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Development of a Portable Linux-Based ECG Measurement and Monitoring

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J Med Syst (2011) 35:559–569
DOI 10.1007/s10916-009-9392-4
ORIGINAL PAPER
Development of a Portable Linux-Based ECG Measurement
and Monitoring System
Tan-Hsu Tan & Ching-Su Chang & Yung-Fa Huang &
Yung-Fu Chen & Cheng Lee
Received: 8 September 2009 / Accepted: 15 October 2009 / Published online: 14 November 2009
# Springer Science + Business Media, LLC 2009
Abstract This work presents a portable Linux-based electro-
cardiogram (ECG) signals measurement and monitoring
system. The proposed system consists of an ECG front end
and an embedded Linux platform (ELP). The ECG front end
digitizes 12-lead ECG signals acquired from electrodes and
then delivers them to the ELP via a universal serial bus (USB)
interface for storage, signal processing, and graphic display.
The proposed system can be installed anywhere (e.g., offices,
homes, healthcare centers and ambulances) to allow people to
self-monitor their health conditions at any time. The proposed
system also enables remote diagnosis via Internet. Additionally,
the system has a 7-in. interactive TFT-LCD touch screen that
enables users to execute various functions, such as scaling a
single-lead or multiple-lead ECG waveforms. The effectiveness
of the proposed system was verified by using a commercial
12-lead ECG signal simulator and in vivo experiments. In
addition to its portability, the proposed system is license-free as
Linux, an open-source code, is utilized during software
development. The cost-effectiveness of the system significantly
enhances its practical application for personal healthcare.
Keywords Portable Linux-based ECG measurement and
monitoring system . Twelve-lead ECG signals .
Embedded Linux platform . Open-source codes
T.-H. Tan (*) : C.-S. Chang : C. Lee
Department of Electrical Engineering,
National Taipei University of Technology,
Taipei, Taiwan
e-mail: thtan@ntut.edu.tw
Y.-F. Huang
Department of Information and Communication Engineering,
Chaoyang University of Technology,
Taichung, Taiwan
Y.-F. Chen
Department of Health Services Administration,
China Medical University, Taichung, Taiwan
Introduction
A significant social problem is that most individuals suffer
great stress due to working and life pressures. Although the
relationship between work-related stress and death remains
unclear, it was found that those with considerable work-
related stress have a 5–20% probability higher than those with
little work stress in suffering from cardiovascular diseases
(CVDs) [1]. A number of studies demonstrated a strong
correlation between stress and CVDs in Japan, North
America and Western Europe [2]. Several studies examined
the relationship between psychosocial work-related stress
and CVDs [3–5]. Of these studies, 24 investigated the
association between job stress and CVDs for men and six
investigated this relationship for women. Most studies
demonstrated a strong positive correlation between job stress
and CVDs; additionally, psychosocial work stressors were
identified as risk factors for hypertension and CVDs [6]. In
2003, the World Health Organization (WHO) claimed that
CVD alone was responsible for 29.2% of total deaths
globally, and this was still increasing annually [7]. The
WHO also reported that over 50% of these deaths can be
prevented by the use of cost-effective monitoring devices for
accurate diagnosis. However, people typically ignore their
health status due to a lack of an appropriate monitoring
device; they are unable to check their health condition
anywhere at any time, greatly increasing the probability of
sudden death. One solution to this problem is to develop a
portable system for monitoring health status ubiquitously.
Since the procedures for measuring heart rate (HR) and
heart rate variability (HRV) have been standardized [8],
using an electrocardiogram (ECG) to identity CVDs has
received much attention [9–10]. Several systems have
been developed for monitoring CVDs; however, most are
only available in medical institutions due to high costs.
Consequently, several personal computer (PC)-based ECG
monitoring systems have been developed [11–13] to greatly
560
reduce device cost and increase accessibility as PCs are
now ubiquitous. A Windows-based client-server architec-
ture for measuring and monitoring ECG signals was
presented in [11]. In the system the client (the ECG unit)
extracts ECG signals, and the server imports or exports the
signals. A PC-based system that captures a patient’s ECG
signals via an acquisition card and displays them on a
monitor was proposed in [12]. In that system, three
electrodes are utilized as sensors that detect ECG signals;
one electrode is placed on the left and one on the right
