The 5G prescription for curing global healthcare

In my previous post Making borderless remote healthcare a reality with 5G, I detailed a basic scenario where three telecom parties were working together to connect the two ends of a medical application. On the left we see the requesting party, where the actual patient is. It might have a dedicated healthcare application running on a local client, let’s say in Paris, France. The application server, being it a real application or a doctor providing a service, in our example is in Milan, Italy.

We wanted the set-up to be implementable even if the service providers were competing. As a result, we coined the term ‘untrusted service providers’ to define the specific set up where the lead, transit and last miles service providers would be part of different groups, and were not intended to  disclose connectivity to their orchestration application. For example, MEF Lifecycle service orchestration(LSO) would suggest with their interlude interface. That led us to design a set up where all the interactions among service providers were pre-negotiated. This enabled the speed we needed, and, most importantly, was strictly regulated via business agreements. These business agreements set the service level agreement (SLA): the expected service to be delivered, their price, and penalties that could be imposed for not meeting the agreement due to service degradation or interruption.

This setup was extremely important as it allowed us to filter in advance the medical services that could be provided between certain locations, and to automatically charge penalties if issues arose.

The guiding idea behind the project was the creation of a partnership between multiple countries and service providers. They could still be joined by a variety of connectivity technologies, despite a difference in local capabilities and maturity. For example, if there was 5G connectivity at the hospitals sites, but 3G at the remote service provider, this combination might have resulted in connectivity problems. However, the ‘untrusted service provider’ set up allowed us to mix 5G and fixed connectivity.

Figure 1- Showing the “untrusted service providers” setup providing the sufficient capabilities needed to support the SLAs of the service.

As we are talking about potentially life-threatening situations, the real time penalties (handled via blockchain), are meant to push service providers to give the highest possible service reliability. A connection drop for a few minutes might not be a big deal for a consumer, but during a remote surgery it could have major ramifications.

The operating support system (OSS) and business support system (BSS) are the technical enablers that will unleash the network power. We realized that due to the dynamicity of the design environment we had to use the capabilities of the stack, which the TMF had been recommending for years. This allowed us to achieve full automation from order entry to network slice instantiation in real time, and it also enabled real time billing and assurance. The end result was the OSS and BSS being as efficient as possible.

We used and combined the application provided by the vendors. We mainly  used TMF OpenAPI to connect the OSS and BSS application and ETSI and proprietary APIs for the network domains. In terms of the network domains, we tested  it using the latest release of Ericsson 5G Core network functions, and also NTT fixed network capabilities.

Figure 2: Displaying a simplified architecture of the stack used.

By utilizing Ericsson’s service orchestration platforms, Ericsson NFVO and NFVI, we were able to instantiate a network slice in a matter of minutes.  We interconnected the MEF proven principle so we could interconnect the various ‘legs.’ This allowed end-to-end connectivity between the two countries required for a point-to-point connection.

Using CENX, we could aggregate the real-time data provided by the service providers involved in the connectivity and do real-time assurance of the intercarrier customer service.

Using Ericsson Billing solution and  Charging solution  we were able to charge and bill for the service using data coming from a dedicated network slice instantiated for the short-lived service (e.g. the 12 hours that might be needed for a remote surgery), which could then be dismantled.

During the catalyst program we were able to both test and prove the technical feasibility of the desirable future of  healthcare applications. However, there are still two main limitations that need to be addressed to achieve the desired outcome :

• The intercarrier interfaces are not yet standardized enough to enable the kind of plug and play capability when a service provider would want to join an “alliance” of this type. The intercarrier interfaces are valid for every industry vertical so the standardization should come from the telecom bodies. The standardization of the medical interfaces at the application layer of the architecture are the domain of the medical vendor.
• The legal boundaries of this multi-country cooperation. Currently, each government has different rules for the medical services, and there aren’t any universal guidelines. For example, if the technology enabled a Japanese surgeon to operate on a patient in United Kingdom, in which country would responsibility lie? How do they validate that the surgeon can actually perform that action?

Our vision is a more interconnected world where telecom capabilities will significantly advance the medical sector. Medical cooperation will become stronger and faster. Ultimately, patients will reap the benefits through equal access to capabilities that today are often only available in the most privileged countries.

To learn more about the values of network slicing and how it can be applied, read our article on applied network slicing scenarios in 5G!