  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.
