Kyeong-Soo Lee

Bio: Dr. Kyeong-soo Lee, M.D. Ph.D. is associate professor at Yeungnam University College of Medicine in South Korea, focusing on R&D project in chronic disease mgmt.(esp, HBP and DM) and health promotion.

He is also in charge of 'Demonstrative Project for Development of Chronic Disease Management Model' and 'Health Promotion Supporting Group' as secretary. He is currently serving as a board member of the Korean Society of Preventive Medicine, a editorial board member of Korean Association of Agricultural Medicine and Community Medicine.

Abstract: About 60% of all deaths in Korea are caused by five major CDs. To manage chronic degenerative diseases, comprehensive approach of managing different areas such as healthy life style, management of disease prevention, health protection, disease prevention, and treatment and rehabilitation, and active intervention at a national level are needed.

So Korean government has developed a policy and formation for chronic disease mgmt. and started a demonstrative project from Aug. 2007 in Daegu city(pop.: 2.5 million).

In this presentation, he will introduce the strategies and programs for managing hypertension and DM of the demonstrative project in Daegu city, and also discuss about know-how and barriers related to implement and evaluation of this project.  

Introduction to Global Online Learning Environments
Parvati Dev

Abstract: New media, Web 2.0, games, and simulation, all provide new opportunities and tools for creating innovative, engaging and effective learning environments. These environments are being applied to teach cognitive knowledge, technical skills, clinical reasoning and ethical attitudes in all areas of healthcare. An overview of these new learning environments will be presented.

Bio: Parvati Dev, PhD Parvati Dev completed her doctoral degree in Electrical Engineering on computer models of the brain at Stanford University. She has worked on the research and teaching staff at M.I.T., Boston University, and Stanford. From 1982 to 1989 she was Vice-President at CEMAX Inc, where she developed products for three-dimensional imaging of patients from computed tomography and magnetic resonance scans. From 1990 to 2007, she led the SUMMIT Research Laboratory for Learning Technologies at Stanford, a pioneer in the development of digital educational materials related to anatomy and surgery. Between 2002 and 2004, she was appointed Associate Dean of Learning Technologies for the medical school. Dr. Dev's research includes simulation and game-based learning, collaborative visualization of human anatomy over Internet2, the simulation of clinical procedures, and the evaluation of learning outcomes. She now leads a new company, Innovation in Learning, Inc., to further develop new online learning environments.  

Collaborative Digital Anatomy Learning Environments
Steven Senger
Professor of Mathematics and Director of the Advanced Computation Laboratory at the University of Wisconsin – La Crosse

Bio: Steven Senger is Professsor and Chair of Computer Science, Professor of Mathematics and Director of the Advanced Computation Laboratory at the University of Wisconsin – La Crosse. His research interests focus on advanced networks for collaboration, virtual environments, visualization and haptics. He is the creator of several software systems that support interactive digital anatomy including the Digital Cadaver and the Immersive Segmentation Environment.

Abstract: High performance networks create unique opportunities to combine remote data and computational resources to create interactive and collaborative learning environments. This presentation will discuss some of the Digital Anatomy applications and middleware developed as part of the HAVnet project funded through the Scalable Information Infrastructure initiative of the National Library of Medicine. These applications support anatomical education and display a range of network requirements and behaviors. The presentation will focus on how the application design creates opportunities for combining various remote anatomical resources and collaboration between users while hiding network details from the user.

Building Healthy Communities, Knowledge Is Infectious
Cammy Huang, Director of Scientific Outreach, Wallenberg Global Learning Network, Lecturer, Computer Science

bio: Camillan Huang, Ph.D. has over 8 years of experience in producing interactive media, developing online curriculum (K-16 and medical education), project management of globally distributed teams, and outreach. She has a Ph.D. in Neuroscience from the University of California, Berkeley and is currently at Stanford University as a lecturer in Computer Science and Director of Scientific Outreach for the Wallenberg Global Learning Network (WGLN). As the outreach director, she manages all aspects of a multi-institutional, interdisciplinary faculty grants program, promotes and cultivates new collaborations, and designs innovative solutions for using technology in educational settings. Her expertise is in educational technologies, instructional design, project management, global collaborations, digital media production, human-computer interaction, and outreach. Current research interests include technology in science education and user experience design. Contact: cammy.huang@stanford.edu, www.stanford.edu/~camillan.

Abstract; Digital content can be affordable, educational, and capable of reaching a broad audience. As computer and internet access continues to grow both in the United States and abroad, we have the opportunity to disseminate scientific knowledge about a range of topics - including human health and disease - to a global audience. Using the Virtual Labs backbone, I will demonstrate the flexibility of online curricula and how it can be distributed in the public and university setting. Together, we can create a network to harness the power of the web to transform education.

