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TR 22.826 (SA1)
Study on Communication Services
for Critical Medical Applications

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V17.0.0 (Wzip)2019/09  61 p.

Rapporteur:  Mr. Lagrange, Mathieu

The present document focuses on 5G communication services targeting the critical medical applications and enabling wireless connectivity between those applications and medical devices.
Those communication services are often submitted to (but not limited to) very low latency, high reliability, and high availability requirements and may be operated on a shared network infrastructure that also provides resources to other less demanding communication services.
Hereunder is reproduced Section 4 "Overview":
The current average spending in the healthcare sector is around 10% of GDP worldwide, with a $7,200 billion market in 2105 according to the World Health Organization [12]. According to Goldman Sachs [13], $650 billion in savings can be expected by 2025 through a shift in focus from volume-based healthcare to value-based healthcare.
This means that the traditional value chain for the medical device industry, which historically has been driven by innovation and research and development, is currently witnessing a shift in the landscape. As governments and health insurers worldwide implement measures to control costs, public hospitals are operating on tighter budgets, while private facilities are receiving lower reimbursements. In the developed world, decisions that used to be the sole preserve of doctors are now also made by regulators, hospital administrators, and other non-clinicians. This broader set of influencers comes with different objectives, e.g. the prioritization of cost effectiveness or even just costs.
As an example, the US medical device industry has been working on traditional business models based on innovation where physicians have been the target audience willing to pay for products with incremental improvements. The efficacy and safety of the products have been the most important criteria for their commercial success. But lately, the shift to value-based healthcare has led medical devices companies to move to business models based on providing clinical value with cost efficiency.
Technological progress and better infrastructures, in particular high-quality wireless networks, have fed this business model transformation, allowing coordinated therapies, services, and health analytics and enabling efficient outcome measurement solutions. In addition, as depicted in [14], the healthcare industry has moved from the traditional paper-record keeping method to electronic or e-records that has bolstered the demand for wireless communications.
On this matter, 5G can have an important impact by enabling personalization of healthcare through wirelessly and continuously collecting patient's monitoring data for processing and centralized storage. In fact, this superior monitoring capability means that 5G can substantially improve the effectiveness of preventive care:
  • As 5G facilitates information collection, information transmission and big data analytics, this is one of the essential ingredient helping healthcare provision to change from a "volume-based" model in which providers of health care are compensated for quantity, not quality, to a "value-based" model in which compensation is linked to the value delivered.
  • Additionally, improvements in well-being and quality of life, which are not always captured in conventional economic measurements such as the GDP, play a key role in work force productivity.
Also, 5G enables shifting care location from hospitals to homes and others lower cost facilities which mechanically translates into additional savings. Additionally, another example showing that 5G can enable cost savings required by the medical industry can be found inside hospitals where wireless transmission of low latency data streams improves operating room planning, enable streamlining equipment usage and simplifies operating theater implementation.
Healthcare systems dictate the means by which people and institutions pay for and receive health services. Interactions between industry's players, driven by who actually pay for healthcare services through which mechanisms, depends on the model that is used. The picture below shows how telco's can integrate the medical ecosystem in case of the National Health Insurance Model (one of the most widely adopted worldwide):
In this technical report we specifically focus on critical medical applications, which is a generic term covering medical devices and applications involved in the delivery of care for patient's survival. In this context 5G can help healthcare providers that face revenue pressures both to adopt new and more efficient care delivery models and to shift to outpatient services in order to reduce administrative and supply costs.
Use cases generated as part of this study are categorized as follow:
  • Use cases covering the delivery of critical care in the context of a hospital or a medical facility where the medical team and the patients are collocated. Those use cases are captured in the "static - local" or "moving - local" sections of this document depending on whether devices or people are moving while the care is delivered. In these use cases, devices and people consume indoor communication services delivered by non-public networks.
  • Use cases covering the delivery of critical care where medical specialists and patients are located at different places. This, in particular, covers medical services delivered by first rescuers. Those use cases are captured in the "static-remote" and "moving-remote" sections of this document depending on whether devices or people are moving while the care is delivered. In these use cases, devices and people consume communication services delivered by PLMNs.

full Table of Contents for  TR 22.826  Word version:   17.0.0


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1  ScopeWord-p. 6
2  References
3  Definitions, symbols and abbreviationsWord-p. 7
4  OverviewWord-p. 10
5  Use casesWord-p. 11
5.1  Introduction
5.2  Static - Local
5.3  Static - RemoteWord-p. 28
5.4  Moving - LocalWord-p. 42
5.5  Moving - RemoteWord-p. 44
6  Security AspectsWord-p. 51
7  Consolidated potential requirementsWord-p. 53
8  Conclusion and recommendationsWord-p. 58
A  Security ConsiderationsWord-p. 59
B  Change historyWord-p. 61

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