5G Remote Surgery and Telehealth Solutions

One of the most controversial 5G use cases is the remote surgery. In this post I want to quickly look at the history and what is possible. Before I go to that, here is a short summary video that I am embedding upfront.



As far as I can recall, Ericsson was the first vendor that started talking about remote surgery. This is a tweet from back in 2017.

With #5G and the tactile internet, doctors can perform remote
surgery on a patient anywhere in the world. https://t.co/U81bayv3ws pic.twitter.com/pSXFg1NCJX

— Ericsson (@ericsson) August 28, 2017

Huawei didn't want to be far behind so they did one at MWC Shanghai in 2018. Their tweet with video is embedded below.

Meet the Remote Surgery Robot. At #MWCS18, Huawei stiches together a vivid picture of how #5G’s reliable connection can save lives: https://t.co/cobykl1KKP #WirelessXLabs pic.twitter.com/Pbme8BmcoT

— Huawei (@Huawei) June 28, 2018

In January 2019, South China Morning Post (SCMP) showed a video of a remote surgery on an animal. While the video and the article didn't provide many details, I am assuming this was done by Huawei as detailed here. The video of the surgery below.



This was followed by Mobile World Congress 2019 demo where a doctor used 5G to direct surgery live from a stage at MWC to Hospital Clinic Barcelona over 3 miles away. The team of doctors was removing a cancerous tumor from a patient's colon. This video from that is embedded below.



Vodafone New Zealand had a silly remote surgery of a dog video but looks like they have removed it.  Nothing can beat this Telecom Italia ad embedded below.



There are some realistic use cases. One of them being that with 5G the number of cables / wires in a hospital can be reduced saving on the disinfection.

NTT Docomo showcased 5G Mobile SCOT (Smart Cyber Operating Theater) which is an Innovative solution to enable advanced medical treatment in diverse environments. You can read more details here.

There are lots of other things going on. Here is a short list:

• April 2020: Because of Coronavirus COVID-19, NT Times has an article on Telemedicine Arrives in the U.K.: ‘10 Years of Change in One Week’ - even though this does not involve 5G, it just shows that we are moving in that direction.
• February 2020: 5G-aided remote CT scans used to diagnose COVID-19 patients in China (link)
• February 2020: Verizon teamed with Emory Healthcare to test new 5G use cases for the medical industry at the latter’s Innovation Hub in Atlanta, in a bid to discover how the technology can be used to improve patient care. The collaboration will explore applications including connected ambulances; remote physical therapy; medical imaging; and use of AR and VR for training. (link)
• February 2020: Vodafone 5G Healthcare – Conference & Experience Day (link)
• November 2019: TIM enables first live remote-surgery consultation using 5G immersive reality (link)
• October 2019: Along with a hospital in Malaga, Telefónica has presented what it claims is the first expert assistance system for medical interventions that runs on 5G. (link and video)
• September 2019: Mobile Future Forward 2019 - World's First Remote VR Surgery Demo conducted on Sept 4th, 2019 in Seattle by Chetan Sharma, James Youngquist, Evie Powell, Nissim Hadar, David Colmenares, and Gabe Jones. (link)

Finally, a nice video on Benefits of 5G for Healthcare Technology by T-Mobile



Related Posts:

• The 3G4G Blog: NTT Docomo's Vision on 5G Evolution and 6G
• The 3G4G Blog: 5G eXtended Reality (5G-XR) in 5G System (5GS)
• The 3G4G Blog: Real-life 5G Use Cases for Verticals from China
• The 3G4G Blog: 5G Private and Non-Public Network (NPN)
• The 3G4G Blog: 5G and Industry 4.0
• The 3G4G Blog: Spectrum for 5G NR beyond 52.6 GHz

How the A6 Measurement Event triggers Secondary Cell Change in LTE Carrier Aggregation Calls

Last week I read in Martin Sauter's blog about the LTE RRC A6 measurement event.

Although I am quite interested in RRC measurements I have never seen the A6 event in action. Rather the eNB vendors have implemented carrier aggregation in a way that the UE provides its capabilities and according to the this the maximum possible numbers of component carriers is added to the connection. There is no RRC measurement report before adding secondary LTE cells to the connection. So what is the A6 event good for and is it used at all?

Surprisingly I needed only 2 attempts to find an example of using the A6 event in a live network configuration. It is used when more component carriers are available than the UE can simultaneously handle. E.g. if there are 4 or more cells with different carrier frequencies available in the same antenna sector the A6 event ensures after the initial CA configuration that the cells with the best radio conditions are selected as secondary cells.