Activity update of APAN medical WG
Shuji Shimizu, M.D. (Kyushu University, Fukuoka, Japan)

Eleven telemedical conferences were performed after last APAN in Xian, and the first Asia Telemedicine Symposium was held in Fukuoka, Japan, on December 7-8, 2007. More than 150 participants from 8 countries discussed activity plans and possible technical improvement with remote presentation from Korea, Singapore, and Australia. We reached an agreement of a standard configuration of local audio-visual set-up in each station. Our telemedicine events in early 2008 will include Early Gastric Cancer Conference between Bangkok and Fukuoka in February, Endoscopic Workshop in Hong Kong and Thoracic Meeting in Singapore in March, Gastric Surgery Workshop in Tokyo and Liver Surgical Course in Mumbai in April, Immersive Medical Telepresence Workshop in Michigan and TERENA Meeting in Belgium in May, Shanghai Live in June, and more. We would like to have your continuous support.  

Homepage for data-sharing for medical WG Nopphol Pausawasdi Faculty of Medicine Siriraj Hospital, Mahidol University


Telemedicine activities among medical workgroups have been conducted for years. One major activity in Asia is a collaboration of doctors, networking engineers, and audio-visual specialists in APAN meeting supported by the Kyushu University Hospital. This workgroup aims to develop a high quality telemedicine utilizing uncompressed video and audio signal transmitted over broadband network across the world. In order to accomplish the objective, it must have a communication tool to allow members from different countries to participate, share knowledge, and know each other well enough to produce effective collaborations. The homepage for data-sharing for medical workgroup is designed to support such collaborations. Members can do following activities on this homepage; member registration, updating members’ profiles, sharing knowledge in areas of audiovisual and computer networking, discussion on web board, and posting news and events. The homepage for data-sharing for medical workgroup will be linked to APAN website under medical workgroup section. This homepage should enhance collaborations among doctors, networking engineers, and audio-visual specialists across the world. It should also lead to a standardized configuration of local set-up for telemedicine activity.

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International Telemedicine Experiment between Japan and Thailand
Yuichi Fujino
Nippon Telegraph and Telephone Corporation
Research and Development Planning Department

In Japan, there are nine million or less optical access network subscribers in March 2007, and they can easily use bidirectional broadband communications. Moreover, the charges for broadband communication are lower than those in any other country. By 2010, Nippon Telegraph and Telephone Corporation called NTT plans to upgrade the service of nearly 30 million of the current 60 million NTT fixed line telephone customers to Next Generation Network (NGN) services. NTT has a plan to start commercial NGN services in this March. NGN is based on the Internet Protocols and more secure and reliable broadband network than legacy telephone or the Internet network. On the other hand, Japan is becoming a super-aging society. So, an efficient medical, healthcare or welfare services are expected. One of the methods to realize these services effectively is a network-based medical and healthcare service using ICT.

Telemedicine is one of the desired applications of the broadband network. From that aspect, we are studying tele-mentoring and telesurgery system over broadband network. We had adopted a robotic tele-surgery system for an international tele-laparoscopic surgery experiment and have been carrying out the trial for three years between Chulalongkorn University in Thailand and Kyushu University in Japan using the Asia broadband network and JGN2. In the telemedicine, tele-mentoring or tele-education field, we have to use an audio and video communication system. So, we need an electronic pointer or writing function on the moving video images. In this experiment, we have made a tele-annotation function and tested it. We will show a configuration of tele-annotation system and scene of tele-mentoring using our tele-annotation system.

Luiz Ary Messina
Organization: Rede Nacional de Ensino e Pesquisa - RNP
The Brazilian Telemedicine University Network - RUTE

Abstract: The Brazilian Telehealth initiatives achieved its federal ministerial integration, Education, Health, Science & Technology, as two main national projects started in 2006 and 2007 respectively: The Telemedicine University Network, RUTE – Rede Universitaria de Telemedicina, bringing telecommunication and Telehealth infra-structure into the University Hospitals, run by RNP; and the National Telehealth Program in the Primary Care, applying in 9 University Hospitals from RUTE and 900 municipalities the National Family Health Program. RUTE in its first phase integrated 19 University Hospitals and will connect in 2008 all federal states, altogether 57 University Hospitals and Health High Education Faculties. The Brazilian Telehealth initiative enables a number of applications, such as video conferencing, diagnosis and second opinion, continuous education and web conferencing, by linking university hospitals, professors, researchers, students and remote health professionals via RNP, Brazil’s national education and research network.

Brief profile Dr.Ing.Dipl.Inf. Luiz Ary Messina, Electrical Engineer, University of Brasília, Master in Automation, University of Campinas, Dr. in Computer Graphics and Assistant Professor 1984-1989, Technology University of Darmstadt. Worked for Siemens Automation in Germany and São Paulo. Founded Messina Informatica: Database Applications for government and health institutions. Coordinated graduate courses: Production Engineering, Computer Sciences, University of Vila Velha. Coordinated T@lemed-@lis with Fraunhofer-IGD. Acquired and coordinated three URB-AL-EU-Projects for the City of Vitória. Coordinated the ICT department of Espirito Santo State Science and Technology Secretary, creating the Health Technology Center at the Federal University of Espirito Santo. Coordinates the Brazilian Telemedicine University Network-RUTE.

