## 4 IoT-Enabled Traffic-Aware Telemedicine Architecture (ITTA)
### Wearable-Device-based Monitoring Algorithm for Edge Device (WDMA-Edge)
**Scenario 2 (V2I) _PLR_: The performance of AODV is found to be much closer to the acceptance limits compared to that of the other two routing mechanisms studied. _DELAY_: The delay observed with GPSR is 200 times lower compared to AODV. The results observed with AODV are as per the QoS requirement, with GPSR performing better. AODV has consistency in its performance and may be considered if stationary nodes are present as compensation to the mobile nodes. #### 5.2.3 Performance Analysis of AQPT-Fog

The risk score of 10 patients was calculated by considering their vital signs and OFEHS. The same is presented in Table 11. The biosignal data considered for the experimentation were derived from the open datasets available at [59; 60; 61]. Four different routes were considered, with multiple links each. As shown in Table 12, each link is assumed to have a communication facility of V2V or V2I or both. Based on the simulation results achieved earlier, the routing protocol used varies dynamically for each link. Table 13 is obtained as a result of the experimentation performed based on input from Tables 11 and 12. From the results, it is visible that the mechanisms, such as AQPT-Fog, function satisfactorily,



## 6 Conclusions

In this paper, we have presented a novel multi-layered architecture for telemedicine networks, ITTA. The objective of this research work has been to design a system that is capable of transmitting the biosignals of critical COVID patients in real time based on the QoS requirement and also by the optimal selection of routes to the destination hospital. WDMA-Edge, which includes a risk scoring mechanism, OFEHS, for aiding ambulance operators in monitoring the criticality level of patients in the ambulance, has been presented in this work. To ensure QoS and reliability of vital data transmission, we have presented and evaluated an algorithm, AQPT-Fog. Performance analysis of the same is performed by considering data from multiple patients and road link data of multiple routes. Along with these, we have also performed a simulation-based study of multiple routing algorithms for gauging the feasibility of applying them during the transmission of vital biosignals from ambulances. For this simulation, we have considered a real case study of Mysuru City, India. Based on the observations of PLR and delay in the two different scenarios of the simulation, we may conclude that AODV is the better-suited routing protocol out of the ones compared. However, a network involving only vehicles is not the correct approach for the transmission of data in highway roads and needs a deployment of stationary units. Alternative communication technologies such as 4G, 5G, WiMAX, LoRa, etc., have not been explored in our work and can be performed in the future. The proposed methods will be used in future ad hoc networks and the communication can be established with the basic mobile networks with the highest latency and the system throughput. The framework proposed can be pivoted to ensure the effectiveness of tele-assistance in a pandemic situation. All experimentation performed in this manuscript is based on simulation study, and future work with real-time implementation can be thought of to observe issues that may be faced in the real world. **Author Contributions:** Conceptualization, A.M. and M.V.R. ; methodology, A.M., A.R.D. and M.V.R. ; software, A.M.; validation, A.M. and A.R.D. ; formal analysis, A.M. and A.R.D. ; investigation, A.M., A.R.D. and M.V.R. ; resources, M.V.R. and V.P.R. ; data curation, A.M. and A.R.D. ; writing--original draft preparation, A.M.; writing--review and editing, A.R.D., M.V.R. and V.P.R. ; visualization, A.M., A.R.D. and M.V.R. ; supervision, M.V.R. and V.P.R. All authors have read and agreed to the published version of the manuscript. **Funding:** This research work has no external funding.