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Question 28/16 – Multimedia framework for e-health applications
(Continuation of Question 28/16)


The evolution of advanced digital telecommunication techniques has enabled the development of multimedia systems to support e-health applications, in particular in the area of telemedicine.

E-health designates the use of information and communication technology (ICT) means to support health needs, while telemedicine is considered as that part of e-health where telecommunication systems which allow interconnecting remote locations and to access distant resources. Examples of telemedicine applications are teleconsulting, teleradiology, telesurgery, etc. (See note below for the definitions from the World Health Organization.)

This Question focuses on standardization of multimedia systems to support e-health applications.
In order to allow a wide deployment of e-health applications (with an initial focus on telemedicine applications), in particular in developing countries, it is important to achieve interoperability among systems and to reduce the cost of devices through economies of scale. Consequently, the development of global international standards with the involvement of the major players (governments, inter-governmental organizations, non-governmental organizations, medical institutions, doctors, etc.) is a key factor to achieve these objectives.

Considering the fact that many organisations are already active in this field (with which ITU has existing cooperation agreements) and that, in addition to technical issues, there are a number of other aspect to be considered (e.g. legal, ethical, cultural, economics, regional), it is considered that ITU T can provide the right environment to harmonize and coordinate the development of a set of open global standards for e-health applications.

In the framework of this Question, Study Group 16, as lead study group for multimedia coding, systems and applications, will coordinate the technical standardisation of multimedia systems and capabilities for e-health applications in ITU-T, and will develop corresponding Recommendations.

The improvements and additions to the specific characteristics of multimedia systems and terminals will be addressed within the relevant equipment related questions of Study Group 16.

Note: According to the World Health Organization, telemedicine is “the use of information and communication technology to deliver medical services and information from one location to another", while e-health is “a new term used to describe the combined use of electronic information and communication technology (ICT) in the health sector”.

Study items

Study items to be considered include, but are not limited to:

  • Identification of users' requirements
  • Multimedia framework (including overall concept) for e-health applications (and telemedicine, in particular)
  • Roadmap for e-health (including telemedicine) standards
  • Generic architecture for e-health applications (and telemedicine, in particular)
  • Specific system characteristics for e-health applications (e.g. video and still picture coding, audio coding, security, directory architecture, etc)
  • Considerations on how to help measure and mitigate climate change


Tasks include, but are not limited to:

  • Update the inventory of existing e-health / telemedicine standards (2009)
  • Creating and maintaining a high-visibility web page documenting the progress of the question (ongoing)
  • Roadmap for e-health / telemedicine standards, compiling and analysing standardisation requirements from e-health stakeholders and identifying standardisation items with priorities (2009)
  • Support of ITU-D telemedicine activities
  • Provide inputs for extension and improvement of existing Recommendations on
    multimedia systems (e.g. H.323, H.264, V.18, etc) (ongoing)

An up-to-date status of work under this Question is found in the SG 16 work programme (




  • H.300-series, H.260-series, V.18, T.80-series, T.800-series


  • 1, 2, 3, 4, 6, 7, 10, 20, 22, 26/16

Study Groups:

  • ITU-T SGs 9, 12, 13 and 17
  • ITU-R SG 5
  • ITU-D SG 2

Other Bodies:

  • e-Health Standardization Coordination Group (eHSCG)
  • HL7, DICOM and other relevant forums and consortia
  • ISO, IEC, CEN, ETSI, IETF, IEEE and other relevant standardization bodies


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