Rural Medicine in Indonesia: Activity Report & Possible Plans
Ali Sungkar
Faculty of Medicine, University of Indonesia.
Jakarta, Indonesia

University of Indonesia, as the oldest and the most leading university, consists of 13 faculties with more than 25,000 students who attend the under and post graduate programs, and also doctoral programs.

The medical faculty itself has 1,250 under graduate students, 1,250 post graduates, 200 doctoral students and 800 staff. The faculty also provides continuous medical education and continuous professional development not only for UI graduates, but also for graduates from other universities. FMUI graduates work in almost every province as general practitioners or specialists in urban areas. To improve the quality of the training programs, FMUI needs supports the programs of distant learning. On the other hand, FMUI also has the obligations as a mentor for other medical faculties in Indonesia such as Syah Kuala in Aceh, Tanjung Pura in West Kalimantan, Islamic University Banten and others. Due to our staff and multimedia materials limitations, FMUI plans to extend the distant learning programs to improve the public services.

FMUI plans to transfer the knowledge, skill and technology to other medical faculties outside Jakarta, particularly outside Java. To do so, due to the big amount of Indonesian citizens and the distribution pattern of the islands as the handicaps, some innovative program is needed to decrease morbidity and mortality of women and children in Indonesia.

As a part of the most leading university and also as a part of scientific societies in Indonesia, Faculty of Medicine has the obligations to support the government to increase the standard of health of the Indonesian citizens. The government programs, which are to increase the health providers and to improve the quality of health, to decrease MMR from 400/100,000 to 125/100,000 annually in the year 2010, to decrease IMR from 45/100,000 to 10/100,000 annually in the year 2010 according to the government program Healthy Indonesia 2010, must be supported by universities in Indonesia particular UI as the most leading university.

The program supporting from government, not only nationally but also regionally. Using INHERENT, GDLN, APAN Network we made tele medicine, tele consultation with other university. We plan to expand this method for our colleague in other university with support from APAN Network and other.  

Implementation of Skills Training Centres

Ross Horley

For many the implementation of a skills training centre is based on a clone strategy of an existing centre. This strategy is in most cases has resulted in a less than optimal facility.For the centre to be successful there are some basic fundamentals but none as important as the needs assessment of the target market. The planning and ultimate development of a centre requires a process that is based on identifying the type of training the skills centre will deliver, cost of training, throughput, numbers of users, staffing levels and then satisfying all that criteria with the design of the building. If those business planning principles are adhered to then there is a significant chance that the centre will be successful.

Ubiquitous medical system for home and hospital tele-care. 

Hiroshi Mizushima, PhD Associate Professor Information Center for Medical Sciences Tokyo Medical and Dental University, Japan

Short Bio: Dr. Mizushima has been working at National Cancer Center for 18 years after his Doctor course at Tokyo University Faculty of Pharmaceutical Sciences. He has been doing research about retroviral infection, while establishing local area network in the institute. After connecting the network to the internet in 1992, he started gopher server and WWW server in 1993, providing not only cancer information but also real time satellite images. He also introduced Japanese first medical oriented supercomputer and established Cancer Center Network, with high definition tele-conferencing system. After training at National Center for Biotechnology Information at NIH in U.S.A., he moved to Center for Medical Genomics in 2000, doing bioinformatics. In Nov. 2006, he moved to Tokyo Medical and Dental University, and now heading the clinical omics project, collecting comprehensive clinical and molecular information from the cancer patients, to make an integrated database system. The Title of the Talk: Ubiquitous medical system for home and hospital tele-care.

Abstract: We have been establishing telemedicine system at National cancer Center from 1994, connecting between hospitals with rather high-grade system. Internet has become available elsewhere with high broadband, and ubiquitous system has now becoming popular in many fields. Medical sensing technology also has been improving rapidly these days. In Tokyo Medical and Dental University, we have been trying to establish ubiquitous monitoring system for the patients in the hospital, even while moving between rooms by stretchers. These system was enabled by Zig-Bee, RFID, Wireless-LAN, medical sensors etc. We recently started to install small ECG and movement monitoring system, so called “Human Recorder” such like Flight recorder or drive recorder. It can monitor ECG and all the 3D movements of a person 24hrs online. I want to discuss the future possibility of tele-care system in hospital and in home.  

Network situation in Trans-Pacific and in Seattle David Sinn 

Through partnerships with APAN member networks we will go over Trans-Pacific connectivity with specific focus on regional connectivity to medical facilities within the Seattle area.  

Remark We will have two or more live demonstrations among multiple stations. We would like to have enough time for preparation or rehearsals at the same room, such as the night before or a few days before the event. Necessary equipments may include multi-point teleconference system, microphones, mixers, and several high-quality monitors.

Copy Right 2008 APAN | Last Updated 30 Jan 2008