Optimisation of a Virtual Clinic System for Use in Austere Environments With Limited Internet Access.pdf

Remote, rural, and underserved areas, also known as austere environments, lack access to medical doctors. This reduces the quality of care available to patients in these areas. Virtual clinics are a telemedicine tool which can connect doctors in well-resourced areas to nurses and community health workers in austere areas to provide clinical support and medical advice. However, virtual clinics implemented in austere environments must overcome the challenge of limited internet availability, as these areas often have limited telecommunication infrastructure. Previously, an initial prototype of a virtual clinic system was developed to address some of the contextual concerns of austere environments within the South African context. The system consisted of a web application and integrated medical devices. The initial design of this system did not optimise the quality of service provided to the end user. This paper aims to provide an optimised virtual clinic prototype that improves quality of service during virtual clinic consultations through implementing a new system architecture. Additionally, the paper will validate this optimised system on 3G, 4G, and 5G mobile networks during mock virtual clinic consultations. The results show that the optimised virtual clinic system improved the quality of service compared to the initial prototype. Additionally, the measured parameters were agreeable with reported values in literature for telemedicine applications. These results indicate that the virtual clinic system may have been improved for austere environments where internet access may be limited, however, further testing within rural environments must be conducted to further validate these preliminary results.