Augmenting Cloud Connectivity with Opportunistic Networks for Rural Remote Patient Monitoring

Current remote patient monitoring (RPM) systems are fully reliant on the Internet. However, complete reliance on Internet connectivity is impractical in rural and remote environments where modern infrastructure is often lacking, power outages are frequent, and/or network connectivity is sparse (e.g. rural communities, mountainous regions of Appalachia, American Indian reservations, developing countries, and natural disaster situations). This paper proposes augmenting intermittent Internet with opportunistic communication to leverage the social behaviors of patients, caregivers, and community members to facilitate out-of-range monitoring of patients via Bluetooth 5 during intermittent network connectivity in rural communities. The architecture is evaluated for Owingsville, KY using U.S. Census Bureau, the National Cancer Institute's, and IPUMS ATUS sample data, and is compared against a delay tolerant RPM case that is completely disconnected from the Internet. The findings show that with only 0.30 rural adult population participation, the architecture can deliver 0.95 of non-emergency medical information with an average delivery latency of ∼13 hours.