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A futuristic IOT based approach for providing healthcare support through E-

diagnostic system in India

Conference Paper · February 2017

DOI: 10.1109/ICECCT.2017.8117810

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 A Futuristic IOT Based Approach for Providing
Healthcare Support through E-Diagnostic System
in India
1
Sayan Sarkar, 2Renata Saha
National Institute of Technology, Durgapur 713209, India.
E-mail:1sayansarkarnitdgp@gmail.com 2saharenata@gmail.com
Abstract – United nation population report predicts that the
world population will hit 8 billion by 2026 with hopping 1.5
billion in India. This increased population demands
improved medical facilities only to realize there are not
adequate doctors on role leading to deaths of nearly 1M
Indians every year & approximately 700M deprived of even
preliminary health treatment thereby carrying 21% of the
global disease burden. In general, doctors are either not
willing to serve the rural areas or they are not available 24x7
that is causing rural population to travel to cities even for
casual ailments. According to WHO (World Health
Organization) reports, India have less than 0.7 doctor /1000
population which is lower as compared to ratio of 4.3 in
Russian federation, 3.8 in Argentina, 2.4 in USA & WHO
Benchmark. Indian government spends just around 30% of
the total budget in healthcare which is a penny in
comparison to the USA & the UK. This increased population
demands lower operational cost with high accuracy, early
detection followed by prevention. In this paper, a futuristic
approach is proposed to support the existing healthcare
system by designing a preliminary multipurpose-health
parameter monitoring chair with E-diagnostic feature within
a medical booth, analogous to an ATM booth. The attractive
part of our system is low priced diagnosis, non-invasiveness,
indigenously built medical apparatus, misdiagnosis
prevention with fast systematic approach.
keywords— Population report; ECG; Healthcare; NHP; BP;
Heart rate; Doctor; Business model
I. INTRODUCTION
According to Mckinsey report, December 2012 prepared
for CII (Confederation of Indian Industry), “Indian
Healthcare: Inspiring Possibilities, Challenges and
Journey”; India will spend 5.5% of the current GDP
compared to 4% on 2022 in healthcare. India is a LMICs
according to World Bank classification with stunning 70%
of the populace still living in rustic territories that has no
or constrained access to healthcare facilities. Despite this
fact, around 80% of experts live in urban ranges. In a
conference at Harvard school of Public Health (HSPH)
in 2012, it was noticed that India spent about $40 per
individual every year on healthcare though US burned
around $8,500. Indeed, the growth in consumption on
aggregate medicinal services in India has been diminished
from what it was 10 years back (from 4.3% to 4.05%). At
this rate, within 10 years, the healthcare system will
become more unorganized because of increase in
population, greater rush on OPD (outdoor patient) &
978-1-5090-3239-6/17/$31.00©2017IEEE
dire need of funds. Long tradition of health sector
analysis makes it clear that unequal income, poverty and
variable distribution of access to resources trigger to
non-fulfilment of health needs of the poor. A huge number
of patients drop out of treatment due to logistics and cost
challenges involved in diagnosis & treatment. Health care
to the poor is directly linked with poverty mitigation as
poor people face barriers in obtaining health care beyond
simply their inability (financial or technical problem) to
afford it. Moreover in villages, male patients have the
provision to go urban areas for treatment but women are
generally deprived of this facility due to household
problem. Improvement in health care infrastructure &
facilities, private funding or PPP (public private
partnership), swift and hassle-free entry into essential
medicinal services for all- are the main path for India to
battle against medical problems. In this respect, other than
traditional healthcare service, biological signal monitoring
through portable, electronic, web-based wearables
approach assumes a basic part in healthcare administration
for treatment, and assessment of treatment adequacy but
our system is comparatively better than them due to
elimination of placebo effect. In recent Intel health
barometer survey which spreads throughout 8 major
countries like India, USA etc., it has come out that 72%
of consumers are willing to see a doctor via tele-health
video conferencing for non-urgent appointments. The
primary objective of unconstrained estimation is to
reasonably screen healthcare related data through natural
biological signs without intruding on the user's standard
every day exercises & extra operations or collaboration
effort to make signal estimations. A scheme is proposed
using wearable electronics which is supporting the
traditional health check-up system by increasing health
awareness on one hand, while on the other keeps the cost
at bay. Not only this, it also helps further development of
National Health Statistics report or development of
Health Data (Digital database of health statistics) through
further analysis. Although CBHI (Central Bureau of
Health Intelligence) are publishing NHP (National
Health Profile) every year, it still lacks in aspect like
“accurate disease profile”. It is a common phenomenon in
which people have medical issues which are known to
them but are unwilling or unable to go to a physician.
