5G in Diagnosis and Screening

According to a study by Research and Markets, the telemedicine market is expected to grow at a compound annual growth rate of 24.1% from 2022 to 2028, parallel with the emergence and rollout of 5G. The ability of advanced connectivity solutions to share large quantities of data in real-time will allow patients to attend consultations wherever is most convenient for them. Currently, around 5% of healthcare appointments in the UK are missed, many of which are not reallocated. Reliable virtual applications could reduce this figure, increasing patient turnover. This will be particularly helpful for people with chronic illnesses, with more than one in two frustrated by long appointment wait times, their inability to get a convenient appointment time and the nonavailability of doctors of their choice. People who live in rural areas will particularly benefit from expertise becoming decentralised, ensuring individuals have access to the specialists they need, wherever they are and without having to make long and costly journeys. 

5G’s high bandwidth and availability promise quicker and more advanced diagnosis. Results (including huge image files) will be shared with healthcare professionals in real-time, and patients can even conduct less invasive procedures from the comfort of their own homes. What’s more, 5G offers the opportunity for NHS Trusts, local authorities or care providers to deploy private networks to deliver secure, ubiquitous connectivity to surgeries, residential facilities and even peoples’ homes. Offering cost advantages over traditional connectivity solutions can help address health inequalities by ensuring the same services are available to everyone. 

Advanced connectivity solutions including 5G promise to enable a new, more efficient, dispersed and inclusive healthcare system, helping to narrow the gap between advantaged and disadvantaged members of our society. 

In Scotland, O2 and the University of Glasgow conducted a pilot trial of a fully connected Covid-19 testing clinic-on-wheels, supported by their 5G mobile network. The three-month trial was designed to provide remote testing and tracking of 550 care home residents and workers over six care homes in Glasgow, as well as deliver essential medical supplies.  

Data on the number of tests performed and the test results were shared to a secure cloud server, with the testing unit providing a dashboard of real-time epidemiological analysis to the NHS, Scottish Government and public health organisations. Crucially, it was designed to minimise exposure of care home residents and staff to Covid-19, ensuring greater efficiency for healthcare workers and enhancing the testing capability of the NHS.

Professor Muhammad Imran, university of Glasgow James Watt School of Engineering said:

"The utility and scope of a mobile health clinic goes beynd this current pandemic. Engineering a fleet of connected healthcare response mobile units can provide services at the doorsteps of fragile and constrained patients all over the country even after the pandemic is over"

Vodafone, Intel, Fivecomm and Altran developed a 5G Covid Robot or “Sentinel Robot”. A 5G-connected Autonomous Guided Vehicle (AGV) with on-board video and thermal cameras enables monitoring, and can identify people that are not wearing masks as well as detect people with above-normal body temperatures. 

High temperatures or non-compliance with mask-wearing generates alarms at a remote command centre and remote operators can then take appropriate actions, such as interacting with the identified person using the devices in the robot (tablet & speakers). The low latency and high performance of a standalone 5G network, enables the remote driving of the robot to approach the person that the operator wants to interact with.

In China, Baidu developed several tools that can be effectively used to screen populations, including an AI-powered, non-contact infrared sensor system that provides users with rapid multi-person temperature monitoring to detect suspected fever.  

Haifeng Wang, CTO at Baidu, said: “Traditional approaches, such as station personnel using frontal medical thermometer devices, can easily cause crowds and increase the risk of cross-infection.  Baidu’s AI temperature sensor system can quickly screen crowds to improve detection efficiency and accuracy without creating unnecessary risks”.

This technology — powered by 5G — is being used in Beijing’s Qinghe Railway Station and can examine up to 200 people in one minute. Accurate mass screening can, therefore, be conducted without disrupting the passenger flow. The immediate threat of Covid-19 may have passed but such solutions could be used to help combat further virus spreads as well as manage the annual cold and flu season.