wrist, and the third electrode, the reference (ground), is
placed on an ankle. A graphical user interface (GUI) for
ECG monitoring was designed using a LabVIEW software
module developed by National Instruments to allow users
to monitor signal waveforms. Additionally, digitized ECG
data can be saved as a text file and then retrieved and
displayed. Furthermore, visual alert for the abnormal
heartbeat is provided. A PC-based ECG measurement and
monitoring system employing Visual Basic 6.0 to perform
HRV analysis in the time and frequency domains was
recently presented in [13]. That system uses the modified
Tompkins QRS detection algorithm to determine HRV via
ECG signals. A universal serial bus (USB) controller
employing Windows API was used to capture and deal
with USB data. Furthermore, this system determines the
HRV of users in real-time and provides the frequency
spectrum of ECG signals for diagnosis.
Although these PC-based systems are useful for monitor-
ing heart function based on ECG signals, they are not portable
and cannot monitor heart function anywhere at any time.
Several Windows-based portable systems have been devel-
oped in recent years [14–16]. For example, Kara [14]
developed a compact ECG with graphic LCD screen and
phonocardiogram unit, enabling physicians and patients to
hear heart sounds simultaneously while examining ECG
signals. The system allows patients to understand their
personal health status directly by hearing heart sounds and
listening to the explanation provided by physician in a real-
time manner. It implemented a receiver program by using
Microsoft Visual C++ programming language. In [15], a
portable ECG recorder with USB storage was used to
acquire ECG signals. In the system, ECG signals are
collected from four electrodes via standard lead placement.
A six-lead EGG can be selected via the lead-selection circuit
and the acquired EGG signals are then stored in the USB
storage for subsequent processing by a PC. In [16], a
portable ECG recording system integrating ECG signal
acquisition, Bluetooth modules and a LabVIEW software
module was proposed. In addition, ECG signals are analyzed
to determine HR, HRV and ECG spectrum. However, the
price of such monitoring devices is high due to licensing fees
for the Microsoft Windows operating system and may incur
a high economic burden for many people.
J Med Syst (2011) 35:559–569
Isolation amplifiers can be used to break ground loops,
eliminate source ground connections, and provide isolation
protection to patient and electronic equipment [17]. In a
bio-potential amplifier, the main purpose of the isolation
amplifier is to protect the patient by eliminating the hazard
of electric shock resulting from the interaction among
patient, amplifier and other electric devices in the patient’s
environment, specifically defibrillators and electrosurgical
equipment. It also has the capability to prevent line fre-
quency interferences.
In this work, we present a license-free portable Linux-
based system for monitoring heart functions based on ECG
signals. High usability, portability, ease-of-use and low cost
are the design objectives of the proposed system. It can be
installed virtually anywhere (e.g., offices, homes, health-
care centers and ambulances). The system allows people
to self-monitor their heart conditions. Additionally, the
data can be sent to a server at a distant hospital via
Internet for remote diagnosis. Furthermore, the proposed
system has a 7-in. interactive TFT-LCD touch screen that
allows users to execute various functions, such as scaling
single-lead or multiple-lead ECG waveforms. Also, an
isolation circuit is added to prevent electrical shocks. The
effectiveness of the proposed system was verified by
employing a commercial 12-lead ECG signals simulator
[18] and in vivo experiments.
The remainder of this paper is organized as follows.
Section “System implementation” describes the implemen-
tation of the proposed portable Linux-based ECG measure-
ment and monitoring system. Section “Experimental
results” then illustrates experimental results and accuracy
of the measured clinical ECG signals. Conclusions are
finally drawn in Section “Conclusions”.
System implementation
Hardware architecture
Figure 1 presents the hardware architecture of the proposed
system, which consists of an ECG front end and an
embedded Linux platform (ELP). The ECG front end
consists of signal amplifiers, an analog-to-digital (A/D)
circuit and control circuit module, and the ELP is a modular
platform that composed of signal storage, signal processing
and graphic display modules for a 12-lead ECG signals
measurement and monitoring system. The key features of
the proposed system are as follows:
1. Low cost due to the utilization of license-free Linux
open-source code.
2. Easy to use due to the fully interactive TFT-LCD touch
screen.
J Med Syst (2011) 35:559–569 561