Obesity, High Blood Pressure, Irregular Heartbeat or
Diabetes gives evidence of such common ailments. In
traditional doctor centric model, nearly 80 % of the
patients opt for hospitals for non urgent cases. In these
cases, individuals are typically encouraged to
intermittently visit doctors for routine therapeutic check-
up but traditional system cannot cater the needs of the
growing population after 5-10 years down the line. Since
late nineties, Wireless Sensor Network (WSN) has always
pioneered in different forms of sensing [1-2]. This
information was transmitted over telephonic systems but
the applications were constrained to measuring basic body
parameters [3]. Framework outlined in [4] for the elderly
individuals who require frequent checkups for numerous
cases which incorporate Real Time Health Advice and
Action (ReTiHA) & parent observing for individuals with
their family living abroad means they can access to their
parent's health records occasionally. Existing literature in
[5] have included checking frameworks in light of
Wireless Sensor Networks with subtle sensors inserted on
the patients does not limit exercises and body
developments but lacks in multidimensional approach.
A.Triantafyllidis et. al [6]-[7] mentioned reconfigurable
and decentralized sensors for observing which will
hereafter permit simple expansion and cancellation of
sensors for new patients to the framework. The utilization
of video to screen the patient in the current design is
specified in literature [8]. The video is activated when
estimations of sensors rupture a specific given limit. An
Android gadget is used to investigate ECG signals from a
portable monitoring terminal is included in existing
literature but multiple test facility is not possible as well
as not customer friendly. Marıa de los, concentrates on the
protection and security issue in a WSN based checking
framework. Machine for Automatic Medical E-doctor:
Web based Support Vector Diagnosis [11] is proposed but
it is not implementable in a country like India due to its’
overcrowded nature (Training of system is nearly
impossible due to its diverse nature) and social taboo
related problem. Rajasthan health department has
started an initiative “Asha Soft” for E- Health monitoring
system but it’s diagnosis is based on observation of health
worker (Tele-medicine) not fully technology oriented. In
Indian Subcontinent E-Vaidya, Practo those companies
are mainly E-healthcare service provider but they
normally do not take into account wearable electronics
section. YOLO health, E- health access etc. are known,
matured start-up companies working in this area but their
business model is not cost effective and has some
operational drawbacks like non-repetitive in nature,
absence of evaluator system. There have been a couple of
thoughts with respect to chair based biological signal
monitoring. Kim et al. built up a chair that employs pulse
arrival time (PAT) calculation from ECG and
Photoplethysmogram (PPG) signals for unconstrained BP
monitoring. ECG was measured utilizing conductive
metal and PPG was measured utilizing a commercial
sensor introduced as a part of the armrest [9]. Wu et al.
built a comparable chair yet rather than conductive metal,
their gadget incorporated a capacitive coupling ECG
sensor. Junnila et al. used electromechanical film (EMFi)
sensors installed in a chair seat to measure
Ballistocardiogram (BCG) in an unconstrained manner.
Karki and Lekkala also recorded BCG utilizing a chair &
their gadget used based on Poly vinylidene fluoride
(PVDF) film rather than EMFi sensors [10]. The BP
measuring chairs portrayed before were proposed to be
totally unpretentious; some still require client
consideration & co-operation. Other designs are less
meddlesome, since they record biological signs while the
subject essentially sits on the seat. The vast majority of
these frameworks give constrained health data, on the
grounds that each measurement includes just a single sort
of flag. In our work, patients are diagnosed utilizing an
efficient chair facility which collects and procedures
information from a variety of wearable sensors. The
precision of the information received and responsiveness
to looming crisis increments with the utilization of higher
amount of sensors or with sensors having more grounded
detecting and preparing capacities. Subsequently the
aggregate number of parameters to be observed must be
planned keeping mind the balance on cost, complicacy
and the unwavering quality of the framework. The system
is focusing to cater the need and reach out to larger
section of population (remote and untapped) with highly
scalable Health ATM model. It is leveraging the gap
between supply and demand by diverting remote
consultations to potential hospital visits by reducing
waiting-times for secondary and tertiary investigations as
well as delivering healthcare without any infrastructure,
man-power and resource overheads.