AI is able to accurately detect 20 percent more breast cancers from mammograms than traditional screening by radiologists, according to early results from a Swedish trial. The study is the first randomised controlled trial to look at using AI in breast cancer screening and comes amid a dramatically shifting landscape for the technology and how it’s regulated. There was also a significant reduction in workload for radiologists, with the doctors having to spend 44 percent less time reading mammograms.

As part of the WM5G programme, 5G-powered diagnostic tools were used to help GPs across the West Midlands, delivering virtual ward rounds. This enables GPs to respond quickly to identified issues and reduce unnecessary hospital visits.
 

The Liverpool 5G Create project deployed 5G-powered solutions to enable remote diagnosis of care home residents. Optical techniques detected infections in urine and transmitted ultra-high resolution images to GP surgeries for analysis. The project also used 5G to deploy a pressure ulcer management system where Artificial Intelligence (AI) imaging techniques and emerging camera technologies categorised pressure ulcers remotely and sent high-quality images to practitioners for diagnosis.

A range of home diagnostic devices are being developed across the globe, giving people at-home access to tools used by doctors during in-surgery exams. One of the closest to market is Tyto, a handheld device that can capture and record a patient’s heartbeat and breath sounds. The built-in camera can take high resolution photos of skin lesions, rashes and moles, as well as enabling examination of a patient’s tonsils and ear canal; using 5G, the patient can send data to a doctor in real time.

In Greece, the Vodafone Foundation Telemedicine Programme is using mobile technology combined with next generation medical devices to provide high-quality specialised healthcare, regardless of location. Using tablets and medical equipment, GPs and rural doctors are able to transfer their examinations to medical specialists for their expert opinion, granting greater access to secondary care for those in remote and rural locations. The programme is implemented in 100 remote areas, covering a population of 500,000 people. Results show an increase in patient engagement and adherence with treatment plans, as well as improved continuity and completeness of care with the ability to identify issues more quickly: around 75% of patients reported a reduction in the number of hospital visits they needed. 
 

Working with the University Hospitals Birmingham NHS Foundation Trust, WM5G conducted the UK’s first demonstration of a remote-controlled ultrasound scan over a public 5G network. The demonstration simulated a paramedic performing an ultrasound scan on a patient, under the remote guidance of a clinician who was able to interpret the ultrasound image in real-time. The ultrasound sensor was manipulated locally by the paramedic under the remote direction of the clinician, who used a joystick to send control signals over the live 5G network to a robotic or ‘haptic’ glove. This created small vibrations to direct the paramedic’s hand, allowing the clinician to remotely control the sensor position and see the ultrasound images in real time. 

Enabling ultrasound scans to be performed by paramedics with remote live diagnosis can bring a number of advantages to both patients and the NHS. In addition to speeding up diagnosis, the technology could reduce the number of ambulance journeys and hospital visits, freeing up resources. Crucially, scans performed in the field can enable faster diagnoses, ensuring more effective outcomes for the patient and increasing overall efficiency for the hospital.

Tim Jones, Chief Innovation Officer at UHB, said:

"We are immensely excited about the potential of 5G to support transformation in healthcare. Our clinicians will in the furture be able to deliver holistic specialist advice in real time, potentially forming virtual multi-disciplinary teams to provide the best patient care using intelligent IT links. Informtation would be accessible at the point of need, ensuring informed decision making leading to improved patient safety, quality of care and patient/clinician experience."

Vodafone Ireland, in collaboration with the ASSERT Centre in University of Cork, is creating the first 5G-connected telemedicine and medical robotics training centre in the world. The team are exploring point of care systems (for example, ultrasounds) and how 5G could transform their use, particularly in developing countries or disaster zones.

Prof Barry O'Reilly, director of the ASSERT Centre and an obstetrician-gynaecologist at Cork University Maternity Hospital, Said:

"This technology also has huge significance for the developing world. Once you introduce 5G to tht market, you could have a midwife in Kenya working in a remote village who can do a scan of a pregannt woman, and immediately get instant feedback from an expert back at the university teaching hospital."