Fig. 1 a Block diagram and

b hardware architecture of the
proposed system Signal Signal Graphic
USB storage processing display
Interface
embedded Linux platform
(a)

ECG ECG
Connector Simulator

USB
Interface

ECG embedded Linux

frond end platform

(b)

3. High portability due to a total weight of only 1.5 kg or so.
4. Allowing people to monitor health status anytime and
anywhere.
5. Enhancing safety by adding an isolation circuit to
prevent electrical shocks.
6. Enabling remote diagnosis via wireless network interface.
The function of each part is described as follows:
1. ECG front end: This subsystem acquires ECG signals
from electrodes and then delivers them to the ELP via a
USB interface.
2. Signal storage: The 12-lead ECG signals obtained are
stored in the RAM disk and SD (Secure Disk) card of
the embedded Linux platform.
3. Signal processing: This module performs time and
frequency domains analyses of the 12-lead ECG signals
using the equations and the Discrete Fourier transform
(DFT) suggested by [19]. Table 1 lists these equations.
4. Graphic display: This module demonstrates the mea-
sured values and graphs of ECG signals in time and
frequency domains on the ELP.
5. ECG simulator: This module is used for testing the
proposed system.
In this study, a scheme proposed in [19] for detecting 12-
lead ECG signals and diagnosing CVDs was adopted. The
functions of this scheme are summarized as follows.
1. Acquisition of ECG signals from a patient using 10
electrodes.
2. Amplification and digitalization of acquired ECG signals.
3. Derivation of the 12-lead ECG signals in the time-
domain from signals acquired using 10 electrodes.
4. Derivation of frequency-domain spectrums of the
12-lead ECG signals.
5. Establishment of the base value of ECG signals using
the determined HR by multiplying HR in beats/second
by a scaling quantity ranging from 3 to 7 (preferably 5).
6. Health evaluation of the heart status by dividing an area
obtained by conducting integration from 0 Hz to the base
value in the frequency domain, by another area obtained
by performing integration from the base value to infinity.
7. Peaks analysis of the power spectrum in the frequency
domain for diagnosing CVDs.
Table 1 Twelve-lead time-domain ECG signals and their evaluation
equations
Lead ECG signals
I = LA-RA
II = LL-RA
III = LL-LA
aVR = RA-(RA + LA + LL)/3
aVL = LA-(RA + LA + LL)/3
aVF = LL-(RA + LA + LL)/3
V1 = C1-(RA + LA + LL)/3
V2 = C2-(RA + LA + LL)/3
V3 = C3-(RA + LA + LL)/3
V4 = C4-(RA + LA + LL)/3
V5 = C5-(RA + LA + LL)/3
V6 = C6-(RA + LA + LL)/3
562
Acquisition of ECG signals
All ECG signals are obtained by sensors placed at 10
sampling points (Fig. 2) which are located on the right arm
(RA), left arm (LA), right leg (RL), left leg (LL) and the
chest (C1–C6) close to the heart. A 12-lead ECG signals
connector (DB15 connector) is employed to transmit ECG
signals to the ECG front end. Figure 3 shows the pin
assignment of DB15 connector.
Design of ECG front end
The circuits proposed in [20] and [21] were adopted and
improved in designing the ECG front end circuit. Since the
circuit layout presented in [20] requires a larger space than
the proposed system can accommodate, a significant space
reduction is achieved by the proposed layout. Additionally,
the A/D converter (AD7888) in [21] does not fit the
proposed system as the resolution of the AD7888 is not
compatible with the ELP; thus, the circuit layout was
redesigned. Figure 4 presents the block diagram of the
improved 12-lead ECG front end circuit.
In addition to designing a highly portable and low-cost
system, another study goal is to achieve long-term ECG
monitoring. Therefore, the circuit should be simplified as
Fig. 2 Sampling points of ECG signals
J Med Syst (2011) 35:559–569
much as possible. To this end, the power of all amplifiers is
supplied by the ELP, thereby decreasing device size and
avoiding the additional cost of any power supply circuits.
Design of amplifiers circuits Skin contact may result in
disturbance during ECG signal acquisition [22]. To sup-
press such disturbance meanwhile amplify the ECG signals
extracted by eight ECG sensors, two precision instrumen-
tation amplifier (AD8221) chips and one quad input and
output amplifiers (AD8604) chip [23] are integrated to
produce V1, V2, V3, V4, V5 and V6 signals, as illustrated
in the amplifiers block Fig. 4. Moreover, three amplifiers
depicted in blocks P10-RALL, P11-LALL and P12-RALL
(Fig. 4) are used to generate RA-LL, LA-LL and RA-LA
signals, respectively, such that the 12-lead ECG signals can
be monitored and analyzed.
Design of analog-to-digital (A/D) circuit The A/D circuit
block is depicted as P06-MPU in Fig. 4. To achieve the design
objectives, an A/D converter, the ADuC841 [23], which
integrates a high-performance self-calibrating multi-channel
analog-to-digital converter (ADC), a dual digital-to-analog
converter (DAC) and an optimized single-cycle 20-MHz 8-bit
MCU on a single chip, is utilized as the main chip in the A/D
circuit. The output signals from nine amplifier circuits are
applied to the ADuC841 chip for digitization. Notably,
each digitized signal is represented by 12 bits. Moreover,
a program was designed on an 8051 built-in ADuC841
chip (speed = 20 MIPS) to extend a 12-bit signal to a
16-bit signal by filling the four most significant bits with
0s, and storing them in the flash ROM embedded in the
ADuC841 chip. Via this program, the ADuC841 chip can
output 16-bit data that comply with the data format to be
processed by the selected USB controller chip. Therefore, the
design complexity of the USB circuit is significantly reduced.
This ADuC841 chip is also powered by the ELP via a USB.
Connection of A/D circuit and ELP via a USB interface A
common USB port is adopted for connecting the A/D
circuit and ELP by taking advantage of the USB 2.0
interface, which supports a maximum data rate of 480 Mbps
and low-voltage peripherals. Additionally, the USB hubs
and power-efficient storage drives can directly use power
from the ELP. The PL2303 USB-to-serial bridge controller
[24] is adopted as the USB controller in the proposed
system. The design and development of the device driver
are according to [23] and chip data sheets described in [24].
Furthermore, the power of the PL2303 controller and laptop
is supplied by the ELP, details of which can be found in
blocks P02-USB and P03-Laptop (Fig. 4). Notably, the
usability of the proposed system can be extended by
employing the Laptop block, such as execution of remote
medical diagnosis via wireless network.
J Med Syst (2011) 35:559–569 563

