Middleware for mobile medical data management with minimal latency

A promise of mHealth is its capacity to facilitate the consumption of Electronic Health Record (EHR) data using mobile devices, which is central to promoting remote healthcare delivery. Our ongoing project, called SOPHRA, in collaboration with the City Hospital in Saskatoon, Canada, focuses on supporting care providers (e.g., physicians) in the collection/recording of medical data from patients remotely. A major challenge that needs to be addressed is the potential loss of communication between the mobile-clients and the health information system (HIS) during the transfer of the electronic health record (EHR). Overcoming this challenge will foster soft-real time medical data exchanges. However, the issue of communication loss can be as a result of the over-reliance on wireless networks such as Wi-Fi, which can sometimes be unstable. Thus, the goal of this work is to propose a mobile health (mHealth) architectural environment that can exploit the limited available bandwidth during the mobile medical data transfer. A middleware is proposed with the capability of managing different states of the medical data as the physicians updates the EHR. The work details the employment of the Bernoulli model as a means of determining and controlling different updates of the mHealth data for effective propagation.