Dr ShiawHooi HoDivision of Gastroenterology & Hepatology

Department of MedicineUniversity of Malaya

Kuala Lumpur, Malaysia

~Leading and Caring~~Leading and Caring~

UNIVERSITI MALAYAUNIVERSITI MALAYAMEDICAL CENTREMEDICAL CENTRE

4th Asia Telemedicine Symposium18th Dec. 2010 at Seoul, Korea

ACKNOWLEDGEMENT

Assoc. Prof. Dr. Salem Omar

Mr. Yoo Sang Nge Information Technology Manager

HISTORYHISTORY

University of Malaya, Malaysia oldest

university, is situated on a 750 acre (309

hectare) campus in the southwest of Kuala

Lumpur, the capital of Malaysia.

Source: Google Maps

HISTORY (CONT)

The first Faculty of Medicine in Malaysia

was established in University of Malaya in

1963.

On August 1968, the spanking new

University Malaya Medical Centre (UMMC)

was officially opened.

DEPARTMENTS IN UMMCDEPARTMENTS IN UMMC• Medicine

• Obstetrics and Gynaecology

• Paediatrics

• Psychological Medicine

• Surgery

• Orthopaedic Surgery

• Primary Care Medicine

• Anaesthesiology

• Otorhinolaryngology

• Ophthalmology

• Sports Medicine

• Medical Physics

• Trauma and Emergency

• Forensic Pathology

• Medical Rehabilitation

• Bio-Medical Imaging

• Clinical Oncology

DEPARTMENT OF DEPARTMENT OF MEDICINEMEDICINE

• Dermatology Unit• Endocrinology Unit• Geriatric Unit• Gastroenterology &

Hepatology Unit• Haematology Unit• Cardiology Unit

• Neurology Unit• Nephrology Unit• Infections Disease Unit• Respiratory Unit• Rheumatology Unit

Collection of data on patients receiving treatment at

UMMC’s in-patient and the out-patient services.

OUTOUT--PATIENT SERVICESPATIENT SERVICES

Out-patient services: Specialist clinics Day-care centres Accident and emergency Primary Care Medicine Medical Rehabilitation.

In 2008, 880, 210 patients as compared with 2007, 750, 858 patients – an increase by 17.2%

Outpatient Chart Year 1997 To 2008Outpatient Chart Year 1997 To 2008

NUMBER OF OUTNUMBER OF OUT--PATIENT ACCORDING TO PATIENT ACCORDING TO CLINICAL DISCIPLINE CHART YEAR 2008 AND CLINICAL DISCIPLINE CHART YEAR 2008 AND

20072007

ININ--PATIENT SERVICESPATIENT SERVICES

The number of beds in 2008 are 846 at an occupancy rate of 80.04%

In 2008, 47,040 patients received in-patients treatment in 2008 compared to 51,814 patients in 2007 (declined by 9.12%)

ENDOSCOPY UNIT

Endoscopy Unit

4th. Floor

East Tower

ENTRANCE

WAITING AREA

GASTROSCOPY ROOM

COLONOSCOPY ROOM

ERCP ROOM

EUS ROOM

RECOVERY AREA

RESEARCH ROOM

CAPSULE ENDOSCOPY

NUMBER OF PATIENT UNDERWENT NUMBER OF PATIENT UNDERWENT

GASTROINTESTINAL ENDOSCOPY IN 2009GASTROINTESTINAL ENDOSCOPY IN 2009

Gastrointestinal Endoscopy No. of Patients

OGDS 3042

Colonoscopy 1229

ERCP 231

EUS 162

Others 408

Total 5072

PAST ANNUAL WORKSHOPS

ANNUAL LIVE ENDOSCOPY WORKSHOP , ANNUAL LIVE ENDOSCOPY WORKSHOP , GASTROENTEROLOGY UNIT, UMMCGASTROENTEROLOGY UNIT, UMMC

Amit Maydeo

Mumbai

Kulwinder S Dua

Milwaukee

Hirofumi Kawamoto

Okayama

Yasushi Sano

Kobe

Ichiro Yasuda

Gifu

Lee Yong-Chan

Seoul

Jerome D Waye

New York

International Faculties of Endoscopy 2009 2009

ENDOSCOPY 2009

SPECIAL LIVE TRANSMISSION ON NOTES(NATURAL ORIFICE TRANSENDOSCOPIC SURGERY)FROM ASIAN INSTITUTE OF GASTROENTEROLOGY, HYDERABAD, INDIA USING 6 ISDN LINES

Dr. DN Reddy Dr. GV Rao

2 live endoscopic workshop sites: UMMC & Selayang Hosp.

Linked with main conference hall via satellite network

APDW 2010

APAN 10TH AUGUST 2010

Event: 30th. APAN Endoscopic Teleconference Theme: “Endoscopic diagnosis: Up-to-date” Inaugural transmission from University Malaya

Medical Centre using MYREN 2 with 6 other participating countries:- Vietnam, Thailand, Hong Kong, Taiwan, Indonesia and Japan

X-RAY

ENDOSCOPE

LCDPROJECTOR

AUDIO PORT

VIDEO PORT

OPERATING THEATERCONFERENCE ROOM

UM

CAMPUS

NETWORK(100Mb/s –

10,000Mb/s)LCD

PROJECTOR

MYREN GATEWAY

AV mixer

MYREN & INTERNET

30Mb/s

FIRE WIRE

40

MYRENMALAYSIA RESEARCH & EDUCATION NETWORK

41UM-Myren running at 30Mb/sConnected to TEIN3Commissioned on August 2010

3030THTH APAN MALAYSIA RESPONDENTSAPAN MALAYSIA RESPONDENTS’REVIEWSREVIEWS

Respondent

Quality of Slides

Quality of Videos

Sound Quality

Contents Preparation of DVTS+

Handling of DVTS+

Problems in teleconference

Suggestion of Programs suitable for next conference

1 Good Very good Very poor Very good Slides-yellowish background, sound-

variable, unstable volume, shaky and choppy

DVTS + Quattro for 8 participating station, Yahoo

Messenger/MS Messenger/Skype for other

stations or Midfield system, for DVTS+ use a director )best an endoscopist) to control which video feed to place on main

screen

2 Very good Very good Poor Very good

3 Very good Very good Very poor Very good

4 Very good Very good Very poor Good The sound kept interrupting throughout-poor quality

5 Good Very good Good Very good Need to upgrade audio and visual quality for the best

performance in future

6 Good Very good Good

7 Good Poor Poor Very good

8 Very good Very poor Very good

9 Good Good Very poor Good Audios form Indonesia and Hanoi-poor

10 Good Poor Cwet good Poor sound quality

11 Good Very good Very poor Good Easy Easy

12 Very good Very poor Easy Easy Malaysia uses PAL system. I think maybe the DVTS+

can support the PAL system

13 Good Very poor Very good To enlarge the video need to do from the side

14 Very good Good Very poor Very good When all cameras were linked, the sound quality deteriorates significantly

CHALLENGES

Need for improvement in terms of technical issues based on the last APAN and other previous reviews

Setting up of a permanent telemedicine conferencing equipments (funding?) and site

Combined training of key technical personnels Need to increase awareness among local doctors

regarding the availability of such facilities and to encourage usage

THANK YOU