Project Mercury aims to establish and prove the commercial viability of a new satellite based communications service that will end the isolation of Mobile Breast Screening Units deployed across the UK as part of the National Health Services (NHS) breast cancer prevention and detection programme.
Objectives of the service
The Mercury project aims at developing, integrating, testing and demonstrating an effective and commercially viable managed service providing the end-to-end secure transmission of medical images through the use of multiple space asset (Satcom, Satnav) from remote mobile Breast Screening Units direct to Central Hospital image reading desks.
The ultimate objective of Project Mercury is to establish an incontrovertible business case for the adoption of a new managed service that can deliver full communications via satellite to mobile breast screening units in the UK.
Breast cancer comprises worldwide 22.9% of all cancers in women. In 2008, breast cancer caused 458,503 deaths worldwide. The likelihood of survival and recovery varies greatly depending on when the cancer stage is detected. Public authorities of some developed countries such as UK have therefore started investing in prevention and early detection of breast cancer, which helps to better define the most appropriate treatment and substantially improve the outcomes. The routine performance of non-invasive (X-Ray, MR imaging and sometimes ultrasounds) examinations (also called mammography) is sufficient for routine preventive check-ups and is able (sometimes with additional tests in case of cancer suspicion) to warrant excisional biopsy as the definitive diagnostic and curative method.
In the United Kingdom, around 180 mobile Breast Screening Units are deployed across the country for daily use, which goes along recommendations of the NHS (National Health Service) Breast Screening Programme established in 1987 to mitigate breast cancer progress. The introduction of a telemedicine service via satellite will greatly support and likely improve the effectiveness of such breast cancer screening campaigns, in particular by meeting the following needs:
- Reducing the risk of clinical data loss during their transfer between the imaging device and the reading desks of radiologists,
- Heading towards a paperless/paperlight working environment,
- Increase the number of scanned patient per day, in particular by reducing the number of no-shows.
Service/ system concept
The transmission via satellite of medical images (mammography data) will bring the following advantages:
- The ability to transfer clinical data from the mobile screening units, in particular when located in remote areas, as an alternative to the current approach of shipping physically hard disks.
- The ability to securely transfer a large volume of medical data (average of 4 images of 2 MB by patient, 50 to 60 patients per day per mobile unit, leading to 480 MB per day per unit).
- The potential improvement of campaigns effectiveness, in particular through the management and update of agendas of the mobile units (e.g. more screenings, less data losses, reduction of staffing costs per screened patient, reduction of the impact of no-show occurrences).
The MERCURY service can therefore be seen as a potentially attractive alternative to current practice for users
Space Added Value
Satcom: relying on physically transporting clinical data from diverse locations has become a source of increasing concern to governmental and medical practitioners for quite some time. The loss of data is both extremely costly and most embarrassing. In the mobile X-ray environment, it has long been the wish to be able to remove the risk to the client and organisation of physically transporting large amounts of data from one location to another and until recently there was no affordable solution. Therefore the use of satcom (Avanti Ka-band Internet services) is key for the success of the project.
Satnav data: GNSS data (date and location) will be indelibly embedded into the patient medical data. Such data can be useful for identification purposes, auditing, mobile units tracking, as well as statistical mapping of breast cancer using anonymous data.
The project will lead to a new service that will eliminate data security concerns, significantly reduce transfer times; speed up turnaround for clients; reduce on board downtime; increase staff efficiency; reduce the current DNA (Did Not Attend) rate and therefore reduce the cost of screening per woman.
The proposed solution will provide a simple (one-touch like) service to package and transmit the complete set of clinical data at the end of each scanning campaign day. The process for this solution will include pre-packaging of the images; indelible geo-tagging for date and location identification; secure transmission via satellite using VPN; unpackaging, auditing and allocation at the hospital end. The overall will occur overnight so that radiologists receive all the medical images before 09:00 on the day after the screening to start their interpretation.
Secure online access to the hospital intranet will also provide the means to manage the agendas online and support the transmission of the screening results back to the remote units.
Using an automatic self pointing satellite platform installed on the roof of breast screening units, the MERCURY software and infrastructure will enable the secure and auditable delivery of images to Central hospitals and the provision of full communications solutions to the mobile units. These will be individually tailored but may include WiFi, Voip, tele-conferencing and a managed image transfer service.
The key issues faced by the users in this environment are: Patient Data Security; speed of turnaround; cost pressures; capacity pressures; efficiency pressures; processing accuracy requirements; isolation of staff; inflexibility of current static applications and a requirement to move towards paperless systems.
MERCURY will propose an integrated solution able to tackle all the above in a secure and reliable way, which will greatly improve the user working conditions.
Following the Final Review Meeting held at ESTEC on 21st August 2014, the Mercury project was declared as successfully completed.
The demonstration phase of the Mercury project has been successfully completed and RedFoot are now collaborating with Avanti to produce a White Paper analysing the results of the 12-week trials. An extension of the contract has allowed RedFoot to improve the MERCURY service for users through the implementation of two additional functionalities: automated cross checking and satisfying Information Governance in neighbouring administrations.
Successful demonstrations of the Mercury Service have been completed across ten sites in England and further sites in Wales and Ireland. User satisfaction has been very high and some of the original sites have already contracted RedFoot for the provision of a commercial service while others are now beginning their migration towards operations under the commercial provision of MERCURY.
Interest from users not initially involved in the demonstration project is now accelerating.
Through the demonstration phase, nearly 250,000 breast screening images were transmitted by satellite without a single loss. RedFoot have successfully delivered live access to Work Lists; NBSS software and standard applications including internet and email. This has all been achieved for users who for twenty years or more have never experienced any connectivity at all.
The service has proven its capability to provide significant advances for the Breast Screening Service in the UK and beyond and it is already proving to be a vital link in the move towards paperless working in the Service.