Let's have a look at this scenario in detail. Figure 1 shows the report configuration for the A6 event. Keep the reportConfigId = 3 in mind.

Figure 1: Report Configuration for Event A6

The next step is the configuration of the Measurement ID as shown in figure 2. Here the reportConfigId is combined with a measObjectId that represents the carrier frequency of the potential SCell.

Figure 2: Measurement ID for Event A6

Now, if the event A6 is triggered in the UE a RRC Measurement Report with this measId = 3 is sent to the eNB as shown in Figure 3.

Figure 3: RRC Measurement Report for Event A6

There we see the RSRP and RSRQ of the primary cell (PCell) and of the currently serving secondary cells (SCells). By the way the servFreqId stands for the sCellIndex value that was linked to the physical cell ID (PCI) when this SCell was added in a previous RRC Connection Reconfiguration procedure. 

And as one can see the neighbor cell with PCI = 470 has significantly better RSRP and RSRQ to offer than both currently used SCell. 

Consequently the eNB decides to replace the SCell with sCellIndex value 1 with the better cell (PCI 470). This is again done with a RRC Connection Reconfiguration procedure as shown in figure 4. And this is the way how the A6 event is used.

Figure 4: Change of SCell

  

Virve 2.0 - Finland's 4G/5G Public Safety Network

State Security Networks Group Finland (Erillisverkot) safeguards the Finnish society by offering authorities and critical operators engaged in critical infrastructure and services secure and reliable ICT services. Much like in the civilian world, communication between authorities includes transferring images and video material to an increasing degree, which results in ever-growing data transfer volumes and, subsequently, new kinds of demands for all communication networks. 

Virve is a means of ensuring communication and cooperation between authorities and other partners across organisational borders into the future. It also entails the introduction of a higher service standard, as the transfer to broadband, estimated to take place in 2022, will make it possible to transfer video material, images and data. This will mean that it will be possible to send video material in a reliable and secure way in the case of accidents, for example. The radio network Virve, based on Tetra technology, will reach the end of its lifecycle by the end of the 2020s. The current Virve network will be used simultaneously with the new Virve 2.0 network until, at least, 2025.

Erillisverkot will acquire the broadband Virve 2.0 radio access network as a service from Elisa and the core systems from Ericsson. Separate networks will ensure the continuity of critical communications and operational capability of public safety in all situations in the future.

I would assume this would be MOCN, similar to the UK deployment of ESN networks as shown here.

Virve 2.0 subcribers will use Elisa’s public radio network, which the operator is expanding to become Finland’s largest data and voice network.

About 80 million messages pass through the Virve system every week. Elisa is committed to increasing the coverage, capacity and verification of its mobile network to meet the requirements of Virve 2.0.

The new online services will provide support for critical communication between public authorities and other parties.

The addition of image, video, and other wireless broadband services alongside existing Virve services will enable a better and more up-to-date view of the day-to-day operations of authorities and other actors.

The IoT enables automatic monitoring of rescue personnel and mobile use of surveillance cameras and drones.

The Virve 2.0 radio network service will be in use from 2021 and will include the 4G and 5G technologies and the internet of things. The contract is for ten years.

Finally, a recent advert of Elisa explaining 5G to outside world



Further Study:

• Erillisverkot: Obstacles for MCX Broadband and how to overcome them [PDF]
• Erillisverkot: Virve Broadband Plans for the Future - Critical Communications Europe 2019 [PDF]
• 5G-XCast Whitepaper: Rapidly Deployable Network System for Critical Communications in Remote Locations [PDF]
• Erillisverkot: White paper - Virve 2.0 RFI Summary of responses [PDF]
• Erillisverkot: Factsheet - What is Virve 2.0? [PDF]

Related Posts:

• Operator Watch Blog: Elisa claims "first in world to launch commercial 5G" - technical details and controversy
• The 3G4G Blog - Finland: A country with only Unlimited Data Plans
• The 3G4G Blog: 3GPP Release-16, Release-17 & Beyond...
• The 3G4G Blog: Update from 3GPP on LTE & 5G Mission Critical Communications
• The 3G4G Blog: Update on UK's Emergency Services Network (ESN) from #BAPCO2019
• The 3G4G Blog: A practical use of MOCN in ESN
• Telecoms Infrastructure Blog: Meshing for BYOC (Bring Your Own Coverage)

The Futuristic Concept of 'Smart & Intelligent' Batteries

I did a presentation back in 2013 on the concept of smart batteries. Even though there has been a lot of progress in wireless charging since back then, it hasn't reached even close to the vision that I have. As a result, I converted it into a video to start a discussion on if and when this would be possible. The slides and video are embedded below and I welcome any discussion in comments below.

