2013 6rd International Conference on Biomedical Engineering and Informatics (BMEI 2013)

A Wearable Health Monitoring System with Multi-parameters

Jun Liua,1, Fei Xiea, Yaqi Zhoua, Jianfeng Wub,2, Qian Zoua
a. Key Laboratory of Biomedical Engineering of Ministry of Education
College of Biomedical Engineering & Instrument Science, Zhejiang University
b. Institute of Industrial Design, Zhejiang University of Technology
Hangzhou, China
1
E-mail: liujun@zju.edu.cn
2
E-mail: jianfw@zju.edu.cn
AbstractA novel wearable health monitoring system with
multi-parameters and its applications for long term monitoring
are presented in this paper. The system provides continuous
monitoring of the users electrocardiogram (ECG), respiratory
status and activity, as well as the local temperature. A belt-type
data acquisition and communication module worn around the
chest includes ECG and respiratory module ADS1292R, six
axis motion sensor MPU6050, high precision digital
temperature sensor Tsic506 and bluetooth 4.0 module CC2541.
The collected data is sent to the mobile device via bluetooth
and the mobile device gives a heart health index of measuring
the body status which includes heart rate, QRS wave, and ST
segment. A remote interactive way is constructed by the mobile
device communicating with the customer management center
via WIFI.
Keywordswearable;
multi-parameters;
monitoring ; heart health index

I.

continuous

INTRODUCTION

Elderly people, postoperative rehabilitation patients, and

persons with special abilities have a strong concern for their
health [1,2]. As health care costs are increasing and the
world population is ageing [3], there has been a need to
monitor a patients health status while he is out of the
hospital in his personal environment [4]. To address this
demand, a wearable health monitoring system with multiparameters is developed.
The system uses bluetooth and WIFI technology to
establish a wireless network covering the human body. By
the belt-type wearable data acquisition front-end, the system
can acquire and transmit the physiological signal to the
mobile device via bluetooth. Automatic diagnosis algorithm
on mobile devices processing the signal can not only display
the waveform in real time, but also make event markers
which reduce the workload of doctors. After giving a heart
health index, the mobile device builds a real-time two-way
communication with the customer management center via
WIFI. Doctors and health care institutions can view the data
according to event markers,sent health advice and health
review to the data terminal by the health platform. They can
also notify family and the nearest hospital by cell phone and
e-mail. The user, family and doctors can obtain more

978-1-4799-2761-6/13/$31.00 2013 IEEE

detailed historical consultation records and long-term

physiological changes by health platform anywhere,
anytime. The intelligent diagnosis system including expert
experience and neural network algorithm, can take
precautions against chronic diseases.
II.

WEARABLE DATA ACQUISITION FRONT-END DESIGN

Figure 1 shows the block diagram of wearable health

monitoring system with multi-parameters. (A) is the belttype vest which is made out of cotton, spandex and silver
fiber and has nine buttons which can adjust the size. Cotton
and spandex make the vest comfortable and elastic. The
silver fiber covers the surface of electrodes (a), (b) and (c),
because silver fiber has good conductivity. In addition, the
silver fiber can effectively prevent electrostatic, sterilize and
has good biological compatibility, so there is no adverse
reaction of long-term wearing. (A) mainly contains the ECG
and respiratory electrodes (a) (b) (c), temperature sensor (d)
and acquisition front-end (e).
A. ECG and respiratory acquisition module
ADS1292 is a low-power, dual-channel, 24-bit analog
front-end for potential measurement, which is suitable for
ECG, portable ECG diagnostic and patient test [5].
Generally, the recommended [6] sampling frequency is
500Hz and the sampling accuracy is 200/mv.ADS1292 can
meet the requirements. The ADS1292R has respiratory
impedance detection function which can be used to calculate
the respiratory frequency.
B. Six axis motion sensor
Comparing with the multi component solution,
MPU6050 integrates six axis motion processing components
which solves the problem of difference of shaft between the
gyro and accelerator, and reduces the amount of packaging
space. Motion processing database of MPU6050 fusion
technology can process complex motion sensing data and
reduces the work of motion processing operations.

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III.

AUTOMATIC ECG ANALYSIS ALGORITHM

A. Removal of DC offset and baseline wander

DC offset and baseline drift be dealt with together is
based on their common characteristics and they belong to the
low-frequency signal. Selection of filter cutoff frequency is
the key. To ensure that the low frequency component of
ECG such as ST segment, QT segment not to be damaged,
according
to
the
American
Heart
Association
recommendation, conventional high pass filter cutoff
frequency is selected as 0.05Hz, but if using a linear filter
with single-pole and phase delay small enough, conditions
could be relaxed to 0.67Hz [8]. To remove the low frequency
interference, and retain ECG active ingredients, the 3dB
cutoff frequency of the filter is selected at 0.5Hz.