Meanwhile, Ericsson is collaborating with Imaginalis — a company that researches, develops and produces robotic imaging medical devices for human and veterinary applications. The project has created diagnostic imaging tools that accurately visualise internal and external structures such as a 3D CAT scan, with the aim of making procedures safer and easier to perform. The images rendered from these scans are several gigabits and today’s uplink channels are not sufficient for live remote diagnosis; Ericsson is working to improve mobile uplink connectivity and data compression to transfer images and perform remote analysis via the power of 5G. 

A mobile health clinic that is fitted with a range of digital tools and software is being used to tackle infectious diseases in London. The ‘Find and Treat’ van is part of NHS Digital’s Future Wireless Project Trials and has been deployed from University College London Hospitals (UCLH). It was recently fitted with an array of high-tech tools and software to enable real-time remote diagnosis and referrals on board the mobile health unit. The new technology includes a digital portable X-ray camera, artificial intelligence software, a teleradiology network to allow remote reading of X-rays using the trials flat-pack satellites, 4G and 5G routers, roaming SIM cards and smart antenna systems. The service aims to tackle a wide range of infectious and chronic diseases such as tuberculosis, Covid-19, Hepatitis B and C, HIV, cardiovascular issues, STIs and Flu.

The Liverpool 5G Create project used a private 5G network to deploy pressure ulcer management systems and urine monitoring systems in the community. This enables faster diagnosis for patients and increased efficiency for the sector.
In the US, the Austin Cancer Center has deployed a high-speed 5G network to quickly and reliably transport huge data files from PET scans (typically up to 1gigabyte of information per patient per study).

Jason Lindgren, CIO of the centre, said:

"To get that much data fromone side of the town to another, you've got to have the network performance to handle it. We used to have to send the files after hours. Now as soon as the patient leaves the scanner, the study is already on its way".

At the Samsung Medical Center in South Korea, typically tissue samples taken from patients during surgery are treated for analysis and sent back to pathologists in an adjacent room; this requires up to 20 minutes of walking back and forth, making it difficult for pathologists to conduct on-site group analyses. But the deployment of a 5G network, which offers ultra-high speeds and low latency, has enabled digital diagnostic pathology: doctors can now send 4 gigabyte frozen section biopsy images at an average speed of 1 gigabyte per second. Data can be easily and readily shared with colleagues in different departments and buildings, facilitating real-time feedback, more efficient working and faster diagnosis for critical patients.

The Chicago based Rush University Medical Center has taken a different approach, deploying sensors and ultra high definition cameras powered by 5G in patients’ hospital rooms to deliver “connected care”. The hospital can continuously monitor patients and, using AI, identify potential issues before they become emergencies — ensuring better patient outcomes. “We strongly believe 5G is a game-changing technology that when fully implemented will help us support better hospital operations as well as provide the highest quality patient and staff experience,” said Dr. Shafiq Rab, senior vice president and chief information officer, Rush University Medical Center and the Rush System for Health. 

5G-facilitated AI is likewise being used in the XiangNan University hospital in Hunan Province, China — quickly detecting and identifying pneumonic lesions, and providing quantitative assessment for diagnosis information. The system can pinpoint the disease in less than one minute, with a detection accuracy of 92 percent and a recall rate of 97 percent on test data sets. Such capabilities will play a vital role in assisting overstretched healthcare wards.  

The Emory healthcare innovation hub has found that 5G’s fast, unencumbered data access can support dynamic digital radiography, improving care for musculoskeletal conditions and abnormalities; combined with AI, this has increased physicians’ diagnostic capabilities.

Scott D. Boden, MD, vice president for business innovation for Emory, explains: “We’re working on a project with one of our partners related to dynamic digital radiography, where, instead of taking a single view in a flex position, we will have the ability to have a short, low-dose movie that shows how the body gets from position A to position B. We believe this has great potential to help us make diagnoses for parts of the body that have abnormalities, such as the spine or kneecap, or other musculoskeletal conditions that would allow us to make diagnoses that are very hard, if not impossible, to make today with conventional X-ray technology.”