Misc: The Futuristic Concept of ‘Smart & Intelligent’ Batteries from 3G4G

Comparing S1AP and NGAP UE Context Release

As an addition to my blog post about the 5G RAN Release procedure I would like to have an in-depth view at the details of NGAP UE Context Release Complete message.

Indeed, the S1AP (known from E-UTRAN) and the NGAP are very similar protocols and when reading the 3GPP specs it is obvious that many message names are identical and the procedures fulfill the same purpose when looking at call scenarios.

However, the difference is visible in the details as one can see when looking at the figure below.

While the S1AP UE Context Release Complete message does not contain any additional information we find in the NGAP UE Context Release Complete the identity of the last serving 5G cell, represented by the NR-CGI, the last visited Tracking Area Identity (TAI) and a list with the IDs of the PDU sessions (E-RABs) that have been terminated when the UE context was released.

This additional information in very valuable for network troubleshooting, since in LTE (S1AP) only the ID (ECGI) of the initial serving cell or a new serving cell ID at inter-node handover was signaled. And if you wanted to know how many E-RABs have been terminated with a S1AP UE Context Release procedure it was necessary to look back into the full sequence of call-related S1AP messages starting with the messages for Initial Context Setup.

All in all, with 5G NGAP trace analysis and the life of RAN engineers becomes easier. Thank you, 3GPP! 

Comparision of S1AP and NGAP UE Context Release Complete Messages

A Look into 5G Virtual/Open RAN - Part 3: Connection Release and Suspend

The 3rd post of this series introduces the details of connection release in the 5G RAN.

Indeed, we find most of the release causes known from E-UTRAN in the 5G specs and it is clear that all protocols that have been involved in the connection setup need to be perform a release procedure at the end of the connection.

However, again the split into different virtual functions brings the demand for some addition messages.

This is illustrated in figure 1 for the a release due to "user inactivity", which means: the gNB-CU UP detected that for a define time (typical settings for the user inactivity timer are expected to be between 10 and 20 seconds) no downlink payload packets have been arrived from the UPF to be transmitted.

So the gNB-CU UP sends an E1AP Bearer Context Inactivity Notification message to the gNB-CU CP that triggers the release procedures on NGAP, F1AP, RRC and E1AP. The RRC Releases message is transported over the F1 interface to the gNB-DU where is forwarded across the radio interface to the UE.

Figure 1: Connection Release due to "user inacativity"

An alternative to the connection release is the RRC Suspend procedure shown in figure 2. Here the UE is ordered to switch to the RRC Inactive state, which allows a very quick resume of the RRC connection when necessary.

Figure 2: RRC Connection Suspend

In case of suspending the RRC connection the RRC Release message contains a set of suspend configuration parameters. The probably most important one is the I-RNTI, the (RRC) Inactive Radio Network Temporary Identity.

If the RRC connection is suspended, F1AP and E1AP Contexts are released, but the NGAP UE Context remains active. Just NGAP RRC Inactivity Transition Report is sent to the AMF.

Related Posts:

• A Look into 5G Virtual/Open RAN - Part 4: Intra-gNB DU Handover
• 3G4G: Open RAN, OpenRAN and O-RAN

A Look at the same RRC Message in LTE and 5G Stand-alone Call Scenarios

Some weeks ago the differences in 4G LTE RRC (3GPP 36.331) and 5G NR RRC (3GPP 38.331) and how both protocols interact in EN-DC call scenarios have been discussed in another blog post.

Now I would like to share a visual comparison of the RRC (Connection) Setup Complete message as it is seen in LTE (including EN-DC) and 5G stand-alone (SA) radio connections.

From the figure below one can see that although this message fulfills the same purpose in both radio access technologies its particular contents may look quite differently.

Different variants of RRC (Connection) Setup Complete message in LTE and 5G stand-alone call scenarios

SCF Releases 5G Functional API to Enable Open Small Cells Ecosystem

The Small Cell Forum (SCF) announced the publication of documents focused on stimulating a competitive ecosystem for vendors of 5G-era small cell hardware, software and equipment. The expanded set of specifications contained in these documents are:

• SCF222 - 5G FAPI: PHY API Specification
• SCF223 - 5G FAPI: RF and Digital Frontend Control API
• SCF224 - 5G FAPI: Network Monitor Mode API

According to the press release:

Expanding upon the 5G Physical Layer API specification, published in July 2019, the new specifications enable small cells to be constructed piece-by-piece using components from different vendors, in order to address the diverse mixture of 5G use cases relatively easily, a common goal to all of the specifications made by Small Cell Forum.

