Figure 1. System Block Diagram
Nowadays, heart diseases are the major cause of death toll. Sometimes, a heart attack results in immediate death and in some case, patients need to be monitored after their first attack to reduce the risk of an attack. This paper is aimed to improve the patient monitoring with minimal number of staffs. In this paper, smart hand gloves are introduced to monitor the patient heart rate and the body temperature. Physiological health parameters are sensed which after collecting and processing, is displayed on the LCD screen. The system is also connected via IoT platform named Blynk, which assists the caretaker in remote monitoring. The data collected can be stored for future diagnostic purposes. Moreover, the system helps the patients to do basic activity on their own. It is equipped with buttons to enable the patient to communicate with the family members and doctors as well. The fitted buzzer will alert family members about emergency situations where the heart rate or body temperature is higher than normal range. Additionally, further advances can be made by real time camera setup to guard the patient's activity.
One in every four deaths are because of heart related diseases. So, we need to take special care of the patient suffering from Cardio Vascular Diseases (CVDs). Thus, we need a smart and highly reliable system to help reduce the number of deaths for those types of patients and help patients in bed, because continuous and long-term monitoring is needed to treat heart disease.
The main objective of our project is to assist the bedridden patient and monitor their body parameters. The working prototype of the health monitoring smart gloves consists of two sensors to measure the pulse rate and body temperature. The button fitted along with the gloves help the patient to have a conversation and demand when needed. Continuous data can be analysed to predetermine the health condition and notify the patient's caretaker and doctor about the upcoming situation to reduce the chance of emergency.
The main component of the working prototype is Arduino UNO, pulse sensor, LM35 (temperature sensor), ATMEGA 328 and four switches to produce 24 combination functions and messages. The switches produce 15 messages, which can be displayed on LCD screen with the help of wireless communication. It can be notified to the concerned person, which would also be helpful for the doctor to treat the patient even when they are not in hospital. This project will not only ensure the patient safety, but also reduce the cost of treatment. Implementation of IoT in the project will give the patient a variety of advancements such as appliance control, for example fan, light, etc. In addition to that, the project is fitted with a buzzer to alert the people in the home, during emergency.
The analysis of project papers related to heart rate monitoring and patient monitoring is done in this section of the paper.
Bansal et al. (2018) implemented Photo plethysmography (PPG) method for real time heart rate measurement. It is implemented using simple infrared transmitter and receiver circuit. Arduino UNO board has been used for calculating heart rate and the same is displayed on LCD. Raspberry Pi is used as an IoT gateway for sending SMS and emails through Message Queuing Telemetry Transport (MQTT) protocol.
Majumder et al. (2018) described that this project is aimed at monitoring physical parameters such as blood pressure, heart rate and body temperature of the patients in a remote location. It consists of IR transmitter and receiver, LM35, MPXV5050GP, Data Acquisition Unit, Arduino and Bluetooth. The system communicates with the devices through Bluetooth and also the communication password is protected.
Pawar (2014) implemented this project that focuses more on the rural patients who need healthcare facility achieved using GSM module, which sends the calculated heart beat from the sensor to the doctors through SMS. As availability of doctors in government hospitals, especially of rural areas are deficit, in this case, it is important to bring the idea of wireless patient monitoring system where doctors can monitor the patients from rural areas.
Mohana and Aradhya (2015)suggested the study which states that heart rate and music are closely related. Pulse sensor circuit is used to obtain the beats per minute (bpm). The calculated bpm is sent to Arduino Ethernet Shield's web server. Arduino is connected to the Audioshield, which plays music for the patient according to the calculated bpm, for example if the heart rate is low then it will play up tempo music and if the heart rate is high it will play slow melodious music. It uses SD card module, DAC, PWM, Arduino, Ethernet shield, TCP protocol for the entire setup.
Paliwal et al. (2016) proposed this project which is designed for obtaining heart rate and heart rate variability using smart phone camera. It is a different concept where a video is firstly recorded by placing left index finger on camera lens and then the PPG signal extracted from the video are used for obtaining heart beat and Heart Rate Variability (HRV) using Fourier Transformation. As the early detection of these, heart rate parameters can save the life of patients, so real-time monitoring is important, which is described in this paper using photoplethysmography technique.
Miah et al. (2013) implemented a computer-based heart rate monitoring system where heart rate is measured from fingertip using the microphone port of a computer. It detects the change in blood volume by an optical sensor based on infrared technology. By interfacing through the microphone port, the signal is processed to get real-time heart rate. The designed project is capable of diagnosing heart diseases like sleep arrhythmia.
Khan and Chattopadhyay (2017) proposed this project which uses biomedical sensors like heart rate sensor and temperature sensor which are interfaced with Arduino UNO board to obtain readings. Initially, the readings are displayed on LCD and then are sent to server, so that the readings can be accessed by the concerned family members or doctors through an android application named S-Health. It also keeps the record of patient's data for future need.