II. OVERVIEW OR SCHEMATIC OF THE PROPOSED
SOLUTION
A. Weight sensor & Height Measurement
A simple weight & height measurer is integrated adjacent
to chair can serve the purpose but lacks in data
connectivity. Commercially available microcontroller
based load cell set up as in Fig.1 with Bluetooth
connectivity & height calculator based on Ultrasonic
sensor or proximity sensor set up can serve the purpose.
Fig.1. Microcontroller based pressure sensitive weighing machine
B. HR, Breathing Rate and BP calculation
The Proposed system uses bio-potential signal (ECG) and
Magneto-Plethysmography (MPG) for the Heart Rate,
Breathing Rate and Blood Pressure calculation [12]. The
very aspect of sitting posture position and arm, rest on the
electrode-equipped arm rest (suitably positioned) is used
to acquire the signal for implementing the monitoring
system [13]. The system comprises the following parts (a)
electrodes (E1, E2, EG) on the two parts of the arm, (b)
Analog front-end electronics, (c) heart rate estimation unit
and display [13].

Fig.2. Health monitoring chair in different view
Two suitably positioned electrodes E1 and E2 are
employed to acquire the ECG signal. When the patient
places his/her hand on the electrode- setup (touching all of
the electrodes E1, E2, EG) of the seat and arm rest, a feeble
voltage signal will be observed at the electrode E1 with-
respect to E2 [13]. This differential signal (say VS1-VS2)
gives raw ECG signal & is processed further by the signal
processing blocks for Heart rate & BP output
computation. [13]
C. GMR Sensor based signal monitoring
An innovative approach for a constant non – invasive and
round about estimation of blood pressure depends on
changes in Pulse Wave Velocity (PWV). [14] Pulse wave
velocity is the speed of pressure pulse spreading along the
blood vessel divider that can undoubtedly be ascertained
from Pulse Transit time (PTT). PTT is time between two
heartbeat waves penetrating through the same
cardiovascular cycle from two separate blood vessel
destinations. PTT shows quasi-linear characteristic for
low blood pressure (BP) values but increases
exponentially at higher pressure.[14] Keeping in mind the
end goal to get a quantitative gauge of the blood stream,
various types of estimation standards and physical marvel
connected with blood stream, for example, capacitance,
impedance, photoelectric, magnetic induction
plethysmography has been concocted and presented.
Impedance, magnetic induction and magnetic
susceptibility plethysmography which are proposed in
past literature [14] are fit for measuring cardiac-volume
changes & cardiac output. The scope of application
was limited to the torso which is supposed to have a
large quantity of moving blood volume. At peripheral
blood vessels, Photoplethysmography (PPG) is broadly
acknowledged method for estimation. Nonetheless, the
level of constriction of either transmitted or reflected light
flags is not related just to the light frequency but rather
additionally to some natural biological components, for
example, the clustering and gathering of erythrocytes.
Alongside these, with a specific end goal to identify blood
volume changes which is less influenced by the optical
and biological attributes of the living tissue, the magneto-
plethysmography (MPG) sensor is utilized in view of the
way that the reflected impedance of an energizing loop
close to an biological sample would be influenced by the
change of the electrical conductivity [14] of the sample as
per the change of blood stream volume. The proposed
System basically consists of three main parts (1) GMR
(Giant Magnetic Sensor) unit, (2) Analog signal
conditioning unit (3) Digital signal processing unit.
[13] The GMR sensor unit consists of a GMR sensor and
magnet placed in vicinity of it. GMR sensor IC responds
to the magnetic field variations around it. GMR sensor is
positioned on the wrist of person & magnet is positioned
around it in such a way to ensure its working in linear
operating region. The flow of blood through the radial
artery will induce the disturbance in constant
magnetic field produced by the magnet and these
disturbances are observed as voltage signal by the
GMR IC [12-13]. The MPG signal obtained from the
GMR sensor is fed to the instrumentation amplifier
(INA) which attenuates the common mode noise of the
signal [13]. The signal is thereafter provided to the
bandpass filter to ensure the removal of high frequency
noise and fed to digital processing circuitry. The signal at
this point consists of two major frequency components,
(1) Low frequency component of Respiration which is
in the frequency range of 0.2 Hz to 0.34 Hz, and (2) High
frequency Heart rate component [13] which is in the
range of 0.8 Hz to 2.5 Hz (max). The MPG signal consists
of low frequency motion artefacts and high frequency
disturbances. [13] Hence it is given to the analog signal
conditioning unit to obtain a clean MPG signal for further
computation.
