The New Zealand government has made major investments in broadband initiatives. Despite its many rural and remote regions the broadband access is good, thanks, to a large extent, to the national digital microwave radio and fiber-optic transmission infrastructure, owned by state-owned company BCL.
Inside the Mobile Surgical Services bus is an operating theatre which has broadband connection and a telepresence video system that enables medical staff to perform surgery.
Surgeon Dr Stuart Gowland started the Mobile Surgical Services company to make sure that people living in remote and isolated areas of New Zealand received the medical care they needed. People who are ill or injured now have access to sophisticated technology and expert medical advice. The medical staff who work in the mobile surgical unit, a big blue bus, have the chance to develop professionally by working, via broadband, with experts in hospitals around the world.
Today, the Mobile Surgical Services bus visits about 20 communities. Gowland says the response has been extremely positive, both from people in the communities who benefit from the service and from the staff who work on the bus.
"The answer to health in little communities isn't pouring more money into them," Gowland says. "You've got to pour ideas in. The bus is like an icon of ideas so what you are really saying to a little town hospital when this thing pulls up is 'Guys, the cavalry is coming'."
The bus started rolling in 2003 and Gowland says the team today is busier then ever. The bus travels around with a minimal staff on a five-week cycle to small New Zealand communities. It is equipped with a broadband connection and a telepresence video system with cameras that zoom in and out and pan around the bus's operating room.
The bus plugs in to the hospital's docking point, which is connected by fibre-optic to a microwave dish on the roof of the building. The connection then goes via Ericsson solution MINI-LINK to the backbone network and then ultimately off to international gateways to link to other hospitals.
Interactive surgeons
The equipment allows regional medical workers to interact with surgeons and nurses at other hospitals. Healthcare professionals on the bus can share x-rays, compare information and even perform surgery with colleagues who are many kilometers away - sometimes in another country.
Gowland participated in a think tank in 1999 to discuss ways of improving healthcare and healthcare access in scattered New Zealand communities. The meeting closed with the thought, "You can have anything if you're prepared to share."
That's when Gowland got started on his Mobile Surgical Services company with its mobile surgical bus. Gowland's bus takes medical services and surgery to where it is needed without the heavy overhead of building a hospital.
The bus enables New Zealanders to have access to medical services without having to travel. It also benefits nurses and doctors in smaller centers who can upgrade their professional skills through long-distance contacts, which encourages them to remain in their home communities. The bus creates a win-win situation for everyone involved: patients, communities and medical staff.
Digital microwave chain
It cost NZD 2.5 million (USD 1.8 million) to build the 20 m bus, with its expandable 5x7m operating room, and about NZD 2 million more to equip it with healthcare technology, including anesthesia equipment, operating microscopes and ultrasound equipment. But the costs are nominal compared to building and maintaining hospitals throughout a sparsely populated country.
The bus also has a WI-FI network so staff on the bus can write up patient records and do patient pre-admission, for example, and synchronize it between hospital and bus where it appears electronically. Gowland says these simple hospital tasks become a little more complicated on the bus, but technology can still achieve them. "This communication system is the way of the future," he says.
New Zealand is a long, thin country with a digital microwave chain running up the center. Gowland explains: "We hang lateral links off that (microwave chain) to the hospitals and then it goes to the Sky Tower in Auckland, which is the international gateway to our global communications."
He says understanding the politics and culture of his medical service is far more difficult than the technology. "You have got to be persistent and you've got to beaver away and be pretty thick skinned because you've got people saying you're a 'nutter' right from the start."
He says that no matter how much technology there is, success lies in changing the culture of the people so they will accept it. "Unless you do, you won't get anywhere."
Ericsson has supplied New Zealand's BCL communications company with Microwave transmission solution MINI-LINK for a number of years. Ericsson is also overlaying BCL's existing network with its next generation IP core network. Mobile Surgical Services was the first BCL customer to benefit from the high-speed multi-service network provided by Ericsson.
Cari Simmons/Kendal von Sydow
