Smart cross-layer approach to multi-access terrestrial and non-terrestrial networks (NTNs): Real-time mobile-health use case

Delivering health care services in isolated rural regions through vehicular communications has recently attracted more attention. Real-time video streaming is one of the most commonly used applications in such services. Escorting this increasing interest, there is a high demand for high-quality streaming video in vehicular environments. However, these services face challenging network characteristics such as high dynamic topology and mobility, leading to high packet loss and degraded visual quality. This paper presents a smart approach to multi-access terrestrial and non-terrestrial networks (NTNs) for high-quality and real-time video streaming in vehicular environments to enhance healthcare services in remote areas. The proposed approach integrates a mobile telemedicine unit connected to an expert site through different channels, including satellite communication, 5 Generation (5G), and long-term evolution (LTE) networks. A modified multipath QUIC extension (MPQUIC) was introduced to stream data hybridly through the network. Furthermore, multiple description coding (MDC) was applied to split data into two different descriptions and prioritize one over the other. Important data would be transmitted through cellular networks, and non-priority data would be transmitted through satellite links, enhancing the reliability of video transmission. We demonstrate the effectiveness of our approach through the use of a connected ambulance as a case study. The Mininet-Wifi was used to emulate network conditions. The peak signal-to-noise ratio (PSNR), structural SIMilarity (SSIM), and video multimethod assessment fusion (VMAF) were measured to evaluate the received video quality; the received data rate and packet loss were also calculated. The obtained results show our proposed method's efficiency by reducing latency by up to 60% and improving the receiving data rate by up to 143% compared with the classical MPQUIC. The proposed system enhances video quality by up to 70%. It minimizes packet loss by up to 50% compared with the unreliable QUIC, showcasing the potential to improve m-health services' efficiency and mobility in isolated rural regions.