WM5G, NHS Arden and GEM CSU, University Hospitals Coventry and Warwickshire, Satellite Applications Catapult and CorporateHealth International explored how a pill-sized camera, enabled by 5G, could be used to deliver a colon capsule endoscopy (CCE) at home under medical guidance. In addition to real-time transmission of the images captured, 5G can facilitate the use of a ‘virtual assistant’ to provide answers and guidance to the patient while clinicians can track and monitor the equipment throughout the process. It is anticipated that 5G will enable home testing, reducing waiting times and speeding up the process of identifying irregularities and any subsequent treatment. 
 

"Each year, over 2 million endoscopies are scheduled to take place through the NHS, but the level of demand combined with limited clinical capacity has resulted in a backlog. This has been exacerbated by COVID-19 as endoscopy rooms require additional cleaning between procedures, limiting the number of appointments that be handled in a day."

Said Ramesh Arasaradnam OBE, Senoir Gastroenterologist at University Hospitals Coventry.

He added: “Through the application of 5G technology, it is feasible that patients can swallow the capsule and undertake the whole process in the comfort of their own homes. Many of these procedures could potentially be undertaken each year, easing the burden on the NHS and reducing stress and uncertainty for patients”

The PillCam — licensed in the US — offers similar functionality, with the ability to film the inside of the gut all the way from top to bottom, allowing doctors to visualise parts of the bowel not possible with traditional endoscopies and colonoscopies. AI spots when the pill is at rest and slows down the frame rate, speeding it up again when it's in motion, making sure nothing is missed and extraneous data isn't being gathered. Thousands of images can be captured and AI also identifies the most important ones for the doctor to review. As with the WM5G trial, patients can be guided remotely and receive diagnoses from their home.

In the Liverpool 5G Create project, 5G and AI were used in a pressure ulcer management system, which automated the categorisation of pressure ulcers before high resolution images were sent to practitioners for diagnosis. This removes the need for doctors to visit patients in their home or a care facility, and speeds up the time it takes the doctor to diagnose. Ultimately, reducing pressure on the sector and facilitating quicker, more effective care for patients.
 

AI is also being used with 5G in the XiangNan University hospital in Hunan Province, China.  AI models can quickly detect and identify pneumonic lesions while providing quantitative assessment for diagnosis information (including the number, volume and proportion). The system can pinpoint the disease in less than one minute, with a detection accuracy of 92% and a recall rate of 97% on test data sets.  

The Liverpool 5G Health & Social Care project worked with CGA to create a social gaming application. Bringing people together, it offered online quizzing, games and chat groups. Such digital skills are important in a world that is becoming increasingly online. Importantly, the application was adapted following feedback from user groups including: individuals with varied learning difficulties attending the Kensington Community Centre; a residential home with users over the age of 60, many of whom suffer from dementia; and a supported living centre where users had a range of learning disabilities and varied in age from 30 to 80. This ensured it was suitable for use by a diverse range of users.

The application was a perfect test case for 5G technology as it needed the high bandwidth and low latency offered by 5G to drive the device-to-device video capability. 

Vodafone has partnered with Mencap to develop a Connected Living solution to help people with care and support needs to receive tailored and personalised support. It uses a range of intuitive and user-friendly IoT devices to make everyday activities easier. These devices are controlled by a bespoke application, helping the user to control their own environment with greater independence. 

In the 5G-enabled health ecosystem, patients will become less passive consumers of healthcare and more engaged participants in driving their own outcomes. Currently, the average patient in the US spends about 15 hours a year with a healthcare provider but has more than 5,000 waking hours to care for themselves. By ‘activating’ some of those 5,000 hours - that is, taking independent actions to manage their wellbeing, diagnostics and treatments - patients can improve their quality of life and medical outcomes and, at the same time, reduce overall costs in the healthcare system. According to PWC, one study found that an activated patient costs US$1,987 less annually than a less activated patient, a 31% difference.