1、 Reference number ISO/TR 16056-1:2004(E) ISO 2004TECHNICAL REPORT ISO/TR 16056-1 First edition 2004-07-01 Health informatics Interoperability of telehealth systems and networks Part 1: Introduction and definitions Informatique de sant Interoprabilit des systmes et des rseaux de tlsant Partie 1: Intr
2、oduction et dfinitions ISO/TR 16056-1:2004(E) PDF disclaimer This PDF file may contain embedded typefaces. In accordance with Adobes licensing policy, this file may be printed or viewed but shall not be edited unless the typefaces which are embedded are licensed to and installed on the computer perf
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5、Secretariat at the address given below. ISO 2004 All rights reserved. Unless otherwise specified, no part of this publication may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying and microfilm, without permission in writing from either ISO at th
6、e address below or ISOs member body in the country of the requester. ISO copyright office Case postale 56 CH-1211 Geneva 20 Tel. + 41 22 749 01 11 Fax + 41 22 749 09 47 E-mail copyrightiso.org Web www.iso.org Published in Switzerland ii ISO 2004 All rights reservedISO TR 16056-1:2004(E) ISO 2004 All
7、 rights reserved iiiContents Page Foreword iv Introduction. v 1 Scope 1 2 Normative references. 1 3 Terms and definitions 2 4 Abbreviations . 11 5 Telehealth and telemedicine 12 6 Interoperability . 13 7 Conformity with standards and interoperability 14 Annex A.15 Bibliography17 ISO TR 16056-1:2004(
8、E) iv ISO 2004 All rights reservedForeword ISO (the International Organization for Standardization) is a worldwide federation of national standards bodies (ISO member bodies). The work of preparing International Standards is normally carried out through ISO technical committees. Each member body int
9、erested in a subject for which a technical committee has been established has the right to be represented on that committee. International organizations, governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely with the International Electrotechnic
10、al Commission (IEC) on all matters of electrotechnical standardization. International Standards are drafted in accordance with the rules given in the ISO/IEC Directives, Part 2. The main task of technical committees is to prepare International Standards. Draft International Standards adopted by the
11、technical committees are circulated to the member bodies for voting. Publication as an International Standard requires approval by at least 75 % of the member bodies casting a vote. In exceptional circumstances, when a technical committee has collected data of a different kind from that which is nor
12、mally published as an International Standard (“state of the art”, for example), it may decide by a simple majority vote of its participating members to publish a Technical Report. A Technical Report is entirely informative in nature and does not have to be reviewed until the data it provides are con
13、sidered to be no longer valid or useful. Attention is drawn to the possibility that some of the elements of this document may be the subject of patent rights. ISO shall not be held responsible for identifying any or all such patent rights. ISO/TR 16056-1 was prepared by Technical Committee ISO/TC 21
14、5, Health informatics. ISO/TR 16056 consists of the following parts, under the general title Health informatics Interoperability of telehealth systems and networks: Part 1: Introduction and definitions Part 2: Real-time systems ISO TR 16056-1:2004(E) ISO 2004 All rights reserved vINTRODUCTION Delive
15、ry of health care services by means of telehealth is advancing rapidly. Telehealth enables providing these services with the use of information and telecommunications technologies. This includes a broad spectrum of capabilities including acquisition, storage, presentation, and management of patient
16、information (represented in different digital forms such as video, audio, or data), and communication of this information between care facilities with the use of communications links. Telehealth interactions may be carried out in three ways: real-time, store-and-forward or with the use media streami
17、ng methods. While real-time interactions imply that all parties directly participate in the telehealth session, store-and-forward interactions involve sending, reviewing, and returning an opinion over a period of time. Streaming is a method of delivery real-time or stored data such as audio, video,
18、documents, still images, or other data type across networks with a reasonable amount of Quality of Services (QoS). With streaming, a receiving system can start displaying (or playing) the data before the entire content arrives. Real-time telehealth sessions usually involve synchronous data transmiss
