Our ongoing project, called HIRT?, in collaboration with the Royal University Hospital in Saskatoon, Canada, is a mobile health (mHealth) facility that enables persons with mild hemophilia to self-manage minor injuries. This is a mobile distributed health information system (HIS) that requires periodic exchanges of the mobile health record. But, these carry-on personal devices such as smartphones and tablets orthodoxly rely on wireless communication media to connect to other network components. And when these communication media (e.g., Wi-Fi, 3.5/4G, etc.) experience sporadic disconnections, the situation leads to services unavailability. As a result, the users are not able to transmit their medical data to the HIS within a reasonable latency window, a situation that can further lead to medical data inconsistency since the process of synchronization can be hindered. In this work, we focus on how to ensure efficient synchronization of the mobile health record in unreliable mobile environments. The proposed middleware is a software-as-a-service (SaaS) layer which enables the mobile health record synchronization between the mobile devices and the HIS. The work details state-of-the-art architecture of the cloud-based middleware and tested for real-world use following the reflective methodology.