D. Digital stethoscope
As per proposed approach, a custom-fabricated [15]
sensor is utilized to catch heart sounds (cardiovascular
mumble) at 8 kHz and proselytes them to electrical signs
to be processed by an ATmega644 microcontroller.[15]
Cardiovascular mumbles are the sounds delivered by the
unusual entry of the blood stream inside the heart because
of the sick valves or tissues. The recorded signs are
yielded by means of pulse-width adjustment to a standard
3.5 mm audio-socket for continuous auscultation. What's
more, the stethoscope utilizes a 1MB external Flash
memory chip [15] to record and playback sound
waveforms. For the user interface (UI), the framework
incorporates a 4-line 20-character wide LCD show and a
16-catch keypad. Continuous and recorded information
can likewise be pictured utilizing a MATLAB interface
that keeps running on a different PC and associates with
the stethoscope framework by means of the USART
interface on the microcontroller as in Fig. 3. [15]
Fig. 3. System design of High level stethoscope [15]
There is a system for creating valuable embedded CAD
(Computer Aided Analysis) devices for heart mumble
identification [15]. The created interface utilizes the
transmitted information to hear and show measurements,
identified with the patient's average heart pulsation every
minute. During the Process, the monitor commands him to
fit the stethoscope connected straps of the back rest across
his chest which faces the valve of the chest piece. The
straps are connected to the X-Y-Z-control positioned at
the edge of his left arm-rest such that patient can control
movement of chest piece throughout his chest for
recording heart sounds in microcontroller. [15]
E. Non – invasive Rapid blood test
Worldwide researches are going on multipurpose portable
blood diagnostic kit. Recently a team of scientist from
EPFL developed a tiny device that can be used to detect
concentration of substance by pricking blood in very
small amount. Researchers of UC Berkley have
developed a prototype onto a flexible circuit board. By
"tasting" a person's sweat, the device can measure
glucose, lactate - a marker of low oxygen levels in the
body - sodium, potassium and skin temperature. But these
approaches can only be implemented after large scale
testing. A POCT based (Point of care Testing) method is
developed using cyclic voltammetry potentiostat which
detects concentration & nature of compound (Bio-
Analyte) in a solution. Initial focus is on Blood related
parameter detection but it can be applicable to any
concentration based detection. (UTI, diabetes mellitus,
uric acid level detection).[16] Cyclic voltammetry is the
most widely used technique which offers a rapid location
of redox potentials of the analyte using Dropsen screen-
printed electrode (a low cost disposable devices
specially designed to work with micro volumes of
sample). Screen-Printed electrodes are made of carbon,
gold, platinum, silver or carbon nano-tubes inks with
general dimensions: 3.4 x 1.0 x 0.05 cm. The arrangement
of the counter & working electrode should be such that it
ensures a uniform current density at the surface of the
working electrode. [16]
Fig. 4. Developed concentration detection kit
Human Bio-fluids like Blood are non-electrolytic in
nature; suitable aptamer will be used to activate them for
further analysis. In a cyclic voltammetry experiment, the
working electrode potential is ramped linearly versus
time. The current at the working electrode is plotted
against the applied voltage to give the cyclic
voltammogram trace. Cyclic voltammetry is generally
used to study the electrochemical properties of an analyte
in solution. The current peak in voltammetry is directly
proportional to the concentration of the species & the
value of the applied voltage at peak current refers to
the oxidation/reduction point of the compound, which
is unique. In a reversible electrochemical reaction, the CV
recorded has well defined characteristics like the positions
of peak voltage do not alter as a function of voltage scan
rate as per Randles-Sevcik equation. As input signal is
created using PWM function of Arduino, it is not linear
rather staircase type, with increasing the no. of steps,
signal become close to ramp & resulted current is ripple
free. Voltage generated to control a potentiostat should be
'clean', undesired noise shall be as low as possible.
Potentiostat circuit is designed using precision Op-amp
and I/O functions.
