Remote healthcare without borders: Fighting epidemics with 5G

An award-winning TM Forum Catalyst proof of concept is using 5G and hybrid network capabilities to enable an instant ‘borderless’ response to epidemic outbreaks.

As recent history has shown, epidemic outbreaks still frequently happen even in well-developed countries. Bird flu, swine flu, Nipah, Ebola and more continue to have a global impact. Speaking in light of the latest outbreak of Ebola in the Democratic Republic of Congo, Michael Ryan, Emergencies Chief at the World Health Organization (WHO), recently warned that the world is entering "a new phase" where big outbreaks of deadly diseases like Ebola are a "new normal”.

The WHO is currently tracking 160 disease events worldwide -- nine of which are at the organization’s highest emergency level. To tackle these outbreaks and limit their spread and impact, swift, coordinated action is critical.

Connectivity is the key

A TM Forum Catalyst project called Skynet Phase II is showing how the telecom sector can enable this by supporting connectivity between hospitals. Key to this is tackling the challenge of how to enable multiple telecom providers technically from different geographical locations to seamlessly provide a set of end-to-end services. To complicate this further, this must incorporate mobile, fixed and hybrid networks that are made up of virtual and physical components.

Demonstrating the will in the telecom industry to make this happen, the Skynet team has 11 champions: BT, Chunghwa Telecom, Deutsche Telekom, Du, NTT Group, Orange, Verizon, Vodafone, Telenet Group, Telecom Italia and Telus. TM Forum Catalyst champions set out a business challenge, with each bringing a unique angle based on geography, strategy and more. They work alongside the Catalyst participants – in this case, Amartus, BearingPoint, Ericsson, EXFO, Infosys and RIFT.IO – to develop solutions to the specific challenge over three to six months. Each provides a different piece to the solution puzzle.

“We are trying to do something that is easily replicable among different countries, different geographies, different telecoms operators in order to build up a collaborative network that can work together to provide advanced eHealth services like remote surgery and video consultations across continents to support these critical use cases,” explains Marco Gatti, OSS/BSS Principle Consultant, Ericsson.

The team’s work builds on the previous phase of the Catalyst, Blade Runner, which focused on enabling a diverse ecosystem of partners to seamlessly provide a composite set of cloud services for the maintenance of remote industrial equipment and vehicles. The team is transferring and developing its initial findings from manufacturing to healthcare.

Orchestration on-demand

At TM Forum’s Digital Transformation World in Nice last month, the team demonstrated the Skynet technical setup, from the portal to the core network slices, including fulfilment, assurance and billing capabilities. Through the portal, hospitals can choose from a catalog of worldwide medical services including legacy services such as voice and video as well as more advanced offerings such as remote robotic surgery, advanced diagnostic/IoT sensors, and drone and disaster management – all made possible through 5G network slicing.

Skynet not only enables networking through 5G, but also takes into account end-to-end slices across hybrid networks including physical, virtual, mobile and fixed networks.

“This is very important,” says Frederic Desnoes Project Director, Orange, “because not all countries have the same infrastructure.”

This ‘every which way’ network means that telcos need to work together closely to enable hospitals in different regions, countries or continents to interact. And, since no one can predict when or where the next epidemic will strike, on-demand functionality is essential.

Further, the operators’ networks must ‘talk’ to one another to guarantee the end-to-end connectivity between the two customer endpoints (in this case, hospitals).

“This is where orchestration and the OSS/BSS roles really come into play because they need to make sure that the slices are activated on-demand on two different carriers, using different ways, using different agreements and different contracts,” Gatti explains. “That is quite complex.”

In Nice, the team demonstrated the ability to deliver a high-performing network reaching across two or more countries connecting the medical centers and enabling the required remote health procedure to take place.

The Catalyst team has now created a ‘blueprint’ for operators to work together and for new operators to join the ecosystem. This was demonstrated with four different operators on as many different continents (Vodafone in the UK; NTT in Japan; and Orange in France and the Ivory Coast) to show how this could work in a live setting.

Achievements

Catalysts are based on collaborative ‘sprints’ of three to six months. In a short space of time, the Skynet team has built a complete inter-carrier orchestration platform which enables hybrid network slices incorporating both physical and virtual 5G networks. It has also demonstrated an assured end-to-end service stretching across different operators in different continents (inter-carrier assurance). Further, the team showcased inter-carrier billing and charging based on blockchain to enable secure settlement across different operators. During this project, the Skynet team also highlighted the importance of business assurance, providing a set of common policies for closed-loop automation through assurance and orchestration systems. In recognition of this, the Catalyst won the Outstanding Catalyst Depicting Business Assurance Awareness award at Digital Transformation World.

Join in

Onboarding new carriers to the Skynet platform is crucial to its success. The Skynet solution is based on an open, flexible architecture and various industry standards. These included TM Forum Open APIs to enable communication between service providers as well as TM Forum’s Information Framework (SID), Business Process Framework (eTOM) and Application Framework (TAM) for a common language between the various standards. The functionalities within the architecture were defined using TM Forum’s Open Digital Architecture (a de facto standard for the design of open digital platforms) and the Business Process Framework. “This is important because in order to enable collaboration between the operators, we need to be able to cope with the industry standard that they choose to use,” Gatti says.

The business case

Ericsson predicts that healthcare will be a $76 billion revenue opportunity for operators by 2026. However, e-health is also a complex and critical area that goes beyond technical considerations, spilling into privacy and ethics, and Gatti notes that this is something telcos will need to acknowledge when moving into these new verticals. He urges operators to collaborate with healthcare providers to foster mutual understanding but also calls for more policy discussions at governmental level. The Skynet team has created a set of telco business models, highlighting four business scenarios for how operators could use and monetize the Skynet platform. “It's not exhaustive,” says Gatti. “But we think it should cover the majority of scenarios. We built something that can enable operators collaborate, even if they have a different business strategy. This is a collaborative, social initiative. We want to have more and more operators join us.” Watch this video filmed at Digital Transformation World 2019 to learn more: