Figure 1. Arduino (ATMEGA 328)
Application with Internet of Things (IoT) have significantly advanced in recent years. Secured healthcare systems to improve human health and wellbeing are potential applications that can be implemented through IoT. A desirable IoT system should be capable of taking care of the patients from all aspects, covering personalized medication, vital signs monitoring, onsite diagnosis and interaction with remote physicians. This paper proposes a solution based on IoT for monitoring patients on a daily basis. The solution will be open platform-based intelligent healthcare system with enhanced connectivity and interoperability for device and service integration. Flexible and wearable bio-medical sensor device enabled by system on-chip voice module helps to reduce the cost of healthcare while simultaneously improving outcomes. The proposed work integrates IoT devices with healthcare services for an improved user experience and better service.
The dependence of healthcare on IoT is increasing day by day to improve access to immediate care, increase the sustainable quality of care and at the same time to achieve these with reduction in the cost of care. Integrated healthcare and patient support is referred to as personalized healthcare, which is based on factors like physiological, social and cultural behavioral characteristics of individuals. Each and every individual gets empowered by the basic healthcare principle “the right care for the right person at the right time”, which leads to better outcomes and improvement in satisfaction thus making healthcare cost effective (Knudsen et al., 2020). Sustainable service focuses on prevention, early detection of abnormalities, and home care instead of costly clinical services and examines overall well-being to anticipate needs and ensure compliance with health plans. Internet of Things promises to manage the personalization of healthcare services, same time maintaining a digital identity for every individual. The classifications of IoT based personalized healthcare systems, advancements in embedded information and communication technologies present enormous potential for the intensified healthcare support to citizens of various age groups. By using these technologies, even at home or at the patient's bedside, people can live independently for a longer period of time, which helps reduce costs and the need for additional resources of caregivers involved in the process.
Telemonitoring and the IoT are perceived as a health boon for developing countries, especially India, where most of the population lives in rural areas. Most of the population is devoid of proper healthcare due to reasons like distant hospitals and no proper integration of medical data from primary health centers to major hospitals. These medical loopholes can be overcome by integrating health monitoring systems, consisting of various sensors, with the communication system, i.e., telemonitoring can be made possible with help of IoT.
Various projects and studies have been carried out till date to make telehealth most affordable and effective. Few of them were reviewed as background work for this paper. A mobile educational application - Android Java-DSP (AJDSP) is discussed by Rajan et al. (2013). This application interfaces sensors, and enables simulation and visualization of signal.
The importance of telemonitoring in checking some of the vital parameters like the kick count of the fetus, temperature and heart beat among rural pregnant women were emphasized by Geo et al. (2013). The tremendous progress in health monitoring including Wi-Fi communication for telemonitoring and deployment of Android devices for mobile healthcare were discussed by many researchers (Wen et al., 2008; Zoric and llic, 2005; Paschou et al., 2013; Gubbi et al., 2013; Yuehong et al., 2016; Rohokale et al., 2011; Hossain et al., 2019). Different projects utilizing various sensors to acquire clinical vitals and interfacing them to the Android devices were found in Husain, & Einerson, (2011). Fahey (2019) have a patent for the design of remote health monitoring system.
A nonstop health monitoring tool for checking patient status and storing vital parameters of the patient information on a server using a Wi-Fi-based remote system was discussed in Valsalan et al. (2020). The extensive literature review strongly supported the idea behind the work suggested in this paper. In Valsalan et al. (2020), a framework for portable physiological checking system was discussed. The vital parameters of the body and some of the environmental parameters of the room were displayed on LCD. This gave us a way to devise an mobile app which could display the vital clinical parameters acquired from patient onto the display screen of the smart phone handled by the physician, from where it could be communicated either to the care takers or to the hospital information system or updated in the clinical database.
The objective of this research is to design a low-cost portable health sensing device which has the ability to communicate the health vitals of the patient acquired from IoT devices to the doctor's mobile phone. Monitoring the health of the individual might be a challenging task, and our goal is to follow the aged person's wellbeing with the help of sensors. The Internet is employed to alert the caretakers and medical team, if there is any abnormality in the sensor reading. The proposed system can monitor heartbeat rate, pulse rate and body temperature. Internet of Things (IoT) is the smart technology, which can handle number of smart objects and smart devices that are connected to the Internet to communicate with each other. In the proposed work, IoT is integrated with the Arduino, which is the heart of this paper. IoT collects and analyzes data without human interaction. Hence, this facility can alert the family member, caretaker or the physician, in case of an emergency. The main reason for choosing IoT for this solution is, because it is completely automated and no human intervention is required. In addition, since the process are fully automated they eliminate any human error. Furthermore, in this proposed system, Blynk app is integrated for processing and communicating the data acquired from sensors.
The hardware components needed for this paper: Arduino (ATMEGA 328), Pulse Sensor (Heart beat detection), DS18B20 (Temperature detection), Voice recognition module, power supply, relays and speaker.
The Arduino Uno shown in Figure 1, is a well known microcontroller board based on the ATmega328. It has 14 digital I/O pins, 6 analog inputs, a 16MHz oscillator, a USB connector, a power jack, an ICSP header, and also comes with a reset button. Thus, it contains everything needed to support the microcontroller; can be directly connected to a computer with a USB cable, powered with an AC-to-DC adapter, or connected to a simple battery to get it started.
Figure 1. Arduino (ATMEGA 328)
The sensor module shown in Figure 2 is a plug-and-play heart-rate sensor for Arduino. It combines a simple optical heart rate sensor with amplification and noise cancellation circuitry making it fast and easy to extract reliable pulse readings. Also, it draws just 4 mA current at 5 V, so it is easy and popular for mobile applications. The sensor module works by just clipping it to the chest or fingertip and plugging it into Arduino which is ready to read heart rate. AD8232 has inbuilt double pole HPF that eliminates the motion artifacts and electrode half cell potential. It also adopts an operational amplifier to construct a three pole LPF, eliminating extra noises. It works in a temperature range of -40 to 85degrees.
Figure 2. AD8382 – ECG ,Pulse ,Heart Rate Sensor Monitoring Kit
The DS18B20 shown in Figure 3, is a digital thermometer that provides 9-bit to 12-bit Celsius temperature measurements and has a nonvolatile user-programmable alarm, which functions upon reaching upper and lower threshold points. The DS18B20 communicates over a single wire bus, i.e., requires only one data line (and ground) to communicate with the central microprocessor unit.
Figure 3. DS18B20 - Temperature Sensor
The module shown in Figure 4 can store 15 pieces of voice instruction. First, the voice instructions are recorded as three groups each containing five voices per group. The groups should be imported one by one through serial commands before it is trained to recognize the voice instructions stored within that group. If it is to be again implemented further to train other groups, that group must be imported first. Only disadvantage is that this module is speaker independent.
Figure 4. Voice Module Hardware for Arduino
The Arduino integrated development environment (IDE) is a cross-platform application written using Java. It helps to write and upload programs to the Arduino board. The Arduino IDE supports programming languages C and C++. The Arduino IDE provides a software library from the wiring project, which supplies many common input and output procedures. User-written code requires two basic functions for starting the sketch and therefore the main program loop are compiled and linked with a supervisory program with the GNU tool chain, also included with the IDE distribution. The Arduino IDE uses a program to convert executable code into a document containing hexadecimal codes, which will be loaded into the Arduino board by the bootloader program found in the board's firmware.
Blynk is a new platform, which allows the users to quickly build interfaces to control, and monitor hardware projects from iOS and Android devices. Once the Blynk app is downloaded, one can create their own project control panel and arrange buttons, sliders, graphs and other widgets on the smartphone screen. It was designed for the Internet of Things. Blynk can control remote hardware, display sensor data, store and visualize data. Blynk Server is responsible for all the communications between the smartphone and hardware module.
The block diagram of the proposed system is shown in Figure 5. The MCU forms the heart of the proposed work. A Client broker system is formed using the microcontroller interfaced with various sensors and the smart phone establishes communication with the server making use of Blynk app.
Figure 5. Block Diagram of Proposed System
This module is divided into two sections namely, Transmitter and Receiver. It comprises of a single Broker and multiple clients where clients are nothing but smartphones and the microcontroller with sensors. All these clients communicate with the server known as Broker as shown in Figure 6. In this protocol, each client needs to connect to an address of the broker, which is termed as the topic to be subscribed in MQTT. There are often multiple topics in a single broker, and clients can subscribe to multiple topics from a unique broker.
