Proceedings of the 11th International Conference on Applied Innovations in IT, (ICAIIT), March 2023

Extended Classification Model of Telemedicine Station

Roman Tsarov1, Iryna Tymchenko1, Vladyslav Kumysh, Kateryna Shulakova2,1 and Liliia Bodnar3
1State
University of Intelligent Technologies and Telecommunications, Kuznechna Str. 1, Odesa, Ukraine
2Anhalt University of Applied Sciences, Bernburger Str. 57, Köthen, Germany
3South Ukrainian National Pedagogical University, Staroportofrankyvska Str. 26, Odesa, Ukraine

[email protected], [email protected],[email protected], [email protected], [email protected]

Keywords: Telemedicine, Telemedicine Station, Telemedicine Network, Classification Model, Facet.

Abstract: In the paper the relevance of the scientific problem of creation and development of telemedicine networks
and telemedicine stations was proved by a systematic analysis of modern scientific research and regulatory
sources. The conducted analysis revealed that there is no unified and system approach in place helping to
solve this problem, especially on designing stage and during the technical implementation of these networks
and their points. It results in complete or partial incompatibility of existing designs, construction
documentation and blueprints as well, which leads to difficulties with various fragments of telemedicine
networks and impedes international cooperation in this field. In order to solve this problem the definition of
the telemedicine station is given, also its subsystems composition is defined, and an extended telemedicine
station classification model is developed in the paper. The proposed classification model is based on the
faceted classification method. It allows constructing classes by using any combination of characteristic
features of telemedicine stations, while omitting and not using some of the characteristic features. Within the
framework of this classification, the intersection of individual classes of telemedicine stations is allowed.
A mathematical description of the classification model in the form of a faceted formula is provided.

1 INTRODUCTION Turkey and Syria, the point of designing telemedicine

centres and networks is more relevant than ever.
The field of telemedicine development is relevant
The modern communications industry is
and largely researched, as evidenced by the large
characterized by the penetration of information and
number of works [1-9, 11-19]. Modern scientists pay
communication technologies (ICT) in all spheres of attention to such aspects as:
human activities. ICT tools have become a key of any  architecture and design of telemedicine
industry system. One of the urgent tasks of modern networks and stations;
society, is to increase the availability of medical  organization of the information component of
services, as well as their quality [1]. The solution to telemedicine;
this problem is the introduction of modern ICT into  telemedicine implementation and development
the health care system and the creation of strategies taking into account national
telemedicine networks on their basis. The main task peculiarities;
of the telemedicine network (TMN) is to solve the  implementation of information services and
problems of health care in providing access to systems for the organization of telemedicine
specialized and high-tech medical care to anyone, services.
regardless of their location and social status.
TMN allows organizing innovative interaction of In [2] an approach of creating the telemedicine
various healthcare institutions of different levels with infrastructure in South Sudan is proposed. The crore
specialized and multidisciplinary national-level of the mentioned approach points to the autonomous
healthcare centres using advanced ICT and the medical clinic on the basis of a transport module
intellectual potential of the industry's leading (container) called Clinic-In-ACan (CIAN), which is
specialists when providing skilled medical care to the ready for use in any location. In [3], the authors
population remotely. In regards to COVID 19 proposed the design and specification strategy for
pandemic outbreak, aggravation of local military using backbone optical communication lines as the
conflicts, war in Ukraine, powerful earthquakes in

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 Proceedings of the 11th International Conference on Applied Innovations in IT, (ICAIIT), March 2023

