TeleMed

Tele-Med wants to satisfy a specific need of the health world, especially for military applications, for disadvantaged areas and islands and for the present epidemic situation that obliges to limit movements and contacts where there is an effective telematic alternative, i.e. virtual presence in surgery or, expressed in other terms, the "Hub - Spoke teleconsultation", aimed at planning of interventions and support during surgery by highly specialized HUBs towards the territorial Spoke where surgery is performed.

Both functions require HUB-SPOKE synchronization but the second requires synchronization to be highly reliable and in real time.

The system is highly effective because:
1. Provides secure and effective sharing of all necessary preliminary images to local processors (CT, MRI, fMRI, segmentation, tractography, etc.)
2. Performs the HUB-SPOKE exchange of the:
• views of 2D/3D anatomical model obtained by medical images(original CT, MRI, fMRI, DWI and elaborated Segmentations of tumors, arteries, gray matter, tractography, etc…);
• tracking of surgical instruments so that HUB is always aware of the situation at the Spoke during the surgery.

• surgical indications drawn on the neuronavigator
• situation images of the operating field (microscope, operating room situation)
• audio / video e-conference to communicate effectively

The system must guarantee a bidirectional flow of data, in fact simultaneously
- the HUB provides surgical indications by tracing on the CAD model which are automatically sent to the spoke;
- at the spoke the surgeon moves the surgical instruments to perform the surgery and their tracking must be sent immediately to the HUB that monitors and supports the surgery;
- both can manipulate the CAD model (changing the 2D / 3D point of view, zoom, opacity of the tissues….);