1
1

Fig. 3 Pin assignment of DB15 connector

P06-MPU P07-VIEW12 P13-12LEAD

P07-AFE
V1L OUT0 IN0+ V1
V2L OUT1 IN1- V2
REF REF REF D+ D1
P02-USB P04-ISOLATION P05-POWER 5VA D2
5VA 5VA D-
AGND AGND AGND IN- LL LL
USB_5V 5V1 Viso Viso Viso 5VD 5VD 5VD
USB_GND GND1 GND2 GND2 DGND DGND DGND
P08-VIEW34
Viso P07-AFE
USB_RST RESET Viso
USB_UPG UPG V3L OUT0 IN0+ V3
RSTN RSTN RST RST V4L OUT1 IN1- V4
USB_TXD# TXD# REF D+ D3
USB_RXD# RXD# 5VA 5VA D- D4
AGND AGND IN- LL

UPG UPG
P03-Laptop
P09-VIEW56
TXDN RXDN P07-AFE
NB_5V
RXDN TXDN
NB_GND V5L OUT0 IN0+ V5
V6L OUT1 IN1- V6
NB_RST REF D+ D5
USB_UPG 5VA 5VA D- D6
AGND LL
AGND IN-
NB_TRX4 5VD 5VD
NB_RX4 DGND DGND A/D converter
P10-RALL
P10-AFE1
Isolation RAL OUT IN+ RA RA
LL
circuit VCC29
REF IN-
VCC29
5VA 5VA COM COM0 COM0
AGND AGNDSHIELD SHD0 SHD0

P11-LALL
P10-AFE1
LA
LAL OUT IN+ LA
LL
REF IN-
VCC29 VCC29
5VA COM1
5VA COM COM1
AGND SHD1
AGNDSHIELD SHD1

P12-RALA
P10-AFE1
OUT IN+ RA
RALA
REF IN- LA
VCC29 VCC29 VCC29
5VA 5VA COM COM2
COM2
AGND AGNDSHIELD SHD2
SHD2
VCC29
VCC29
AGND
AGND
Amplifiers

Fig. 4 Block diagram of the improved circuit of the 12-lead ECG front end
564 J Med Syst (2011) 35:559–569