The new release also includes two completely new specifications, SCF223: 5G NR FAPI P19 FrontEnd Interface Specification and SCF224: Network Monitor Mode API for Small Cells.

According to Dr. Prabhakar Chitrapu, Chair of SCF, “FAPI helps Equipment Vendors to mix PHY & MAC Software from different suppliers via this open FAPI interface. So, FAPI is an 'internal' interface.”

“5G-nFAPI (network FAPI) is a 'network' interface and is between a Distributed Unit and Centralised Unit  of a Split RAN/Small Cell network solution. An open specification of this interface (nFAPI) will help network architects by allowing them to mix distributed and central units from different vendors.”

SCF nFAPI is enabling Open RAN ecosystem in its own way by allowing any small cell CU/DU (S-CU / S-DU) to connect to any small cell radio unit (S-RU)

Here is a video playlist from SCF that explains the new API's



Related Posts:

• Telecoms Infrastructure Blog: Small Cell Forum Releases 5G FAPI API Specifications
• The 3G4G Blog: A quick tutorial on Open RAN, vRAN & White Box RAN
• Telecoms Infrastructure Blog: SuperMicro's 5G Pole-Mounted DU Server Solution

Mobility Analysis: Austrians Stay at Home

The Austrian company Invenium Data Insights GmbH has partnered with the mobile network operator A1 to analyze and visualize subscriber mobility pattern on a public dashboard to illustrate the impact of the severe restrictions on people’s mobility (and its expected reversal) due to the COVID-19 pandemic.

Screenshot of the public dashboard (click picture to enlarge)

In a side note (in the screenshot highlighted in yellow) and in their blog the partners guarantee that the underlying data is fully anonymous and not derived from customer data. This was certified by TüV, an independent Technical Inspection Association.

Although I have no insight into this particular project I assume that the underlying raw data is provided by eNBs using the 3GPP-defined maximum detail level cell trace according to 3GPP 32.423.

This means that the trace collection entity gets the full ASN.1 contents of all RRC, S1AP and X2AP messages, but NAS messages - if provided at all - are encrypted. Also the eNB has not insight into any user plane applications since it has no means to decode the IP payload. This guarantees that neither IMSI, IMEI, web addresses nor phone numbers are found in the raw data.

The key for a meaningful mobility analysis using this data might be the fact that the S-TMSI value in E-UTRAN rarely changes and due to user inactivity settings each subscriber generates multiple RRC connections per hour. Within these RRC connections we find RRC Measurement Reports and typically also some vendor-specific events providing other important radio parameters from the radio interface lower layers including uplink radio quality measurements like PUSCH SINR.

By looking at multiple RRC connections of the same S-TMSI and the reported air interface measurements it is possible to determine if the subscriber remains at the same place or moves around. It it also possible to determine if a subscriber is located indoor or outdoor.

The trace collection entity writes the analysis results into a comprehensive data set that can be used to mask and scramble even S-TMSI values for additional data privacy. The raw data is deleted.

At the end this methodology allows a highly reliable mobility analysis while simultaneously protecting the data privacy of subscribers. The key difference in comparison to statistics based on crowd-sourced data as published e.g. by umlaut is the fact that the 3GPP cell trace provides data for all RRC connections in the network while crowd-sourced data collection requires the installation of certain apps (in case of umlaut only Android apps are supported) and the subscriber's confirmation to collect the data.

However, it must be mentioned that the 3GPP cell trace cannot be used as a data source for the widely discussed Corona contact tracking apps that allow to identify subscribers that have been in close proximity with someone who has been tested positive for COVID-19. For this purpose cell trace data lacks the necessary accuracy to determine the subscriber's and its neighbor's positions.

Spectrum for 5G NR beyond 52.6 GHz

3GPP TR 38.807: Study on requirements for NR beyond 52.6 GHz has recently been revised with all the new information post WRC-19. There is a section that details potential use cases for this new spectrum.