Figure 1. The block diagram of the wearable health monitoring system of

multi-parameters. (a) is the ECG and respiratory common positive
electrode. (b) is the ECG and respiratory common negative electrode. (c) is
the ECG right leg driven electrode. (d) is the temperature sensor (worn in
the armpit). (e) is the acquisition front-end, which includes (B) ECG and
respiratory module, (C) motion sensor, (D) temperature module and (E)
bluetooth module. (B) transmits the ECG and respiratory impedance signal
of the human body by SPI to (E) .(C) sends the six axis motion data via I2C
to (E).(D) transmits the body temperature signal by the ZAC protocol to
(E). (E) packages all physiological data and sends to (F) the mobile device.
(F) analyses the signals in the mobile terminal, displays the waveform and
gives the health index.Then (F) transmits the signal to the (G) customer
management center via WIFI and (G) implements real time monitoring and
long-term storage, and the doctors can check the signal data when the event
occurs.

C. The temperature acquisition module

The Tsic506 is a high resolution, high precision, low
power consumption and fast response temperature sensor
integrated circuit of the Germany ZMD company. With
different accuracy levels, when measured in the range
between +5 to +45 degrees Celsius, the measuring precision
can reach 0.1 degrees Celsius. The user does not need to recalibrate, because it has been completed the special
calibration. Easy to be embedded, the Tsic506 reduce the
cost and time of application development. The signal
transmission needs only one ZAC protocol signal wire.
Because of data rapid measurement, temperature conversion
time needs only 65 to 85 milliseconds and it is the most
suitable acquisition solutions for temperature. With low
power consumption, the signal line's maximum current is
only 45uA and also has outstanding long-term stability [7].
Therefore,Tsic506 is very suitable for the application of the
wearable front-end.
D. Data transmission module
Bluetooth 4.0 module CC2541 is used as the signal
sending module. CC2541 with low power consumption and
downward compatibility can transmit more than 100 meters
and contains an enhanced 8051 core. Therefore, CC2541 can
communicate with all the acquisition modules and upload the
data.

B. Removal of high frequency noise

High frequency noise in ECG consists of EMG and highfrequency interference in the environment (such as
electromagnetic disturbances in space) and so on. In order to
keep the ECG active ingredients, the cutoff frequency is set
to 125Hz [8].
C. Removal of power-line interference
Power-line interference is due to the electromagnetic
fields generated by electricity through the human body and
electronic equipment. In the paper [9] the ECG signal is
divided into linear and nonlinear segment according to the
quasi-periodicity of ECG. This method works well and has a
certain self-adaptive.
D. Signal quality detection
In addition to the above noise, sometimes lead-off noise,
electrode contact noise, motion artifact appears in the ECG.
These noises can only be detected through the signal quality
to alert subjects or remove the corresponding interference.
Because the system can access to campaign data, and
using an intensity algorithm to handle the motion data to
know the movement of the subject, with subject movements
can perform detection of the ECG signal quality.
E. QRS complex detection algorithm
QRS complex detection is the key of automatic ECG
analysis. By comparing several QRS complex detection
algorithms, the System chooses the method proposed by
PAN and Tompkins in 1985 [10].
F. QRS complex onset and termination detection and ST
segment detection
After several algorithms [11-13] in contrast, the System
selects the minimum angle algorithm proposed by I.K.
Daskalov [13].
ST segment is used in myocardial ischemia analysis. It is
an important part in ECG analysis. The System adopts a
squeeze approach based on R-wave and T-wave [14], this
method has the following advantages: high noise immunity,
good real-time performance, robustness and high accuracy.
After analyzing the characteristics of arrhythmia, the
system decides to use medical diagnostic criteria as a

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foundation.Firstly uses a decision tree algorithm to classify

the heart beat, and then figures out cardiac rhythms based on
the relationship between the heart beat.
Beat classification algorithm as follows: heart beats are
divided into the most significant representative of the sinus
beat, premature ventricular beat, atrial premature beat and
bundle branch block beat using the obtained RR interval and
QRS complex width according to the clinical criteria.
Combining the cardiac rhythm diagnostic criteria with
heart beat classification, cardiac rhythms can be
distinguished.
In summary, the system distinguishes four kinds of beats
and eight kinds of rhythms.
IV.

TEST AND RESULT

Stability is the main content in hardware test. Stability

tests using the following scheme. Utilize a signal generator
to generate the test signal similar to the ECG. Then the
system continuously acquires the test signal for a long time
and stores the data on the SD card of the mobile device. At
last, analyze the data on a computer.
Experiments show that the stability of the system is good
and it can be used to monitor ECG for a long time.
The algorithm results have been evaluated on the ECG
signal generator MPS450 of FLUKE company. Test results
are shown in Table 1, there is a slight gap compared with the
literature [10] in the QRS complex sensitivity and specificity
aspect.
TABLE I.

SENSITIVITY AND SPECIFICITY

QRS complex detection

Beat classification

Se

Pe

Se

Pe

99.05%

99.33%

95.05%

93.16%

Se- Sensitivity, Pe-Specificity

V.

