Toward physiology-aware DASH: Bandwidth-compliant prioritized clinical multimedia communication in ambulances

The ultimate objective of medical cyber-physical systems is to enhance the safety and effectiveness of patient care. To ensure safe and effective care during emergency patient transfer from rural areas to center tertiary hospitals, reliable and real-time communication is essential. Unfortunately, real-time monitoring of patients involves transmission of various clinical multimedia data including videos, medical images, and vital signs, which requires use of mobile network with high-fidelity communication bandwidth. However, the wireless networks along the roads in rural areas range from 4G to 2G to low speed satellite links, which poses a significant challenge to transmit critical patient information. In this paper, we present a bandwidth-compliant criticality-aware system for transmission of massive clinical multimedia data adaptive to varying bandwidths during patient transport. Model-based clinical automata are used to determine the criticality of clinical multimedia data. We borrow concepts from DASH, and propose physiology-aware adaptation techniques to transmit more critical clinical 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 as proof of concept to support our experiments. Our preliminary evaluation results show that our solutions ensure that most critical patient's clinical data are communicated with higher fidelity.