Adaptive Clinical Data Communication for Remote Monitoring in Rural Ambulance Transport

For emergency medical cyber-physical systems, enhancing the safety and effectiveness of patient care, especially in rural ambulance transport, is essential. Use of telecommunication technologies can enhance effectiveness and safety of remote monitoring of patients by the physicians at the center hospital during ambulance transport and provides vital assistance to the emergency medical technicians (EMT) to associate best treatments. However, the communication along the roads in rural areas can range from 4G to 2G to low speed satellite links, with some parts suffering from communication breakage. This unreliable and limited communication bandwidth together with the produced mass of clinical data and the many information exchanges pose a major challenge in real-time and smooth supervision of patients. In this paper, we present parts of developed physiology-aware communication architecture, a bandwidth-compliant criticality-aware system for transmission of clinical data adaptive to varying bandwidths during patient transport. We propose adaptation techniques to transmit more critical data with higher fidelity in response to changes in disease, clinical states, and bandwidth condition. In collaboration with Carle's ambulance service center, we develop a bandwidth profiler, and use it to collect communication traces to support our experiments. Our evaluation results show that our solutions ensure that most critical patient's clinical data are communicated with higher fidelity.