Figure 6. Broker Client Module
First, we need a MQTT broker. There are many broker for MQTT but we have used Blynk MQTT broker. It is quite simple for using Blynk MQTT broker; we need to make an account on Blynk as depicted in Figure 7(a) and Figure 7(b). Fill up the basic details of email. There are multiple options at the right corner of the page to edit the blocks, add new blocks, get the key, etc. Now one could start with making a new block on the dashboard by clicking on the button, i.e., “Create a New block”.
Figure 7. (a) Creating Account in Blynk App, (b) Network Establishment with Blynk Server
There are several number of blocks which could be added in this window viz., toggle button, push button, slider, etc. In our proposed work, we have utilized the first block, i.e., toggle button. Click on ‘Create’ button and we will end up with the options as shown in Figure 8.
Figure 8. Feeding Max and Min Values of Sensor
Later provide feed name, which should be unique because this feed name is nothing but the topic, which clients will be subscribing. We can set the time to switch on and off the device as shown in Figure 8. We can then choose name of the feed as Temp, ECG & Pulse. Now click the ‘Create’ button and click on the ‘Choose’ button in front of the feed name. Then click on the ‘Next step’. We need to provide string maximum and minimum value for each sensor and click on ‘create Block’.
Now we are done with the broker side. Account holder at Bylnk IO will have their unique key, which is also called as password for the subscription. One can get their key by email.
In this paper, we used two clients: the first is the ESP866 12e development board, the second is our smartphone. First, you need to download library for MQTT client by Blynk. Now, open the example in Arduino IDE named “mqtt_esp8266”. Just change the SSID name, password for internet access and provide your broker username and password (AIO key), then just upload the program because in the example sketch, they have already subscribed to the topic on off so no need to change anything in this. Then open serial monitor and your Blynk dashboard side by side. As MQTT is very lightweight, the response can be observed in couple of milliseconds (TECHISMS, 2018). It is extremely fast and you can see in the Serial monitor side by side, which is publishing value of counter on the topic named Temperature, ECG and Pulse. Another Client is our smart phone by using user name and password of Blynk subscriber (the doctor), who can monitor patient's body condition.
The health condition of the patient is monitored and the information is sent to the caretaker. The hardware that is shown in Figure 9 consists of several sensors to measure heartbeat rate, pulse rate and body temperature. With the help of the physician, the health parameters such as body temperature, pulse rate and heart rate were measured manually with the medical equipment and compared with the values obtained from the hardware.
Figure 9. IOT Health Monitoring System with Voice Module
Figure 10 shows the Initializing of the client server connection between the physician mobile and Blynk app. Figure 11 shows a doctor's smartphone screen that displays real-time sensor readings when the equipment is connected to a patient.
Figure 10. Initializing the Client Server Connection
Figure 11. Display of Live Sensor Readings in the Physician’s Smart Phone
The heart rate and body temperature were collected from various persons and a comparative study was done with the data obtained by conventional measurement techniques viz., from ECG and the thermometer. The error rate for heart rate and body temperature, is demonstrated respectively in Table 1 and Table 2. From the Tables, it is evident that the error rate is extremely low and the solution model is acceptable.
Table 1. Comparison of Heart Rate with Conventional Method (from ECG)
Table 2 Comparison of Temperature with Conventional method (From Thermometer)
It is concluded that IoT technology is a emerging contribution towards healthcare services. In the proposed system, a mobile health vital monitoring system is presented, which is able to continuously monitor the patient's heartbeat, blood pressure and other critical parameters, and the system is able to carry out a long-term monitoring on patients condition and is equipped with an emergency rescue voice control mechanism using IoT. This implementation, though small and simple, will be a very great and useful step in the field of healthcare. The healthcare monitoring system has been experimentally proven to work satisfactorily. The functional diagram and architecture of system is analyzed, and the patient's vital parameters such as heart rate, pulse rate and temperature are measured using sensors and these values are entered into a database and are uploaded into a web server.
By adding video as a function for personal consultations between doctors and patients, we can improve the system. Also additional measurements that are important for determining the patient's condition, such as diabetes level, blood pressure, breath monitoring, etc., can be viewed as future work. This prototype is very simple to design and use. These systems can be useful in the case of infectious disease like a novel coronavirus (COVID-19) treatment. Doctor can maintain social distancing while giving treatment to patient. This proposed system can monitor 112 patients using a single dashboard.