CHAPTER ONE

1.1 INTRODUCTION

Health is always a major concern in every growth the human race is advancing in terms of
technology. Like the recent corona virus attack that has ruined the economy of China to an extent
is an example how health care has become of major importance. In such areas where the epidemic
is spread, it is always a better idea to monitor these patients using remote health monitoring
technology. So Internet of Things (IoT) based health monitoring system is the current solution for
it.
Remote Patient Monitoring arrangement empowers observation of patients outside of customary
clinical settings (e.g. at home), which expands access to human services offices at bring down
expenses. The core objective of this project is the design and implementation of a smart patient
health tracking system that uses Sensors to track patient health and uses internet to inform their
loved ones in case of any issues. The objective of developing monitoring systems is to reduce
health care costs by reducing physician office visits, hospitalizations, and diagnostic testing
procedure. Each of our bodies utilizes temperature and also pulse acknowledging to peruse
understanding wellbeing. The sensors are linked to a microcontroller to track the status which is
thus interfaced to a LCD screen and additionally remote association with have the capacity to
exchange alarms. If framework finds any sudden changes in understanding heart beat or body
temperature, the framework consequently alarms the client about the patient’s status over IOT and
furthermore indicates subtle elements of pulse and temperature of patient live in the web. In this
manner IOT set up tolerant wellbeing following framework viably utilizes web to screen quiet
wellbeing measurements and spare persists time. There is a significant capability between
SMS based patient flourishing viewing and IOT based patient checking framework. In IOT based
framework, subtle parts of the patient flourishing can be seen by different clients. The explanation
behind this is the information should be checked by passing by a site or URL. While, in GSM
based patient viewing, the flourishing parameters are sent utilizing GSM by strategies for SMS.
In most of the rural areas, the medical facility would not be in a hand reach distance for the natives.
So normally the people neglect any kind of minor health issues which is shown in early stages by
variation of vital elements like body temperature, heartbeat rate etc. Once the health issue has been
increased to a critical stage and the life of the person is endangered, then they take medical
assistance, which can cause an unnecessary waste of their earnings. This also comes into account
especially when certain epidemic is spread in an area where the reach of doctors is impossible. So
to avoid the spread of disease, if a smart sensor is given to patients, who can be monitored from a
distance would be a practical solution to save many lives. (Prajoona Valsalan et al 2019).
IoT based health monitoring can provide useful physiological information in the home. This
monitoring is useful for elderly or chronically ill patients who would like to avoid a long hospital
stay. Wireless sensors are used to collect and transmit signals of interest and a processor is
programmed to receive and automatically analyze the sensor signals. In this project, you are to
choose appropriate sensors according to what you would like to detect and design algorithms to
realize your detection. Examples are the detection of a fall, monitoring cardiac signals.
Using a single parameter monitoring system an approach to a remote health monitoring system
was designed that extends healthcare from the traditional clinic or hospital setting to the patient's
home. The system was to collect a heartbeat detection system data, fall detection system data,
temperature data and few other parameters. The data from the single parameter monitoring systems
was then availed for remote detection.
 CHAPTER TWO

LITERATURE REVIEW

2.1 BACKGROUND HISTORY TO IOT BASED HEALTH MONITORING SYSTEM

In recent days, various IoT systems were developed for health monitoring systems. Wang et al
(2013) designed a compatible IoT system for medical devices which was having multiple
communication standard. A resource-based data retrieving method (UDA-IoT) was proposed by
Xu et al (2014) for information-intensive health applications.
Peer-to-Peer (P2P) and IoT technologies were combined in a medical system called as a smart box
to keep the patients in control. Kolici et al implemented that compared the experimental results for
different scenarios. Web Real-Time Communication (WebRTC) was given by Sundholm et al
(2014) which focused mostly on the secured transmission of data multiple concurrent streams in
an efficient manner.
By enabling the electronic sphygmomanometer to communicate via Bluetooth, an Android
application was developed to record the data such as SBP-Systolic Blood Pressure, DBP - Diastolic
Blood Pressure and Heart Rate. That application made it easy to transmit the recorded data using
any mobile device and such data is then be recorded, abnormality is found out and message is
conveyed to the people.
A real-time application was presented with distributed flow environment for the IoT healthcare.
When the person under observation moves beyond range, data will be recorded in the local server
and communicated later. A Galileo board is an IoT-based device with embedded medical platform
for the designed for electrocardiogram (ECG) signal analysis and based on an algorithm, heart
function is monitored.
In market, few IoT Portable Medical Devices were introduced which upgraded the patient’s
mobility. But the security threats and few drawbacks were also there while using Portable Medical
Devices. When we started to consider light-weight IoT devices, using the existing databases,
diseases were predicted. But while such predictions, issues were in storage of databases and
analysis using those databases. A new cloud-based fine-grained health information access control
framework was introduced which addressed the security challenges and the cloud reciprocity
issues.
A proxy-based approach for end-to-end communication between the IoT-enabled living systems
was proposed to challenge the real world applications. A portable electric aid device was designed
specifically for the blind people in which ultrasonic range finders are mounted on the belt to find
the obstacles present in the users way and to direct the blind people through Bluetooth headphone.
Another depth sensor based den avigation system for the blind people with high accuracy and to
alert user via vibrio tactile feedback in the hand gloves.
When the previous works are addressed, there is a limitation of database connectivity between the
different cloud environment in monitoring the data in constant time intervals and to analyze data.
Considering this limitation, in this paper, we present a cloud-based Internet of Things system that
can be implemented in different health monitoring systems.

