Table 4: Summary of QoS requirements for e-Health services.

Types of e-Health servicesExample e-Health applicationCommonly used media typesGeneral QoS requirements

Real-time conversational tele- consultationAudio conferencing between patient/doctor or doctor/doctorAudio  ms E2E one-way<1% packet loss ratio (PLR) preferred <3% limit

Real-time conversational video- based tele-consultationVideo conferencing between patient/doctor or doctor/doctorVideo  ms E2E one-way (upper bounds reported as 400 ms)1% PLR

Real-time robotic servicesTele-surgery
Robotic control data, audio, video  ms round-trip-timeZero (may tolerate minimal PLR of )

Real-time tele- monitoringTransmission of patient vital signs and streaming video in emergency situationsBiomedical data collected by sensorsDepends on sensors and applications ms E2E one-way for hard real-time ECG (certain applications may tolerate <1 s E2E for ECG)Zero

Non-real-time tele-monitoringTransmission of patient vital signs for post- hospital home careBiomedical data collected by sensors, context data (e.g., collected by environmental sensors)Not Available (N.A.)Zero

Real-time tele- diagnosisTransfer of medical images to remote location in emergency situationsImages, text, dataN.A. (Depends on image size. Smaller images should be transferred within a few seconds.)Zero

Non-real-time tele- diagnosisNon-emergency remote diagnosis: transfer of medical images to a remote location where specialists analyze data and return a diagnostic report.Images, text, dataN.A.Zero

Real-time EHR data accessEmergency medical personnel at accident/disaster site accessing a patient’s EHRData, text, graphics, imagesN.A.Zero

Non-real time EHR data access/storageWeb-based end user (patient, doctor, additional health personnel) application for access to EHR during patient check upData, text. graphics, imagesN.A.Zero

Real-time messagingAlarms sent to care givers indicating patient emergencyText, small images, dataN.A.Zero

Non-real time messagingAutomated patient alerts (e.g., reminder for check up, reminder to take medication)Text, small images, data 10 s [26]Zero

Conversational research and educationCollaborative research/education tools involving conversational audio/videoAudio, video<150 ms E2E one-way for audio<3% PLR audio
<1% PLR video
<250 ms E2E one-way for video (upper bounds reported as 400 ms)

Interactive research and educationInteractive surgical simulations: remote control of instrumentsData, images<300 ms round-trip-time1% PLR

Streaming research and educationEducation tools involving streaming mediaAudio, video, data<10 s start up delay for audio and video<1% PLR audio
<2% PLR audio

Interactive health information data exchangeHealth portals: Web sites offering health related dataAll 2 s/page for Web-browsing [26]Zero

Non-interactive health information data retrievalDistribution or diagnostic imaging textbooksAllN.A.Zero

Administrative and financial transactionsPatient referrals: appointment scheduling; charging and billing applicationsTextN.A.Zero