19、ion while store-and-forward can usually be regarded as asynchronous. Streaming uses time-synchronized streams of continuous media during transmission. However, data presentation uses buffering, if the receiving system receives data more quickly than required. If the data is not received quickly enou
20、gh, the presentation of the data is interrupted. Interoperability of telehealth systems and networks is critical in ensuring the telehealth technology serves well the care recipients and providers and meets their expectations. While this requirement is essential to the long-term sustainability of te
21、lehealth, interoperability is difficult to achieve. There are many reasons that make telehealth interoperability difficult, however, the following three need urgent addressing: (1) too broad definition of telehealth, (2) lack of standards specifically designed for telehealth, and (3) collaboration b
22、etween the information technology and telecommunications industries. There are multiple definitions of telehealth. The services provided by telehealth cover a broad spectrum of activities ranging from videoconferencing through exchange of health information to providing care services in emergency an
23、d complex clinical cases. From a technology perspective, the scope of these services is too broad and this makes it difficult to develop telehealth standards and products. There is no official telehealth standard. The telehealth industry uses high-level health care guidelines and technical standards
24、 developed for various technology sectors including multimedia conferencing, information technology, data communications, and security. These guidelines and standards focus on functional and operational requirements and do not address interoperability. To further complicate the problem, all of these
25、 standards as well as the telehealth needs and practices are rapidly changing. Telehealth, more than any other recent development, bridges the boundaries between telecommunications and information technologies. The business goals and attitudes of these two industries are different. Telecommunication
26、s industry has a history of regulation, standardization, and control of the customer premises equipment. Interoperability and reliability have been the key factors to growth. The information technology industry (the desktop computing industry in particular) has achieved success through encouraging i
27、nnovation, diversity, and tremendous cost-efficiency not always paying attention to interoperability aspects of the technology. The marriage of these two cultures and the integration of their respective technologies proved to be challenging. To address the needs for interoperable telehealth systems
28、and networks, telehealth services must be clearly defined in terms of their scope and interrelationships with other health-related services, a set of telehealth-specific standards must be developed, and subsequently implemented by the respective industries. This two-part ISO Technical Report address
29、es interoperability issues in telehealth systems and networks. This document has been structured as follows: Part 1: Introduction and Definitions. Covers an introduction to telehealth and includes the definitions of telehealth, interoperability, and related terms. Part 2: Real-Time Systems. Defines
30、the scope of the technical standards related to real-time applications, (including video, audio, and data conferencing), identifies gaps and overlaps in the standards, defines requirements for interoperable telehealth systems and networks, and identifies building blocks for interoperable telehealth
31、solutions. ISO TR 16056-1:2004(E) ISO 2004 All rights reservedvi This Technical Report is to be complemented by two other documents that will cover interoperability of store-and- forward and media streaming telehealth applications. The target users of these documents are care providers and health ca
32、re organizations, telehealth equipment vendors and implementers of telehealth solutions, professional organizations, and governments. ISO TR 16056-1:2004(E) ISO 2004 All rights reserved 1 Health informatics Interoperab ility of telehealth systems and networks Part 1: Intr oduction and definitions 1
33、SCOPE This Technical Report entitled Interoperability of telehealth systems and networks - Part 1: Introduction and definitions includes a brief introduction to interoperability of telehealth systems and networks, along with definitions of telehealth and related terms. The scope of this document doe
34、s not include the conformity and interoperability tests or functional specifications for telehealth systems and networks. A more detailed description of issues concerning the interoperability of telehealth systems and networks capable of operating in real-time mode (including audio, video, and data