Fig. 5.Operational procedure
A plotter which receive data from hardware circuit and
trace live plot is required to trace the cyclic curve
between output signal and applied voltage signal &
related Cyclic plot is drawn on X-Y plotter using
“Processing” based on available data from serial port of a
computer/mobile and saved for future analysis. After
every half cycle plot data i.e. Voltage and Current
values are saved in CSV file format. Development of
GUI (Graphical User Interface) using “Meganulink
Pro” will integrate the job of Arduino code uploader and
graph plotter as in Fig.4 & Fig.5 inside a single window
(compactness). It will enable a common user to use the
device easily as well as open the wide area of mobile app
based testing. It is tested for electrolytic solution and
performing quite well. The resulted data is transmitted
using “ESP 8266” module via mobile to nearby health
centre or ATM booth’s setup which in turn lead the
periodic health check-up scheme for rural woman &
medical technician can easily access the device remotely
and troubleshoot it.
III. SECURITY, PRIVACY & PREVENTIVE MEASURES
In this segment, we have talked about the different issues
identified with this E-health monitoring framework. As
the framework is worried with the state of human
healthcare & medicine, prescribed online by the specialist,
it is the earnest way to consider suitable efforts to
establish safety. This is required to secure the patient's
health and to guarantee whether the patient is accepting
legitimate medicinal direction or not. In the event that the
patient's profile is traded off or a remedy is
transferred or altered by any unapproved individual
other than specialist, this can have malicious impact on
the patient.
A. Confidentiality of data
Health record of a patient is secretive in nature with the
end goal that the privacy of the patient is guaranteed
(Physician Patient Privilege). In the proposed
framework, an arrangement is kept for trusted individuals
(family members)[5] to get to the patient health record
along with the patient health profile which is linked via
ADHAR type card which is Password or ID no. specific.
The timestamp information can be handled utilizing 8-bit
or 16-bit processor which guarantee the novelty of the
information. [17] This information is sent to the cloud
from gadgets through HTTPS association that hinder any
sort of security dangers in regards to privacy.
B. Integrity & Authenticity
Purity guarantees exactness of information throughout the
procedure. Secure Hash Algorithm [17] (SHA-1 or the
most recent adaptation of it) can be utilized as a part of
this framework to guarantee message purity. The
timestamp is additionally checked to know the novelty of
the information. In the event that the information is not
time stamped, it must be disposed of as the state of a
patient may change any moment. The identity of both the
specialist and patient requires approval keeping in mind
the end goal to guarantee legitimacy of the framework.
[17] In order to be able to use our system, he/she has to
register their personal details which include demographic
information, fill in an online questionnaire on medical
history & eating habits and finally, sign a personal data
consent form or in an emergency basis he/she can opt for
quick registration. For this situation, advanced marks or
unique fingerprint scanner can be utilized as an image
of approval through which it is guaranteed that the
individual is genuine & is really who he/she is asserting to
be. Non Repudiation is one of those standards of the
security framework [17] which guarantees trustworthiness
and genuineness of information. In the event that a
message is sent, the sender can't deny that he/she has sent
the information. Additionally the beneficiary can't deny
the way that the information has been obtained. In the
event that non-denial is guaranteed the specialist ought to
be dependably in charge of each of his reactions through
the framework.
IV. SYSTEMATIC CASES & THEIR ANALYSIS
In this section, we have talked about a couple of the
practical utilizations of our framework. There are genuine
situations, where the framework can turn out to be
proficient and helpful.
A. Doctor Registration
This architecture can support storage of regional databases
from which the information about a patient can be
fetched. During sign up process, they will have to upload
the scanned copy of their certificates, bank account details
and upload a Statement of Purpose as to why they want to
join this community. It is completely the choice of the
patient, whether he/she will consult a doctor after the
preliminary tests. Questions may arise why a doctor will
choose our system leaving traditional one where he can
earn sufficient money. According to model
implementation approach, it is easy to use interns (current
MBBS pass out student) who are skilled but do not have
much earning & experience, it can be useful for them to
get vast experience. In rural India, health care providers
without formal medical training & self-declared
“doctors” are sought for up to 75% of primary care
visits. The status of informal providers in the complex
Indian health system is the subject of a highly charged
debate among policy-makers and the medical
establishment. Recent research by Das, Jishnu, et. al [18]
reveals that the impact of training informal health care
providers increases correct case management by 14.2%
yet diminishes the utilization of superfluous drugs and
anti-infection agents. Their study suggest that informal
health providers incorporation with multiple medical
training [18] along with our proposed booth setup offers a
viable methodology to enhance medicinal services in a
stopgap approach. The database must be overhauled
routinely, so that, at whatever point the patient feels
unwell, he/she can have approach the framework, picking
doctor from the proposed list of doctor by the framework.