Omoogun et al., (2017) used wearable devices or biomedical sensors to monitor vital signs like body temperature, heart rate, blood pressure, ECG, etc. As monitoring these, vital signs can lower the risk of any kind of emergency. The system has two components: One is the wearable wireless monitoring device that measures heart rate, body temperature, etc., of a patient wearing it and the other component is web application which allows the patient and health care provider unit (hospitals) to interact together. The system can record the vital signs even when the person is moving or the person is in any part of the world, because the system uses a cellular module that provides mobile network even when the person moves from one place to another, without connection loss. The system can help patient by requesting help from a nearby hospital which can provide health care facility in case of emergency using patient's current location.
Deshmukh and Shilaskar (2015) proposed a system for patient monitoring, which seeks to maintain care providers, link hospitals, doctors, medical laboratories and patient's home. It comprises of wireless communication modules, sensors, wearable materials, power supplies, actuators, processing units, control units, software, advanced algorithms and interfaces for the user. The wearable health monitoring system which interfaces with smartphone and remote workstation, allowing the patients and the person supervising the patient to access real time health parameters with complete picture of user's health with past physiological data. The patient's details that sever maintains in a database are of great importance, as they are the indication of the patients health in past days, which can be an important data to improve the patient's condition at present.
Vippalapalli and Ananthula (2016) proposed a Body Sensor Network (BSN) to provide cost saving methods to both health care providers as well as patients. It aims to offer flexibility of operation by obtaining patients physiological data and by tracking and monitoring of the patient's health. As patients at bedrest are connected to so many wires and large machines, it becomes difficult for them to make any kind of movement, therefore the monitoring system is made more patient friendly and cost effective. Arduino Fio is used in the system.
Arora et al. (2014) presented a prototype which overcome the challenge of accurately measuring the heart beat using heart beat sensor and then converting into pulses using an operational amplifier LM324, LED and LDR. The concept behind its working is that when a person places his/her finger in-between light beam and LDR, the light falling on the LDR varies according to the movement of the blood in that person's body. These variations are amplified using LM324 and converted to pulses which can be measured using timer and counter of micro controller. The project replaces the electrodes and big machineries, which are used for ECG measurement by simple heart beat sensor.
Megalingam et al. (2012) proposed a system for bedridden and mostly elder patients. The system called HOPE, which assists them while monitoring their body parameters such as body temperature, heart rate, tilt and fall. Sensors are embedded in the patient's body and the collected information can be sent to the caretaker via smart phone through Bluetooth support.
Sathya et al. (2018) proposed a system aimed at monitoring the health parameters of patient, located remotely. The system is worn by the patient, and collects real time data. The collected information is analysed, and processed to assist the physicians in the early monitoring of diseases to provide better treatment. The system is light weight and economical. It is a type of invasive medical procedure, through which accurate health parameters can be obtained.
Patil et al. (2017) described a system which focuses on monitoring the various body parameters. The patient carries a hardware in which sensors are installed that determines real time parameters. The device is sensitive and predicts precise values. Due to the advancement in internet based devices, the system is connected to smartphones. The smart phones can alert the patient's family and can provide location of nearby hospitals in case of emergencies.
Kabilan et al. (2019) suggested a system which monitors the elderly people. The system designed is highly efficient and reliable for measuring health parameters. It measures heart rate, body temperature and blood pressure. It works on the principle of alerting the patient's concern, when the health parameters go beyond the certain limit. Further, it also monitors the children by tracking their location via GPS module.
Ahmed et al. (2018) highlighted the different opportunities that IoT platform provides. The designed system is simple in architecture, cost-effective and consumes less power. The system automatically senses patient's health condition and then sends the collected data through internet. Arduino Nano, Raspberry pi, LM35, GSM SIM900D, piezoelectric sensor is used in this system.
Baker et al. (2017) got through many papers on patient health monitoring and presents a system which can overcome all the challenges faced by healthcare IoT. Pulse sensors, respiratory rate sensors, body temperature sensors, pulse oximetry sensors are the main components of this wearable system. BLE and NB-IoT are employed for short-range and long-range communications. Also, cloud came out to be the best option for data storage and organizing big data in healthcare.
Anliker et al. (2004) described AMON, (Advanced care and alert portable telemedical Monitor) a wearable patient monitoring and alert system. The system is designed for collecting and evaluating vital health parameters, especially for cardiac/respiratory patients. This is an intelligent multi-parameter medical emergency detection system, which uses GSM technology to communication with health care providers.
GSM module is used for sending recorded physiological parameters to healthcare providers but here, multiple users share the same bandwidth because of which transmission can encounter interference which is the greatest limitation of the GSM communication (Anliker et al., 2004; Omoogun et al., 2017; Pawar, 2014). Bluetooth communication has low bandwidth as compared to wi-fi, it can lose connection in certain conditions. Also, only shortrange communication is allowed between devices. For overcoming these limitations IoT platform (Bansal et al., 2018; Paliwal et al., 2016) used PPG method for calculating BPM which are very susceptible to motion artefacts caused by hand movements. (Ahmed et al. (2018); Bansal et al., (2018) used Raspberry pi as an IoT gateway, even though it can perform different tasks, there are some limitations due to its hardware also it is not compatible with other operating systems.