wired terrestrial telecommunication component of the  Incompatibility of designs used for different
telemedicine network. Though [4] proposes a fragments of the telemedicine network.
comprehensive approach to creating a network
In fact, it can be noted that research in
architecture for a nationwide telemedicine network
that connects all regional hospitals and medical telemedicine is not systematic - some tasks and
centres with the city hospitals and state hospitals. The problems are given considerable attention, while
approach considers the use of a web-based others, on the contrary, are little elaborated. All this
telemedicine system, which provides the basic has led to the fact that today mostly there are no
services for medical teleconsultations. It is obvious unified approaches and system solutions for
that for the modern telemedicine networks and developing and creating the technical projects and
centres, the key network service is video designs of telemedicine networks and stations.
conferencing. The peculiarities of organizing the Mostly to this moment telemedicine networks and
telemedicine system based on videoconferencing are stations were created separately, without coordination
investigated in [5]. The proposed structure is based on and planning for further integration with other similar
a service-oriented architecture, taking into account networks and stations. As a result a significant
the hierarchical relationships inherent in a medical number of the implemented projects are incompatible
organization. The authors of [6] investigate the use of with each other, which in turn affects the
cloud technologies and Grid-systems in the concept development of national telemedicine networks.
of telemedicine. Namely, they propose to use a As already mentioned, the construction of
computer network in a way of distributed sharing the telemedicine networks and stations is an urgent
Internet access to ensure the connection of remote scientific problem, but the lack of unified and
telemedicine stations in rural areas. In [7] the issue of systematic approach towards its solution has led to
creating a telemedicine network based on a significant confusion, starting even with the
distributed peer-to-peer structure with all terminology. This causes certain problems during the
telemedicine stations as peers is investigated.
creation and implementation of international projects
and initiatives in the field of telemedicine. For
example, the term telemedicine itself has more than
2 CURRENT STATE OF THE 100 different definitions [1, 8, 12-16].
PROBLEM AND PAPER GOAL The purpose of this work is to provide a basic
definition of the term telemedicine station as the
The analysis of studies has shown that the need to ground element of a telemedicine network and to
create and to develop the telemedicine networks and develop a classification model of telemedicine
telemedicine stations is undeniable, though there are stations. This classification model is called to become
a number of difficulties when implementing such a foundation in order to create standard, unified
projects, such as [1-8]: technical and design solutions for constructing the
 Lack of a unified regulatory framework telemedicine stations and networks.
governing the activities of telemedicine centers
and the procedure for providing telemedicine
services. This leads to inconsistency between 3 TELEMEDICINE STATION
the options for TMC construction and the
requirements in standards, the characteristics of CLASSIFICATION MODEL
protocols adopted in medical diagnostics and
MIS formats. In [11] it is stated that telemedicine station and
 Lack of unified approaches in development of telemedicine center are the basic objects of
technical designs when constructing and telemedicine network (Figure 1).
building TMNs. The requirements to TMN These two terms are fairly widely used. The term
may be formed by several participants – the telemedicine center is more formalized, although
medical institution, the regulatory organization different sources provide somewhat different
(ministry, health department), the project definitions for this term. For example, [14] defines
organization itself. It may cause the such concepts as a telemedicine consultation center
inconsistency and contradiction of these and a specialized telemedicine center, [12, 13] defines
requirements. the term telemedicine center, and [15] defines such a
concept as a telemedicine resource center. On the

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 Proceedings of the 11th International Conference on Applied Innovations in IT, (ICAIIT), March 2023

other hand, the term telemedicine station is not as media, transmission and provision of medical data
formalized: it is widely used in various studies [10, and background information on request.
17, 18], but there is no official definition of this term. TS medical devices subsystem includes a set of
With this in mind, the following definition of the term instruments, devices, accessories, equipment,
is proposed: materials and other products used for medical
Telemedicine station (TS) is an element of the purposes, whose functional purpose is not realized by
telemedicine network that enables the clinical tasks pharmacological, immunological, genetic or
handling, equipped with all the necessary facilities to metabolic effects on the human body. Medical
provide and deliver the telemedicine services at the devices can be used separately or in combination, as
station. well as together with other accessories necessary for
the intended use of these products, including special
software.
ТS Telecommunication subsystem of the TS is
ТС
ТS intended for connecting the medical devices (which
have network interfaces) to the TS telemedicine
ТС Internet
information subsystem, as well as connecting TS
ТS ТS
itself to telemedicine centers, specialized stationary
ТS
medical institutions or to external data transmission
Consumers of
telemedicine services network (e.g., Internet). Telecommunication
subsystem includes hardware and software, as well as
МТS
RТS communication lines.
Obviously, depending on the clinical tasks the
ТS Telemedicine station МТS Mobile telemedicine station
telemedicine station will perform, the services it will
ТС Telemedicine center RТS Remote telemedicine station provide, and on the external conditions - its
characteristics and structure of its subsystems may
Figure 1: A generalized diagram of telemedicine network vary. So, telemedicine stations can be classified in the
organization. space of their features, and in general, the entire set
of telemedicine stations can be described on the basis
It follows from the proposed definition that of a classification model. Obviously, in this case,
telemedicine station should contain the following there will be no rigid classification structure, because
subsystems, namely: the same telemedicine station may have functional
A) Basic subsystems: characteristics that correspond to different classes.
1) Telemedicine (information) subsystem. Moreover, a finite number of classes in the
2) Medical device subsystem. classification system cannot be clearly defined in
3) Telecommunications subsystem. advance since the new classes may appear in the
4) Power supply and electric lighting process of analyzing the characteristics of different
subsystem. TS. With that said, we propose to create the TS
B) Specialized subsystems: classification model based on faceted classification
1) Engineering subsystems (ventilation, technique [10].
water supply, sewerage, air conditioning, The faceted classification technique enables the
heating, etc.). creation of a classification system from many
2) Security subsystems (access control, video independent subsets – facets. Each facet  i contains
surveillance, emergency and fire warning, a number of values taken by this feature or criteria.
etc.). These values are mutually excluded.
3) Transportation subsystem. In general, the classification system can be
described by the following faceted formula
Telemedicine (information) TS subsystem
ClS  (1 , 2 ,..., n ) .
includes hardware and software for automation of
workflow and diagnosis, remote examinations, video Let’s consider some set of telemedicine stations -
consultations and videoconferences. Technically PT, over which the UPT set of stations’ features is
these achieved through the collection, input/output, defined:
digital processing, intelligent analysis, visualization, U PT  u PTi | i  1,...k  ,
classification, storage, archiving, transfer to various
here u PTi stand for the elements of UPT set.