This framework will help a patient to go to near-by
specialists for crisis after ordinary registration and can
execute quick registration as opposed to setting off to the
healing centre. This will lead to the decrease of no. of
unattended patient. Moreover, the focus on hospitals will
be shifted on secondary & tertiary healthcare while the
preliminary health check-up can be done outside the
hospital. This in turn reduces the rush of Outdoor Patients
(OPD) during peak hours of treatment time in doctor’s
clinics and chambers.
B. Customer friendly Nature
The system is designed in such a way patient can only opt
for a prescription. Taking an example from our daily life,
a patient suffering from stomach ache is given high
dosage of useless vitamins because that doctor gets good
revenue from the medical representative who sells that
vitamin. According to their qualifications and the SOP
uploaded, the doctors will be then grouped into two
categories: (1) Examiner (2) Evaluator. This sort of
malpractices as mentioned beforehand can be forcefully
stopped because the evaluator re-checks the prescription
periodically. Examiners are ordered to write only the
generic name of the medicines in the prescription. If
he/she wishes to consult doctor, then the registration
numbers of the available doctors according to his
symptoms are displayed on the monitor screen. Patient
can select any one doctor of his choice. The doctor listens
to symptoms and just types a prescription with the
medicines. The typed prescription is then sent for
validation to the evaluator of the patient’s choice which
will also be displayed on the monitor screen and
subsequent barcode is printed on the paper. The evaluator
rechecks the prescribed medicines according to the
symptoms of the patient and barcode will be updated. In
cases, if evaluator is not available, then, the patient
receives the prescription marked as not evaluated and after
evaluation his final prescription will be attached to his
health profile. The final prescription is generated & a
digital copy is deposited as well as mailed to his/her
account for further use & national health profile tracking.
V. PROCESS FLOW & BUSINESS MODEL
A. Treatment flow
A person feeling unwell or on a periodic basis may stop
by and seek entry into such a booth by surpassing a
fingerprint scanner maintaining database of the patient or
can opt for quick registration programme through mobile.
The booth will be preferably located adjacent or near a
pharmacy. A helper will be there to assist him to sit on the
chair placed in front of the monitor.
Fig. 6. Treatment flow model diagram
The session starts with webcam’s rolling. The monitor
displays a command asking the patient to choose preferred
language. Abiding by the commands displayed on the
monitor, the helper assists the patient to take up all the
medical tests namely, Blood pressure, ECG, heart
sounds using Digital Stethoscope, Height, and Weight
etc. All these recorded data will be transferred to monitor
via Bluetooth 4.0 or Wi-Fi module. Monitor then displays
a message or dictates in his preferred language giving
choice to the patient whether he wants to consult a doctor
as in Fig. 6. If the patient approves the request to consult
a doctor, he/she is given two options if he wants to access
previous doctor for better service or not. If he approves of
that choice, patient can contact the previous doctor or
move on with some different doctor which the patient
selects afterwards. If the doctor is available, he is
contacted online. He/she will diagnose the patient
listening to his symptoms. The reports are then transferred
to the doctor who then prescribes medicines & stored in
the cloud server for future use. The pharmacy will scan
the barcode with an app specially built for them and give
them the prescribed medicines as well as printed
prescription with doses. The patients who have contacted
the doctor will have to pay some extra money to the
pharmacy or hospital outlet to receive the medicines.
Estimated time of the entire session is 6-7 mins where all
the tests are done which is very less than the prevalent
medical system. The more organized a system would be,
the harder it will be for the cash to vanish ‘in the process’.
The tangible benefit of our system is that it is fast and
versatile but other benefits such as preventing corruption
at its nascent stage. The system is organised and it will
help raising health awareness among ordinary people as
preliminary health diagnosis is cheap. (INR 30) Besides,
we will make assure of the abundance of the health booths
in the localities such that people have easy access to check
their health. (1 booth for approximately 8000 people).
