Buhl, VictorKennedy, SeanBarber, DonTummala, MuraliMceachen, JamesRogers, DarrenMceachen, John2024-12-262024-12-262025-01-07978-0-9981331-8-8279a3151-7dfe-4d2b-9cea-cebfe0884ec2https://hdl.handle.net/10125/109253In remote locations, satellite communication is the only practical option for telemedical backhaul. Enabling telemedical applications over low earth orbit (LEO) and geosynchronous orbit (GEO) satellite communications links requires a detailed analysis of how the characteristics of these links impact telemedical applications. This article investigates the characteristics of Starlink LEO and Viasat GEO satellite communications to assess which is better suited to support telemedicine in remote locations. Through experimentation, the performance of medical application traffic over LEO, GEO, and terrestrial internet service provider links is compared to show how different link characteristics impact network traffic. Terrestrial internet service provider links provide a baseline for comparison since most applications perform optimally on high-speed terrestrial communication links. The analysis uses objective data to show that the non-interactive and near real-time application tested performs better on a GEO link, while the interactive near-real time and interactive telemetry with messaging applications tested perform better on LEO links. While GEO links add latency impacts to interactive communication that cannot be mitigated, this work reveals that the protocol stack for telemedical applications can be selected or designed to optimize performance over LEO satellite communication links.10Attribution-NonCommercial-NoDerivatives 4.0 InternationalHealthcare in Motion: Innovations in Mobility-integrated Health Systemslow latency communication, networking, satellite communication, telemedicine, throughputConference Paper