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

Augmenting Cloud Connectivity with Opportunistic Networks for Rural Remote Patient Monitoring