Model implementation approach
Healthcare rural model- https://youtu.be/6809hB_XlR8)
Healthcare town model- https://youtu.be/4cczQVAPYe8)
B. Cash flow
Fig. 7. Cash flow model diagram
Our business model is basically "Freemium" model
which is a web based business model, where basic
services are provided free of charge or at a very low cost
while more advanced features must be paid for. If the
patient has opted for doctor, during medicine collection a
specified amount of fee as in Fig. 7(algorithm based) is
collected through pharmacy shop which will be submitted
to government during course of action. It will also
diminish the OTC (over the counter) related medical drug
problems in India. Doctor will receive a stipend as well as
some non-monetary benefit for their service. Technician
will also receive a stipend on a scheme basis. Business
can be developed in this segment using direct model or
collaboration model. We are Proposing empowerment in
franchise model to a rural man / woman (preferable) by
engaging them as a technician as well as pharmacy shop
owner (micro entrepreneur) trained to serve the medical
needs with revenue sharing model. In revenue sharing
model, basic setup cost (land, electricity etc.) & 40% cost
of the doctor’s salary will be borne by the pharmacy
owner whereas rest cost will be borne by the start-up. For
this, 35% of the income will be shared by the pharmacy
shop & rest will be shared by the start-up. Financial
burden has been considerably decreased over the
developer through this system. It will lead to win- win
situation for all stakeholders like government, public,
pharmacy etc. (Physician patient privilege).
VI.POTENTIAL FAILURE MODES & RISK MITIGATION PLAN
1. Technical challenge - SNR (signal to noise ratio)
variation is observed for the ECG signal with cloth
thickness. [13] Different SNR is observed for different
type of clothing. It is noted that if the cloth thickness is
increased the SNR value decreases. Direct contact sensors
can be provided at the hand for nullifying the problem of
cloth thickness [13]. Best results are observed with the
cotton cloth. Earlier literature reported that, it is better to
use cloth materials as electrodes [19]. If the system is used
in the periphery of a strong magnetic field it can lead to
Saturation of the GMR sensor, which in turn will stop
the MPG signal observation, Existing literature are
planning to use different IC with larger linear range of
operation for improving the systems performance. [13]
2. Infrastructural challenge: - The developed system is
thoroughly dependent upon internet connectivity. In the
developmental stage, we are assuming good network
speed (bandwidth) with remote server (storage &
application server) in rural villages. It is a subject of
research that how can we improve the efficiency of the
system in poor bandwidth. In India database maintaining
might be a challenging task and developing a new health
card is cumbersome. It can be possible to link ADHAR
card with the health profile so that government can keep
an eye on the workflow as well as maintain database.
3. Social challenge: - Raising Healthcare related
awareness is a challenge in our system mainly because of
social and ethical issues such as people in the rural areas
would not want to shift from traditional approach to e-
diagnostic feature approach. It is very often that rural
woman suffers from gout, arthritis so it may not be
possible to step up on the van (mobile case).
VII. CONCLUSION
The early research is focused to assess how fast, effective
programming system that can be designed & any
interference that may interfere with the system. According
to calculation, initial set up will cost very less compared
to traditional approach and it will decrease with mass
scale production. This system can be mobile with few
modifications which can go remote villages for periodic
health check-up of the stakeholders & in a nutshell this
system has the potential to change the traditional
architecture at the same time supporting it, if properly
implemented. This venture if properly implemented can
furnish patients with a more quick witted and more
customized means through which they can get therapeutic
input, spare significant time, fulfil their craving for
individual control over their own health, and lower the
cost of long haul medicinal care. It is noted that doctor’s
business are mainly reputation worthy. (Patients are
concentrated on one or two specific doctors). As the
identity of doctor is not revealed, there is uniform
distribution of patients towards doctors. It improves the
traditional system where some good doctors are deprived
of their earnings because of lack of reputation.
REFERENCE
[1]. Jovanov E, Raskovic D, Price J, Chapman J, Moore A,
Krishnamurthy A, "Patient monitoring using personal area
networks of wireless intelligent sensors", Biomed Sci
Instrum.
[2]. Hongwei Huo,Youzhi Xu, Hairong Yan, Mubeen S., "An
Elderly HealthCare System Using Wireless Sensor Networks
at Home", Third International Conference on Sensor
Technologies and Applications, 2009. SENSORCOMM '09,
18-23 June 2009, pp:158 – 163
[3]. Virone, G., A. Wood, L. Selavo, Q. Cao, L. Fang, T. Doan,
Z. He, and J.Stankovic. "An advanced wireless sensor
network for health monitoring." In Transdisciplinary
View publication stats
Conference on Distributed Diagnosis and Home Healthcare
(D2H2), pp. 2-4. 2006.