The developed system enables the patient to communicate with the family using buttons present in the gloves in case if patient is bedridden and face difficulty in conveying, which was not implemented in any of the mentioned paper. In contrast to other devices which uses expensive biomedical sensors, our device uses cheap sensors which makes the complete system cost efficient and affordable. In addition, our device allows the patient to control appliances.
The prototype consists of various hardware as well as software interlinked together to execute the function of data acquisition, data transmission, data processing and data representation. Data acquisition is done through pulse sensor, temperature sensor, switches and buttons. Data transmission is done through wires, RF module, Wireless-Fidelity (Wi-Fi) module. Data processing is done by ATMEGA 328 microcontroller and data representation is done on LCD display, BLYNK platform and Android smartphone. All of these hardware are integrated on the gloves. The fitted micro-switches help to reset the system during any failures. The sole purpose of the algorithm and our system is to simplify the computer interface for disabled patients.
Heart Sensor: Heart rate sensor is an optical device, which is used to monitor the amount of changes in the volume of blood flowing in the blood vessels. Here, we use LM358, a low power operational amplifier consisting of a bright LED light of red colour and a light detector to detect the light modulation by blood when the blood flows through the blood vessels, the fingers become more opaque so that the detector gets less light and thus produces a variable electrical pulse, which is BPM (Beats Per Minutes) in common language. It is placed in the fingertip of a person.
Temperature Sensor: LM35 is used to measure the temperature. It is a series of precision integrated circuit in which output voltage is linearly proportional to temperature in degree Celsius. Main advantage of LM35 is that it is linear, i.e., 10mv/°C which means for every degree rise in temperature, the output of LM35 will rise by 10 mV.
ATmega 328: The ATmega328 is an 8-bit and 28-AVR singlechip micro controller created by Atmel Corporation, the mega AVR family. It has flash type program memory of 32 kilo bytes. It has a modified Harvard architecture 8-bit RISC processor core. It is used in Arduino UNO board and it supports SPI Protocol.
ESP8266: The ESP8266 is a Wi-Fi module, low cost microchip, which connects the Wi-Fi to the microcontroller using TCP/IP connections. It is a 32bit microcontroller and is manufactured by Espressif systems in Shanghai, China.
Blynk: Blynk is a cloud platform which is designed for IoT and used to control the hardware through android and IOS device. It can monitor, store and display the data.
Embedded C: Embedded C programming language is extended version of C language to support the enhanced microprocessor features. It has some additional header file, which may vary from controller to controller. Arduino IDE is a tool used to write an upload code to the Arduino
Figure 1 shows the block diagram of the system. The patient should wear gloves to take the necessary measurements. The pulse sensor and temperature sensor will record the data and transmit these data to the micro controller. There are four switches connected on the gloves which act as binary inputs to the micro controller, hence sixteen different inputs can be provided to the micro controller. The micro controller is interfaced using Arduino for the generation of binary signals, which have pre-decided messages. The body temperature and heart rate values are displayed using an LCD. The system allows to set the limits of heartbeat.
Figure 1. System Block Diagram
After setting these limits, person can start monitoring the heartbeat and whenever the person's heartbeat goes beyond a defined value, they can get an alert on high heartbeat and possibility of heart attack. Also, the system alerts for lower heartbeat. When a patient presses any of the key, the message dedicated to that key will be processed by the microcontroller and sent to the concerned person via cloud using the IoT software BLYNK. Furthermore, the patient can control a number of room appliances using the keys in the glove, for example - tube lights, fan etc. In case of an emergency, the patient in need will simply have to press any key, then person concerned will be notified immediately. Basically, the sound source to produce the alarming sound is a buzzer consisting of piezo-electric diaphragm.
The proposed system transmits the real time data to the patient's doctor and caretaker for diagnosis. Physiological health parameters are sensed and are displayed in the LCD screen. The patient can communicate by using button provided in the gloves or just by pressing down them, which displays the message in the LCD screen. The message is displayed in the LCD screen with 24 logic combinations. In which 0000 combination shows that the system is active while 0001 to 1111 are used for displaying the messages such as help me, need water, washroom, need medicine etc (Table 1).
Table 1. LCD output messages
The system is also connected via Blynk platform, which notifies the concerned person immediately when in need. In case of emergencies, a buzzer is provided which alerts the family members and to prevent the upcoming emergency situations. In addition to that, the Blynk platform can be used for two-way communication, in which doctor may also prescribe the medicine as well as suggest different exercises.
In this paper, we have developed a wearable health monitoring system, which consumes less power and is considerably cheaper. The main aim of our system is to continuously monitor the patient's health parameters and displaying them on the LCD screen. The real time data collected can be stored and is accessed by doctors and family members during emergencies. If the parameter crosses the threshold limit, an alarm is sent as a precaution.
We are extremely grateful to our mentor for continuous support and guiding us in the field of medical electronics and thankful on doing this project under head of department and team members.