Breakthrough in Telemedicine: 60fps Audio-Video Technology Enables Real-Time Medical Imaging Collaboration

With the accelerated development of internet connectivity and smart devices, the telemedicine industry is gaining unprecedented opportunities for growth.

China started relatively late in the field of telemedicine, only beginning exploratory research trials in the late 1980s. The rapid development and widespread application of true telemedicine infrastructure did not begin until the 21st century.

In early 2020, the sudden outbreak of the pandemic brought telemedicine to a broader general public, providing many people with the opportunity to recognize and utilize specialized telemedicine services. This accelerated the adoption of telemedicine and online consultations, while also reshaping people’s consumption concepts and habits.

Physicians can maintain communication with patients via telephone, email, and webcams. Meanwhile, they can also use these tools to collaborate with one another, enabling timely and comprehensive clinical decision-making.

Undoubtedly, the rapid development of telemedicine offers significant benefits to China. Impoverished regions in the country commonly face challenges such as lagging medical infrastructure, scarce medical resources, and a severe brain drain of healthcare professionals. Traditional health poverty alleviation measures have yielded diminishing returns in these areas. However, the “Internet Plus Telemedicine” model can break this deadlock by partially compensating for the shortage of medical resources in remote areas, promoting the downward allocation of healthcare resources, addressing the public’s difficulties and high costs in accessing medical care, and thereby achieving the goal of precise international poverty alleviation. Furthermore, it contributes to the further improvement and refinement of medical service levels in major cities, significantly fostering the development of the healthcare and medical industries.

However, all of this remains at the initial stage; true “telemedicine” is still in its infancy.

Technical Dilemmas of General Telemedicine Services.

Due to current technological limitations and the quality of audio-video transmission, telemedicine has yet to meet the requirements for real-time interaction and high-definition imagery. Telemedicine remains largely confined to video and telephone consultations, with many auxiliary diagnostic materials not immediately accessible. For instance, X-rays and CT scans cannot be adequately captured simply by pointing a camera at them. Although image sharing capabilities have been implemented, current telemedicine approaches are clearly insufficient for complex and rare conditions that require more robust real-time imaging support for clinical decision-making.

In telemedicine scenarios, diagnostic information such as audio and video must be exceptionally clear and accurate to meet clinical diagnostic requirements. Remote experts need to identify heart sounds, lung sounds, and murmurs in remote patients using digital stethoscopes; they also rely on voice and video interactions to observe in real time the patient’s skin color, as well as the size and shape of lesions. Currently, the transmission of large-sized imaging data over teleconsultation networks is severely challenged by frequent latency and packet loss. Furthermore, due to insufficient video frame rates and poor audio-video transmission speeds, highly clear medical images cannot be transmitted in real time. This makes it even more difficult for experts to engage in real-time image review and interactive communication with physicians at primary care hospitals. A significant limitation of telemedicine lies precisely in this inability to conduct further medical observation and judgment.

In recent years, the entire digital video ecosystem—spanning cameras, monitors, mobile devices, and the burgeoning field of game animation—appears to have comprehensively upgraded to frame rates of 60 frames per second (fps) or higher. The higher the video’s frame rate (measured in frames per second, or “fps”), the smoother the perceived motion. Moreover, the smoother the perceived motion, the more realistic the video appears.

However, setting aside the hardware sector, the vast majority of applications in the online video industry, which has evolved over several decades, remain stuck at 30 frames per second (fps) or even lower. It must be acknowledged that due to the persistence of vision in the human eye, which can only distinguish images at around 30 fps, this frame rate is indeed sufficient for most daily use cases, including certain telemedicine scenarios such as the diagnosis of common and straightforward conditions. However, for remote consultation and diagnosis of diseases affecting deeper anatomical structures, such as those involving the heart and cerebral vasculature, simple observation of external signs and patient interviews are far from adequate to support accurate remote diagnosis. Instead, real-time ultrasound examination of deep-seated structures is required as an adjunct. For instance, remote cardiac ultrasound examinations necessitate the clear visualization of heart valves, intracardiac structures, cardiac pulsations, and blood flow dynamics. Therefore, the refresh rate of the real-time ultrasound video transmitted remotely must reach 60 fps to meet the requirements for diagnostic accuracy.

So why has online audio technology remained stuck at 30 frames per second in recent years, failing to make a breakthrough? It is important to understand that even with rapid advances in network bandwidth and CPU processing power, achieving 60 frames per second is no small feat.

1. Efficient Memory Management and Compression. Once these frames reach the computer, they are sent to the video platform’s encoding pipeline, where they are loaded into memory, processed, and then flushed from memory. The processes of allocating memory, compressing frames, and releasing memory must be highly efficient to prevent frame loss.

2. Client and Server Processing Capabilities. High-frame-rate video transmitted over the network requires decoding on the client side and display on the screen. At 60 frames per second (fps), the client must operate with high efficiency to capture frames from the data stream and render them on the screen at a rate synchronized with the screen’s refresh rate. Compared to 30 fps, both ends of the communication link must encode and decode twice as many images per unit of time, posing greater challenges to computational performance.

3. Bandwidth Challenges. Achieving 60 fps technology requires approximately 1.5 times the bandwidth of 30 fps; for instance, the bitrate for 1080p@30fps is 2.5 Mbps, while that for 1080p@60fps is 3.75 Mbps.

Tangqiao Technology has developed industry-leading end-to-end 60fps technology based on its self-developed medical audio-video PaaS platform. This technology achieves the highest 60fps processing capability in the field across the entire workflow, from video capture and terminal codec processing to final screen display. It not only delivers exceptionally clear images but also attains the upper limit of smoothness perceptible to the human eye, ensuring fluidity and packet loss resistance during transmission, thereby providing the most authentic visual presentation for remote consultations.

This means that real-time synchronization of the most technically demanding and high-clarity imaging modalities, such as cardiac ultrasound, cranial ultrasound, and angiography, can now be integrated into telemedicine schedules, marking a major breakthrough for telemedicine!

Echocardiography enables direct, non-invasive assessment of cardiac structures, wall motion, valve morphology, blood flow, and cardiac function. However, it demands rigorous operational techniques, multi-planar and multi-angle scanning, and real-time dynamic imaging. The challenge is further compounded when encoding and transmitting data for synchronized remote consultations. Currently, no technical solution has fully resolved this issue, resulting in a lack of significant breakthroughs in remote echocardiography consultations. Tangqiao Technology’s medical audio-video PaaS platform supports multi-stream video encoding and multi-channel video display on unified terminals. With 60-frame-per-second technology, it facilitates comprehensive, multi-channel video presentation throughout the remote medical process, capturing everything from participants’ facial expressions to physicians’ operational techniques and real-time imaging. This helps overcome existing bottlenecks and enables seamless remote echocardiography consultations.

We believe that this technological breakthrough will enable telemedicine services to reach more patients, with even the minutest details captured and presented with utmost precision on camera, thereby facilitating more accurate diagnoses by physicians.