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 Proceedings of the 11th International Conference on Applied Innovations in IT, (ICAIIT), March 2023

Then the facetted set ClS can be defined over the Table 1: Telemedicine station extended classification
U set as following: model.

ClS (U )  ClS k | k  1,...t , Facet

Faceted value
th
(feature/criteria)
here ClS k denotes the facet, which defines the k Type of Wired connection
classification feature of the telemedicine station. connection to Wireless connection
Each facet can take the defined set of possible TMN
Degree of Stationary
values: mobility Portable
ClSk  k1 ,...km  , Mobile
Type of Basic (only one type of
here m denotes the number of possible values of ith
telemedicine telemedicine service is provided)
facet. service provided Diagnostic (several types of
Each element of PТ set should contain at least one diagnostic telemedicine services
value of the faceted feature: are provided)
 j (uPTi )  ks (uPTp ), p  1,...k   ClSk .
Universal (any telemedicine
services provided)
The set containing all the facetted features can be Type of energy "Green" (station is powered using
and power supply the renewable sources e.g. solar
defined as following: energy)
 j (uPTi )  ks (uPTp ), p : p  1,...k  ,  j (u PTi )   . Hybrid (power supply designed
by the classic scheme, and the
The overall faceted formula Ff to classify the backup using the renewable
telemedicine station is following: sources)
Distance to the Local
[ClS j :  j (uPTi )] | ClS j  ClS (U ),  . central or regional ( Outlying
Ff (uPTi )    telemedicine hub

 j PTi
(u )   FSk
 j  {1,..., k },  j (u PTi )    6)
Type of placement Station of walking accessibility
In [18], the following criteria are proposed as (located in places of mass
classification features (facets): gathering of people e.g. airports,
business centers, etc.)
1) Type of communication TS (connection) with Establishment station (located on
the telemedicine network. the territory of some medical
2) Type of energy and power supply organization institution)
in TS. Separate station (separate
3) Type of provided telemedicine service in TS. institution with all the necessary
4) Distance to the central or regional nodes of the infrastructure)
telemedicine hub. Type of Open station
construction Cabin
5) Type of placement.
Cabinet
6) Type of construction. Subordination National
7) Type of ownership. level Oblast/Regional
8) Subordination level. Urban
9) Degree of mobility. District
Type of ownership State
Further research allows to supplement this list Municipal
with the following criteria, namely: Private
 Type of telemedicine services provision mode. Type of Station of provision of services in
 Type of access mode. telemedicine automatic mode (monitoring)
 Integrity level. services provision Station of provision of services on
mode demand
Taking into account additional classification Type of access Personal station
mode Stations of common use
criteria and, grounding on the basic classification
Integrity level Distributed station
model of telemedicine stations [18], the following Non-distributed station
extended classification model can be formed
(Table 1).
A clear interaction between all participants of the
TS design process can be achieved only if all parties
have the same understanding of TS characteristics,
which is impossible without the initial TS

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classification. After implementing the classification International Conference on Information

