Fog Computing and Graph-Based Databases for Remote Health Monitoring in IoMT Settings

Remote patient monitoring is a promising and transformative pillar of healthcare. However, deploying such systems at a scale—across thousands of patients and Internet of Medical Things (IoMT) devices—demands robust, low-latency, and scalable storage systems. This research examines the application of Fog Computing for remote patient monitoring in IoMT settings, where a large volume of data, low latency, and secure management of confidential healthcare information are essential. We propose a four-layer IoMT–Fog–Cloud architecture in which Fog nodes, equipped with graph-based databases (Neo4j), conduct local processing, filtering, and integration of heterogeneous health data before transmitting it to cloud servers. To assess the viability of our approach, we implemented a containerised Fog node and simulated multiple patient-device networks using a real-world dataset. System performance was evaluated using 11 scenarios with varying numbers of devices and data transmission frequencies. Performance metrics include CPU load, memory footprint, and query latency. The results demonstrate that Neo4j can efficiently ingest and query millions of health observations with an acceptable latency of less than 500 ms, even in extreme scenarios involving more than 12,000 devices transmitting data every 50 ms. The resource consumption remained well below the critical thresholds, highlighting the suitability of the proposed approach for Fog nodes. Combining Fog computing and Neo4j is a novel approach that meets the latency and real-time data ingestion requirements of IoMT environments. Therefore, it is suitable for supporting delay-sensitive monitoring programmes, where rapid detection of anomalies is critical (e.g., a prompt response to cardiac emergencies or early detection of respiratory deterioration in patients with chronic obstructive pulmonary disease), even at a large scale.