2.2 IOT BASED HEALTH MONITORING SYSTEM

The system with low cost based on IoT is used in several areas especially in the safety of
environment. This IoT device is an integrated network architecture and has a mechanism for inter
connecting various other sensors and transmission IoT data with the use of internet, the sensing of
the environment is done by sensors with a local sensors.
Naina Gupta et al. put forward a structure which aims to resolve the issue of time wastage during
the ambulatory services and in hospitals, they forces to send the data via GSM module connect
through the Bluetooth technology. Routine health check and monitoring the different body
parameters with the help of the different sensors attached to the body is the main focus. They
focused on developing a small size wearable system that can transfer the data through GPRS to
custom networks. (Naina Gupta et al. 2017).

Fig. 1: IoT based health monitoring systems

2.3 APPLICATIONS OF IOT BASED HEALTH MONITORING SYSTEM

IoT could have various applications in medical industry for improving the quality of life, saving
lives and reduce treatment cost. By using IoT based technologies, medical industry can improve
the ability of the healthcare system in minimizing human error, simplifying the treatment process
and quality of life for caregiver as well patient. IoT based monitoring system can help doctors in
treatments and predict a symptom before starting diagnosis. Monitoring system can also alarm in
medical emergency situations like falling of old age patient, patient has abnormal behavior as in
the intensive care unit (ICU).

• Health Monitoring
Medical sensors and wearable devices can capture vital health sign for health monitoring
and personal fitness program. Sensors can capture blood pressure, blood glucose, weight,
ECG, heart rate and body temperature etc. to monitor pediatric and aged person.
• Personal Fitness Monitoring
This class of sensor application is for those who want to stay fit and health. Sensors can
track personal fitness / progress of fitness level. Individual can track and record many
parameters to check his/her performance and workout routine. sensor are used here are
weight measuring sensors, activity monitors sensors like walking time counter, step
counter, speed counter, calorie counter and heart rate and blood pressure measuring
sensors.
• Chronic Disease Monitoring
Millions of people are suffering from chronic diseases like cancer, diabetes, asthma, heart
diseases, sleep disorders and arthritis. Special care is need in such kind of disease. It
required disease specific diet and treatment plans. By using physiological sensors like
ECG(electrocardiogram), EMG(Electromyography) and EEG(electroencephalogram) with
activity monitor sensors like step counter, speed counter, calorie counter etc. can be used
for early detection of symptoms and adverse changes in a patient’s health condition that
will cause to early and timely medical treatments.
• Medication Management
It is general human tendency of noncompliance of medication prescribed by physicians.
This may cause threat to patient health as well financial loss. IoT based an intelligent
 packaging method for medicine boxes can be used for medication management. This
packaging method have controlled sealing which is based on delaminating materials and
that is controlled by wireless communications.
• Home Rehabilitation
IoT based healthcare has the potential to improve rehabilitation. IoT based Sensing
technology with Virtual Reality environments and augmented feedback systems can be
used for home-based rehabilitation system for aging population. IoT based technologies
can be used for remote consultation.