Communication and Embedded Systems (ICICES),
system the further success of the design stage depends 2013, pp. 780-784.
on the development of the unified approaches to [4] F. Lemma, M. Denko, and S. Kassegne, “Hierarchical
solving 2 interrelated tasks: Model Based LAN Architecture & VSAT-Based
 initial selection of the optimal option to WAN for a National Telemedicine Network in a
implement a given class of TS; Developing Country: Case of Ethiopia,” Addis Ababa,
Ethiopia: Addis Ababa University, 2011.
 subsequent standard design at all stages of the
[5] Y. Zhai and et al., “Design and application of a
technological process of building and telemedicine system jointly driven by
deploying TS infrastructure. videoconferencing and data exchange: practical
experience from Henan Province,” Telemedicine and
To determine the class of TP based on the e-Health, vol. 26, no. 1, pp. 87-98, 2020.
proposed model, it is necessary to get answers to [6] S. Saravanan, M. AnbuRajan, and A. Venkatraman,
some of questions regarding the structure of TP and “Cloud and Grid Computing Based Telemedicine
related factors. This process can be formalized in the Using Computer Communication Network through
Internet,” in Global Trends in Computing and
form of an algorithm, which is a further step of the Communication Systems: 4th International
research. Conference, ObCom 2011, Vellore, TN, India,
December 9-11, 2011, Proceedings, Part I, Springer
Berlin Heidelberg, 2012, pp. 434-446.
[7] S. Saravanan, M. Anbu Rajan, A. Venkatraman,
4 CONCLUSION N. Sriraam, and P. Thirusakthi Murugan,
“Telemedicine using computer communication
network,” International Journal of Computer Science
In this paper we define the telemedicine station term, and Communication, vol. 2, no. 2, pp. 623-631, 2011.
determine the composition of its subsystems, and [8] ITU-D Report on Question 6/2 Impact of
develop an telemedicine station extended telecommunications in health-care and other social
classification. The advantage of the given services First Study Period, 1995-1998.
classification model is the possibility of almost [9] R. Wootton, J. Craig, and V. Patterso, “Introduction to
unlimited addition of the number of telemedicine Telemedicine,” 2nd ed. London: The Royal Society of
Medicine Press Ltd, 2006, p. 206.
station features and the use of already created
[10] B. C. Vickery, “Faceted Classification: A Guide to
classifiers as facets, which allows adding new classes Construction and Use of Special Schemes,” Front
to the model and developing the model. The proposed Cover, Aslib, 1960, p. 70.
classification model allows one to determine the class [11] “Recommendations on the application of modern
of telemedicine station quickly, which will greatly technical solutions in the design of e-health systems,
including telemedicine networks,” [Online].
simplify the task of telemedicine station design and Available: https://www.itu.int/en/ITU-D/Regional-
will reduce the time-range required to develop the Presence/CIS/ Documents/RI-WTDC17/ONAT_RI2
necessary design documentation. Recommenda-tions_Rev2.pdf.
It is obvious that the proposed classification [12] D. Rudel, M. Fisk, and R. Roze, “Definitions of Terms
model is not exhaustive and can be further in Telehealth,” Slovenian Medical Informatics
Association (SIMIA), vol. 16, no. 1, p. 28, 2011.
supplemented and modified. Further research should
[13] L. Otto, L. Harst, P. Timpel, B. Wollschlaeger,
be aimed at obtaining standard design solutions for P. Richter, and H. Schlieter, “Defining and
constructing the telemedicine stations and networks delimitating telemedicine and related terms-an
in conditions of different types of input data. ontology-based classification”, Stud Health Technol
Inform, vol. 268, pp. 113-122, 2020.
[14] S. Mishra, L. Kapoor, and I. Singh, “Telemedicine in
India: current scenario and the future”, Telemedicine
REFERENCES and e-Health, vol. 15, no. 6, pp. 568-575, 2009.
[15] “Essential Telemedicine Terms Should Know”,
[1] World Health Organization, “Telemedicine: [Online]. Available: https://www.wheel.com/blog/
opportunities and developments in Member States: essential-teleme-dicine-terms-clinicians-should-know
report on the second global survey on eHealth,” 2010. [16] N. Sodhi, R. Weinstein, K. Stewart, and C. Doarn,
[Online]. Available: “Analysis of Telehealth Versus Telemedicine
https://apps.who.int/iris/handle/10665/44497. Terminology in the Telemedicine and e-Health
[2] G. Sworo, M. Kam, and E. Juan, “Design of a Between 2010 and 2020”, Telemedicine Journal and
Telemedicine-based system for Clinic-In-A-Can,” in E-health: the Official Journal of the American
IEEE Global Humanitarian Technology Conference, Telemedicine Association, Decaber 2022; vol. 28, no.
2012, pp. 265-270. 12, pp. 1861-1865, doi: 10.1089/tmj.2022.0073.
PMID: 35417253.
[3] M. Krishnan, D. Sheela, and C. Chellamuthu, “Design
and dimensioning strategies for telemedicine [17] “Komplekt prakticheskih dokumentov dlya okazaniya
backbone networks with optical links,” in pomoshi gosudarstvam-chlenam MSE v
proektirovanii i vnedrenii telemedicinskih punktov, v

41
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tom chisle na osnove vozobnovlyaemyh istochnikov

energii,” [Online]. Available:
https://www.itu.int/en/ITU-D/Regional-
Presence/CIS/Documents/ Publications.
[18] R. Tsaryov, I. Tymchenko, and V. Kumysh, “Basic
classification model of telemedicine station,” //
Kolektivna monografiya “Problemy ta perspektyvy
telemedytsyny v Ukraini,” Kyiv, Vyshcha shkola,
2014, pp. 20-34.

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