[4]. Triantafyllidis, A., V. Koutkias, I. Chouvarda, and N.
Maglaveras. "An open and reconfigurable wireless sensor
network for pervasive health monitoring." In Pervasive
Computing Technologies for Healthcare,2008.
PervasiveHealth 2008. Second International Conference on,
pp.112-115. IEEE, 2008.
[5]. Elaine Lawrence, Karla Felix Navarro, Doan Hoang, Yen
Yang Lim,"Data Collection, Correlation and Dissemination
of Medical Sensor Information in a WSN", Fifth International
Conference on Networking and Services, 2009. ICNS '09, pp:
402 – 408
[6]. Applications in Wireless Sensor Networks",WRI
International Conference on Communications and Mobile
Computing, 2009. CMC'09, (Volume:1 ), 6-8 Jan. 2009, pp:
563 – 567
[7]. M. Fischer, Yen Yang Lim, E. Lawrence, L.K Ganguli,
"ReMoteCare:Health Monitoring with Streaming Video",
Mobile Business,7thInternational Conference on 2008. ICMB
'08, 7-8 July 2008, pp: 280 -286
[8]. Wan-Young Chung, Seung-Chul Lee, Sing-Hui Toh, "WSN
based mobile u-healthcare system with ECG, blood pressure
measurement function",30th Annual International Conference
of the IEEE, Engineering in Medicine and Biology Society,
2008. EMBS 2008, 20-25 Aug. 2008, pp: 1533 – 1536
[9]. “E-Doctor: A Web Based Support Vector Machine for
Automatic Medical Diagnosis” A. Kampouraki, D. Vassis et.
al.2nd International conference on Integrated
Information,Procedia - Social and Behavioral Sciences 2013
467 – 474
[10]. H. J. Baek, G. S. Chung, K. K. Kim and K. S. Park, "A Smart
Health Monitoring Chair for Nonintrusive Measurement of
Biological Signals," in IEEE Transactions on Information
Technology in Biomedicine, vol. 16, no. 1, pp. 150-158, Jan.
2012.
[11]. Arduino based personal digital weighing scale & height
measurer, DIY project.
[12]. R. K. Singh, A. Sarkar, R. K. Thakur and C. S. Anoop, "A
real-time heart-rate monitor using non-contact
electrocardiogram for automotive drivers," 2016 IEEE First
International Conference on Control, Measurement and
Instrumentation (CMI), Kolkata, 2016, pp. 484-488.
[13]. V. K. Chugh, K. Kalyan and C. S. Anoop, "Feasibility study
of a giant Magneto-Resistance based respiration rate
monitor," 2016 38th Annual International Conference of the
IEEE Engineering in Medicine and Biology Society (EMBC),
Orlando, FL, 2016, pp. 2327-2330.
[14]. Y. J. Lee et al., "Magneto-Plethysmographic Sensor for
Peripheral Blood Flow Velocity," in IEEE Sensors Journal,
vol. 14, no. 5, pp. 1341-1342, May 2014.
[15]. Digital Stethoscope A portable, electronic auscultation
device, Michael Wu, Garen Der-Khachadourian, Cornell
university report
[16]. E. M. Avdikos, M. I. Prodromidis, and C. E. Efstathiou,
"Construction and analytical applications of a palm-sized
microcontroller-based amperometric analyser," Sensors
and Actuators B: Chemical, vol. 107, pp. 372-378, 2005.
[17]. Mukherjee, Srijani, Koustabh Dolui, and Soumya Kanti
Datta. "Patient health management system using e-health
monitoring architecture." Advance Computing Conference
(IACC), 2014 IEEE International. IEEE, 2014.
[18]. Das, Jishnu, et al. "The impact of training informal health
care providers in India: A randomized controlled trial."
Science 354.6308 (2016): aaf7384.
[19]. (Yoo, J.; Long Yan; Seulki Lee; Hyejung Kim; Hoi-Jun Yoo,
"A Wearable ECG Acquisition System With Compact Planar-
Fashionable Circuit Board-Based Shirt," in Information
Technology in Biomedicine, IEEE Transactions on , vol.13,
no.6, pp.897-902, Nov. 2009)