2.4 ADVANTAGES OF IOT BASED HEALTH MONITORING SYSTEM

• Reduction in treatment cost

Internet of Things based healthcare provides 24/7 and real time patient monitoring. It will
definitely reduce unnecessary hospitals visits and transportation cost too. Patient can have
doctor advice through online video streaming at their home and only on critical situation
patient may reach to hospitals only. IoT based healthcare monitoring can reduce insurance
premiums as well patient working leave for health checkup.
• Reduction in human error
In IoT based healthcare monitoring Physical health information like blood pressure, sugar
level etc. is collected vary accurately by sensors and corresponding decisions is taken by
big data analytics technique. It helps in minimizing human errors.
• Remove geographical barriers
Any patient can take medical advice from any corner of the world because Physicians and
patient are connected globally via internet.
• Early detection of chronic disorders
Using big data analytics and data mining techniques on Physical health information that is
generated by medical sensor, it is possible to predict chronic disorders in early stage and
treatment can be done before it become incurable.
• Immediate medical attention
IoT based medical devices can alarm healthcare provider or family members in case of
medical emergency like rise in blood pressure or fall of a senior family member.
2.5 LIMITATIONS OF IOT BASED HEALTH MONITORING SYSTEM

• Security and privacy

Security and privacy remain a major concern deterring users from using IoT technology
for medical purposes, as healthcare monitoring solutions have the potential to be breached
or hacked. The leak of sensitive information about the patient’s health and location and
meddling with sensor data can have grave consequences, which would counter the benefits
of IoT.
• Risk of failure
Failure or bugs in the hardware or even power failure can impact the performance of
sensors and connected equipment placing healthcare operations at risk. In addition,
skipping a scheduled software update may be even more hazardous than skipping a doctor
checkup.
• Integration
There’s no consensus regarding IoT protocols and standards, so devices produced by
different manufacturers may not work well together. The lack of uniformity prevents full-
scale integration of IoT, therefore limiting its potential effectiveness.
• Cost
While IoT promises to reduce the cost of healthcare in the long-term, the cost of its
implementation in hospitals and staff training is quite high.

2.6 RELATED WORKS

Some important works have been done in the field of medical science using IoT to monitor
patient’s health. The works associated in this field are outlined as follows.

Tamilselvi et al. (2020) developed a health monitoring system that can monitor basic symptoms
of a patient like heart rate, percentage of oxygen saturation, body temperature, and eye movement
in IoT network. For this purpose, the system used Heartbeat, SpO2, Temperature, and Eye blink
sensors as capturing elements and Arduino-UNO as a processing device. The developed system
was implemented but no specific performance measures are described for any patient. Acharya et
al. (2020) introduced a healthcare monitoring kit in IoT environment. The developed system
monitored some basic parameters of human health like Heartbeat, ECG, body temperature, and
Respiration. The major hardware components which are used here are pulse sensor, temperature
sensor, BP sensor, ECG sensor, and raspberry pi. The data were collected from sensors and sent it
to raspberry pi for processing and again transmitted it to IoT network. The major drawback of the
system is that no interfaces for data visualization are developed.

Banerjee et al. (2016) proposed a pulse rate detection system based on a noninvasive technique.
The proposed system used plethysmography process and correspondingly displayed the output
digitally that made it a real-time monitoring device. The method has proved as reliable for the
patient compared to other invasive techniques. Gregoski et al. (2012) introduced a smartphone-
based heart rate monitoring system. The system used a mobile light and camera to track finger
blood flow and calculated blood flow-based cardiac output. The developed system described an
integrated device that wirelessly transmitted a person’s pulse to a computer, empowering people
to test their heart rate by merely looking at their phones instead of using hands each time. This is
an excellent design but it is not feasible if continuous heart monitoring is needed. Oresko et al.
(2010) mentioned a fully functional cardiovascular disease sensing system for smartphones,
identifying a tool that is developed to be the same given sufficient time and monetary resources.
The developed prototype only tracked coronary rhythm in real-time, did not track heart rate over
time, and could not detect any cardiovascular disease.

Trivedi et al. (2017) suggested a mobile device regulated Arduino-based health parameter
surveillance framework. The collected sensor data are analog and sent it to the board of Arduino
Uno. By the integrated analog to digital converter, the recorded analog values are converted into
digital data. Bluetooth transmitted the physical qualities to the developed device. The Bluetooth
device used a module not covering a wide area. Kumar et al. (2017) developed an adaptive IoT
safety monitoring device. The configuration of the framework is separated into three layers such
as the control layer, the device layer, and the transport layer. A DS18B20 sensor was used for the
measurement of body temperature in the control segment and a pulse sensor is used for the pulse
measurement. The data were loaded from Arduino into the cloud through the Wi-Fi module and
Ethernet shield on the transport layer.
 CHAPTER THREE

DISCUSSION

Melisa Pereira and Nagapriya Kamath K tries to solve the issue of wireless data transmission by
considering Body Fat percentage & heart rate as her primary element. For the proposed solution,
they used Arm 7 processor which work on data transmission through Wi-Fi. The whole system
seems to be limited because the use of technology that doesn’t support such long range
communication. (Melisa Pereira and Nagapriya Kamath K, 2017).