New spectrum above 52.6 GHz – Potential use cases and deployment scenarios from a presentation by Kari Pajukoski, Oskari Tervo and Jari Hulkkonen, Nokia at the #6GSummit https://t.co/BqYPK7xpcz #Free5GTraining pic.twitter.com/6gqz0jCL3A

— 5G Training (@5Gtraining) January 16, 2020

Quoting from the specs:

The relatively underutilized millimeter-wave (mmWave) spectrum offers excellent opportunities to provide high speed data rate, low latency, and high capacity due to the enormous amount of available contiguous bandwidth. However, operation on bands in frequencies above 52.6GHz will be limited by the performance of devices, for example, poor power amplifier (PA) efficiency and larger phase noise impairment, the increased front-end insertion loss together with the low noise amplifier (LNA) and analog-to-digital converter (ADC) noise. In addition, bands in frequencies above 52.6GHz have high propagation and penetration losses challenge. Even so, various use cases are envisioned for NR operating in frequencies between 52.6GHz and 114.25GHz. Some of the use cases are illustrated in Figure 5.1-1 and following section provide detailed description of the uses cases. It should be noted that there is not a 1-to-1 mapping of use cases and wireless interfaces, e.g. Uu, slidelink, etc. Various wireless interfaces could be applicable to various uses cases described.

• High data rate eMBB
• Mobile data offloading
• Short-range high-data rate D2D communications
• Vertical industry factory application
• Broadband distribution network
• Integrated access backhaul (IAB)
• Factory automation/Industrial IoT (IIoT)
• Augmented reality/virtual reality headsets and other high-end wearables
• Intelligent Transport Systems (ITS) and V2X
• Data Center Inter-rack Connectivity
• Smart grid automation
• Radar/Positioning
• Private Networks
• Critical medical communication

There is quite detailed information for each use case in the document that I am not detailing here.

Getting ready for our 5G training next week - https://t.co/6YXW3YlDvD - this picture summarises the 5G mmWave frequency proposals pre #WRC15, approved for study at WRC-15 and available for IMT post #WRC19#3G4G5G #CWTechTrain #5G #Spectrum #5GTraining @cambwireless @UK_5G pic.twitter.com/KoWEpD89Pz

— 3G4G (@3g4gUK) March 3, 2020

It also details information on the allocation within the frequency range 52.6 GHz to 116 GHz in ITU Radio Regulation (see table below). The column with comments contains (a subset of) information on protection requirements for incumbent services. For the full details please refer to the Radio Regulations.

Quoting from the specs:

Within the range 52.6 to 116 GHz, the frequency bands 66-76 GHz (including 66-71 and 71-76 GHz) and 81-86 GHz are being studied under WRC-19 Agenda Item 1.13 for potential IMT identification. Results of sharing and compatibility studies, potential technical and regulatory conditions are included in Draft CPM Report, and the final decisions are to be made in WRC-19 with respect to IMT identification or no IMT identification, along with the corresponding technical and regulatory conditions.

For 66-71 GHz, Studies were carried out for the ISS, MSS (Earth-to-space) indicating that sharing is feasible, with a need for separation distance in the order of few kilometers for the case of MSS (space-to-Earth). The need for studies addressing interference from IMT towards RNS is still under debate. Thus, final conclusions in the regulatory and technical conditions for this band cannot be drawn.

For 71-76 GHz, studies were carried out for the FS, RLS and FSS (space-to-Earth) indicating that sharing with FS and FSS is feasible. However, additional limits of the IMT BS and UE unwanted emissions is needed to protect RLS in the adjacent frequency band 76-81 GHz.

For 81-86 GHz, studies were carried out for the FS, FSS (Earth-to-space), RAS (in band and adjacent band), EESS (passive) and RLS. Studies are not needed for the SRS (passive), as this service is dealing with sensors around other planets and no interference issue is expected. Studies were also not carried out for the MSS. The results of those studies indicate that sharing with FS, FSS and RAS (in band and adjacent band) is feasible. Notice that additional limits of the IMT BS and UE unwanted emissions would be needed to ensure protection of EESS (passive) in the adjacent frequency band 76-81 GHz and RLS in the adjacent frequency band 86-82 GHz.

An interesting paper looking at Waveforms, Numerology, and Phase Noise Challenge for Mobile Communications Beyond 52.6 GHz is available here.


Related Posts:

• The 3G4G Blog: Examples of 5G Use Cases & Applications
• The 3G4G Blog: 5G Private and Non-Public Network (NPN)
• The 3G4G Blog: 5G Integrated Access and Backhaul (IAB) Enhancements in Rel-17
• The 3G4G Blog: What is Industrial IoT (IIoT) and how is it different from IoT?
• The 3G4G Blog: 5G and Industry 4.0
• Connectivity Technology Blog: 5G Indoor Precise Positioning
• The 3G4G Blog: 5G eXtended Reality (5G-XR) in 5G System (5GS)