RESPIRATORY ALGORITHM

Changes of volume in the human body chest when

breathing causes the human body impedance cyclical
fluctuations. Using the waveform of human body impedance
and the autoregressive (AR) model, respiratory frequency
can be calculated by the following steps.
(i) Fit an all-pole model [15] to each 20 s segment.
(ii) Pick a reasonable frequency range: 0.066~0.917
Hz(4~55 breath/minute).
(iii) Pick the poles within the range.
(iv) Keep all the poles with magnitude of at least 95% of the
highest magnitude pole.
(v) Pick the pole with the smallest angle. The frequency
associated with this pole is the breathing frequency.

(vi) The window is advanced by 5 s and the above process

repeated so that a respiration rate is available every 5 s [15].

VI.

HUMAN MOTION ALGORITHM

Using an accelerometer to distinguish movements of the

human body is a hot area and several classification
algorithms have been developed [16,17,19]. Currently,
using of the accelerometers have been successfully applied
to human motion tracker products. The type of products are
mainly used for the analysis of adults and children sleep,
exercise habits, as well as other aspects of sports and fitness.
The system not only can be used in these areas, but also can
be monitored the human body better because the system
combined with ECG, respiration and movement. The system
utilizes different algorithms for exercise intensity and
human movements.
A. Exercise intensity algorithm
Exercise intensity can be calculated using the three-axis
acceleration data. The system calculates the variance of the
three axes and gets the sum of variance, and then mapped
the sum to the 0 - 100 range.
B. Human movement classification algorithm
Currently, most classification algorithms are based on
the 3-axis accelerometer monitoring data [16]. Using the
MPU6050 not only can get triaxial accelerometer data but
also can obtain triaxial angular velocity data and improves
classification accuracy and specificity of human movement.
Firstly, the system preprocesses the signal using an FIR
filter which -3dB cutoff frequency is 20Hz in order to
reduce the high frequency noise because essentially all
measured body movements are contained within frequency
components below 15Hz [18]. By comparing J48, AODE,
neural networks, support vector machines of four kinds of
machine learning algorithms, the system selects the J48
decision tree algorithm.
VII. HUMAN BODY TEMPERATURE
Relatively constant body temperature is one of the
important conditions for maintaining a normal life activity.
If the temperature is above 41 degrees or below 25 degrees,
Celsius will seriously affect the human system functional
activities and even endanger life. Long-term record of body
temperature,observing the changes is important in the
diagnosis of disease or determine the prognosis of certain
diseases.
The system can detect patient body temperature in real
time and the monitoring center will be long-term record
subjects and draw a trend chart temperature change in body
temperature. Doctors can combine trend chart temperature
changes and other parameters to make appropriate
recommendations or diagnosis of the client.

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VIII. COMPREHENSIVE ASSESSMENT

In order to make it easy for subjects without much
medical knowledge to learn more about their health, the
algorithm on the mobile device gives a motion intensity
score according to the motion states of the subjects,then
judges weather heart rate is normal according to this score.At
last the algorithm on the mobile device gives a composite
score based on the heart rate, the QRS segment and the ST
segment, the score is the so-called heart health index.
Notably, the above parameters have different weight.
Clinical cardiac physicians assigned different weights based
on the clinical severity of the above parameters and the
specific type. The system not only gives heart health index,
but also gives advice. Subjects can take action according to
the advice. The algorithm on the mobile device can also do
the fall detection according to the change of the gyroscope
data and the acceleration of a subject. When detecting the
fall, the mobile device will inform the family members.

Figure 3. The intelligent diagnosis system

IX.

Figure 2. The ECG waveform and heart health index on the mobile device
TABLE II.

Heart health
index
0~29
30~59
60~79
80~100

HEART HEALTH INDEX AND DESCRIPTION

Description
Morbid, avoid strenuous exercise and pay
attention to weather changes.
Vulnerable to disease, reduce outdoor sports
and pay attention to work and rest rules.
Not easy to get sick, take proper exercise
and keep a good mood.
Healthy, exercise more and keep it up.

The customer management center includes an intelligent

diagnosis system. The intelligent diagnosis system which
includes an expert diagnosis system which contains a lot of
knowledge and experience of chronic disease, using a human
expert knowledge, can judge and take precautions against
chronic diseases. The intelligent diagnosis system can also
use the neural network algorithm, using the patient database,
after the modeling and data training, to judge the chronic
disease according to the physiological parameters.

DISCUSSION

The wearable health monitoring system uses multi

parameter of ECG, respiration, movement and temperature
signal, rather than a single parameter and gives a
comprehensive analysis of the physiological parameters. The
wearable acquisition front-end has high stability. According
to the analysis of the breath and motion combined with the
ECG signal, the system can be effective in the health care of
the users and daily data accumulation. Using the data mining
to build applications and derived physiological parameter
model, the system provides a chronic disease prevention
mechanism with the pattern recognition technology. The
system can also effectively save medical resources.
ACKNOWLEDGMENT
This work is supported by Zhejiang Provincial Natural
Science Foundation of China (Grant No.LY13H180004)
National Natural Science Foundation of China (Grant
No.61103100) and Major Program of Zhejiang Provincial
Natural Science Foundation of China (Grant No.
2011C11052) .
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