Tati Erlina et al. made a system which is focused to solve the issue of monitoring comatose
patient’s physiological condition by monitoring heart-beat, respiratory rate & eyelids status. This
total system is made to send the data to Android App on the mobile phone on which application is
made to show different readings measured. But the solution is failed to hold the security of the
system and put the important data on risk. (Tati Erlina et al. 2018).

Kumar et.al uses Raspberry Pi along with sensors to track Patient’s Body temperature, heart beat
Rate, body movement and Respiration Rate. Here IR transmitter and receiver is used to monitor
Heart beat rate. In this system he is using general circuitry or basic electronics system for the
conditioning of the system like amplifier to increase the gain of the system as transference of the
signal from range may lead to attenuation for that part used amplifier. Transformer specifically
step down transformer is used to bring the input voltage of 230 V to convert into 9 volt and 5 volt
and here SMPS (Switched Mode Power Supply) is also used because every sensor have different
input. (Kumar et.al, 2016).

Ashwini Gutte et.al. Proposed an IoT based fitness tracking system of aged persons in which he
used different parameters of Body glucose, Blood Pressure, Heart Beat Rate as well activity
monitoring etc., with the approach of Raspberry Pi. Gutte also used ECG (Electrocardiogram)
sensor for heartbeat and other diseases. He also proposed different IoT based protocols which can
be used in this type of system. (Ashwini Gutte et.al, 2018).

Zia Uddin Ahmed and his team proposed this Iot Based structure for monitoring the wellbeing of
the patients with the help of wearable biomedical devices. In this system, sensors are connected to
microcontroller along with GSM module for sending information to the user or its family in an
emergency situation. This system comprises of so many hardware devices which are directly
connected to the body of patient. And this data is distributed in multiple sectors and this gives the
user an opportunity to take data from multiple locations. (Zia Uddin Ahmed et al, 2017).

Uddin et al. proposed a real-time tracking system that can be supportive in ICU. This system
configures all the data with the help of body sensors in support of Arduino Uno and transfers it to
an application. This app is helpful in monitoring various parameters in a specific range and
connectivity. With the help of IoT Cloud and IoT protocols, they offer a varying range of
transmission of data to the developed app. (Uddin et al, 2018)
 CHAPTER FOUR

SUMMARY AND CONCLUSION

4.1 SUMMARY

Personal physiological data from the patient is collected that simulates fall detection, heartbeat,
temperature, humidity, toxic gas, air quality control, pressure. The readings are collected in a
simple cloud database and can be viewed remotely by a doctor or Healthcare giver. The data can
also be used in research on medical issues affecting the elderly or chronically ill. On the security
of the data, the database system is protected with Advanced Encryption Standard (AES). This
generates the secret key which can be used to decrypt the patients’ records ensuring that only
authorized personnel access the data. This safeguards the patients’ records from unauthorized users
and hackers who may want to intercept.

4.2 CONCLUSION

The system introduced smart healthcare to monitor the basic important signs of patients like heart
rate, body temperature, and some measures of hospital room’s condition such as room humidity,
the level of CO and CO2 gases. The rate of success between the observed data and actual data is
approximately greater than 95% for all cases of the developed healthcare system. Authentic
medical staff can view and track the data in real-time even though the patients perform the tests
outside of the hospital. The system can also benefit nurses and doctors in situations of epidemics
or crises as raw medical data can be analyzed in a short time. The developed prototype is very
simple to design and use. The system is very useful in the case of infectious disease like a novel
coronavirus (COVID-19) treatment. The developed system will improve the current healthcare
system that may protect lots of lives from death.

Although the system looks somewhat bulky, it will be a tiny device by proper manufacturing in
the near future. The video feature can be added for face to face consultation between the doctors
and patients. Some more measures which are very significant to determine a patient’s condition
like the level of diabetes, respiration monitoring, etc. can be addressed as future work.
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