  In emergency patient transport from rural medical facility to center tertiary
hospital, real-time monitoring of the patient in the ambulance by a physician
expert at the tertiary center is crucial. While telemetry healthcare services
using mobile networks may enable remote real-time monitoring of transported
patients, physiologic measures and tracking are at least as important and
requires the existence of high-fidelity communication coverage. However, the
wireless networks along the roads especially in rural areas can range from 4G
to low-speed 2G, some parts with communication breakage. From a patient care
perspective, transport during critical illness can make route selection patient
state dependent. Prompt decisions with the relative advantage of a longer more
secure bandwidth route versus a shorter, more rapid transport route but with
less secure bandwidth must be made. The trade-off between route selection and
the quality of wireless communication is an important optimization problem
which unfortunately has remained unaddressed by prior work.
  In this paper, we propose a novel physiology-aware route scheduling approach
for emergency ambulance transport of rural patients with acute, high risk
diseases in need of continuous remote monitoring. We mathematically model the
problem into an NP-hard graph theory problem, and approximate a solution based
on a trade-off between communication coverage and shortest path. We profile
communication along two major routes in a large rural hospital settings in
Illinois, and use the traces to manifest the concept. Further, we design our
algorithms and run preliminary experiments for scalability analysis. We believe
that our scheduling techniques can become a compelling aid that enables an
always-connected remote monitoring system in emergency patient transfer
scenarios aimed to prevent morbidity and mortality with early diagnosis
treatment.