35、conferencing) is included in Part 2. Real-Time Systems. That document identifies standards for real-time telehealth systems, examines interoperability aspects of telehealth applications, and defines interoperability requirements for telehealth systems and networks. Other documents will describe the
36、issues surrounding interoperability of telehealth systems that use store-and-forward and media streaming technologies. An informative annex describing the Telehealth Technical Reference Architecture has been also been included to describe more clearly the various components of a telehealth system an
37、d the elements that need to be addressed in formulating a set of requirements for these various components. 2 NORMATIVE REFERENCES This Technical Report incorporates by dated or undated reference, provisions from other publications. These normative references are cited in the appropriate places in t
38、he text, and the publications are listed hereafter. For dated references, subsequent amendments and revisions of any of these publications apply to this ISO Technical Report only when incorporated in it by amendment and revision. For undated references, the latest edition of the referenced document
39、(including any amendments) applies. CEN/TC 251/N99-097 (1999) Health Informatics - Interoperability of Healthcare Multimedia Report Systems. Final draft CEN Report ISO/IEC 17000:2004 Conformity assessment Vocabulary and general principles ITU-T Recommendation G.711 (1988) Pulse code modulation (PCM)
40、 of voice frequencies. ITU-T Recommendation G.722 (1993) 7 KHz audio - coding within 64 kbit/s. ITU-T Recommendation G.728 (1992) Coding of speech at 16 kbit/s using low-delay code excited linear prediction. ITU-T Recommendation H.221 (1993) Frame structure for a 64 to 1920 kbit/s channel in audiovi
41、sual teleservices. ITU-T Recommendation H.230 (1997) Frame-synchronous control and indication signals for audiovisual systems. ITU-T Recommendation H.242 (1996) System for establishing communication between audiovisual terminals using digital channels up to 2 Mbit/s. ITU-T Recommendation H.243 (1997
42、) Procedures for establishing communication between three or more audiovisual terminals using digital channels up to 1920 kbit/s. ISO TR 16056-1:2004(E) ISO 2004 All rights reserved2 ITU-T Recommendation H.224 (1994) A real time control protocol for simplex applications using the H.221 LSD/HSD/HLP c
43、hannels. ITU-T Recommendation H.281 (1994) A far end camera control protocol for videoconferences using H.224. ITU-T Recommendation H.233 (1996) Confidentiality System for Audiovisual Services. ITU-T Recommendation H.234 (1996) Encryption key management and authentication system for audiovisual serv
44、ices. ITU-T Recommendation H.320 (1996) Narrow-band visual telephone systems and terminal equipment. ITU-T Recommendation T.120 (1996) Data protocols for multimedia conferencing. ITU-T Recommendation T.121 (1996) Generic application template. ITU-T Recommendation T.122 (1993) Multipoint communicatio
45、n service for audiographics and audiovisual conferencing service definition. ITU-T Recommendation T.123 (1994) Protocol stacks for audiographic and audiovisual teleconference applications. ITU-T Recommendation T.124 (1995) Generic conference control. ITU-T Recommendation T.125 (1994) Multipoint comm
46、unication service protocol specification. ITU-T Recommendation T.126 (1995) Multipoint still image and annotation protocol. ITU-T Recommendation T.127 (1995) Multipoint binary file transfer protocol. 3 TERMS AND DEFINITIONS For the purposes of this Technical Report, the following definitions apply.
47、3.1 accreditation third party attestation related to a conformity assessment body conveying formal demonstration of its competence to carry out specific conformity assessment tasks 3.2 A-law variant of the G.711 audio encoding used primarily in North America and Japan NOTE Related terms include -law
48、 and G.711 3.3 asynchronous transmission transmission of individual bytes without time-dependency between the bytes 3.4 audiographics terminal terminal that has audio and graphics capabilities, but no video capability ISO TR 16056-1:2004(E) ISO 2004 All rights reserved 33.5 audiovisual terminal term
49、inal that has audio, video, and graphics capabilities 3.6 basic rate interface BRI ISDN service comprising two B (bearer) channels operating at 64 Kbps each and one D (data) channel operating at 16 Kbps 3.7 call point-to-point multimedia communication between two H.32x endpoints 3.8 call setup process of establishing a group of communication users and includes the initialization of any shared application and other resources which the user may require to be available 3.9 call signalling channel reliable channel