1
+IN +OUT
-IN -OUT

1
D
S

Fig. 5 The proposed isolation circuit

Design of isolation circuit The power for the amplifier chips Software structure
(AD8221 and AD8604) and A/D converter chip (ADuC841)
are supplied by the ELP via the USB port. Notably, users of Real-time operation system (RTOS)
the proposed ECG monitoring system may have CVD.
Therefore, one must account for risk of electrical shock The Real-time Operating System (RTOS) is a basic
caused by a static charge, a requirement of certified medical building block of most Embedded Systems (ESs). This
facilities. Thus, an isolation circuit block, the P04-isolation subsection describes the RTOS of the embedded system and
(Fig. 4), was added to prevent electrical shocks. structure of the real-time operating system [26]. The RTOS
Figure 5 shows details of the isolation circuit, in which is an operating system that schedules tasks in a real-time
the ADuM1401C digital isolator chip [23] functions as a manner. Additionally, the system manages system resources
DC/DC converter which transforms the input DC voltage efficiently and provides a consistent basis for application
into a lower DC value. The feature of the DC/DC converter
is adopted in the design to supply DC power to other chips Fig. 6 High-level view of an
in addition to achieving the purpose of isolation. Notably, it RTOS
has important features as follows:
1. 5 kV rms isolation rating with IEC-60601–1 [25]
medical safety approval.
2. Short-circuit protection for xD+ and xD− lines (USB
lines must automatically switch between actively
driving D+/D−, receiving data, and allowing external
resistors to set the idle state of the bus).
3. Class 3A (4,000 to <8,000 Voltage) contact Electro-
static Discharge (ESD) performance per ANSI/ESD
STM5.1–2007.
J Med Syst (2011) 35:559–569 565

Fig. 7 Data flow of the

proposed 12-lead ECG signals
measurement and monitoring
system

development. A good RTOS should be scalable to various A feasible portable ECG monitoring system should have
applications. An RTOS can be a combination of various at least the following six functions.
modules, including the kernel, file system, networking
1. Extraction of ECG signals.
protocol stacks and other components required by a
2. Reading and saving of ECG signals.
particular application. In embedded systems, the Board
3. Domain transformation of ECG signals.
Support Package (BSP) is a collection of user-provided
4. Display of ECG signals.
facilities that interface an RTOS and application with a
5. Analysis of ECG signals for diagnosis and generation
specific hardware platform. The BSP is commonly built
of an alarm or alert.
with a bootloader containing minimal device support to
6. Execution of a remote medical diagnosis.
load the operating system and device drivers for all devices
on the board. Figure 6 presents a high-level view of an This study focuses on the first four functions as the
RTOS. remaining two require support from medical, telecommu-

Fig. 8 Flowchart of the scheme

proposed in [19]

∞
∫
566
Fig. 9 Qtopia software stack on
the embedded device
nication and governmental institutions. Figure 7 shows the
data flow of the proposed portable 12-lead ECG signals
measurement and monitoring system. The first function is
described in Section “Acquisition of ECG signals”; the
other three functions are described as follows.
Reading and saving of ECG signals
Two functions in the proposed system read and save ECG
signals (Fig. 7). One reads/saves ECG signals form/to the
RAM disk and the other reads/saves ECG signals from/to
the SD card.
Fig. 10 Human–machine interface
J Med Syst (2011) 35:559–569
Domain transformation of ECG signals
For analysis, the 12-lead ECG time-domain signals are
transformed into frequency-domain to obtain their corre-
sponding power spectrums via the DFT. The 12 corresponding
power spectrums denoted by P[i], i=1, 2, …, 12 are
calculated using Eq. 1 [19],
P½i ¼ S ½iS * ½i ð1Þ
where S[i] is the DFT of the ith lead and S*[i] is the
conjugate of S[i].
First, a patient’s heart rate (HR) is measured prior to any
health evaluation based on ECG signals. As suggested in
[19], the HR base value is obtained by determining a
patient’s resting HR in beats/second and multiplying this
rate by a scaling quantity between approximately 3–7 to
establish the base value, f0, in Hz, as illustrated in the
Obtain heart rate and Base value blocks (Fig. 8). Notably, a
compromising scaling factor of 5 is suggested in [19].
Employing the base value, f0, as a boundary, the
integration of the 12 power-spectrum signals derived from
Eq. 1 are executed within 0-f0 (low-frequency area) and
f0-∞ (high-frequency area), as in the Integration blocks
(Fig. 8). The derived information can be employed to
J Med Syst (2011) 35:559–569
localize detected CVDs according to [19], as in the blocks
Peak analysis and Localize detected heart disease (Fig. 8).
Display of ECG signals
Qtopia [27], a platform for embedded Linux devices,
provides end-users with a set of core applications, such as
an address book, calendar and media player. The Qtopia
software stack on the embedded device has four main layers
(Fig. 9). Notably, Qt is a cross-platform C++ application
development system that allows developers to design a
graphical user interface (GUI) at will. Developers need only
be proficient with an Application Programming Interface
(API) when compiling programs and these programs can be
executed on any platform. Additionally, Qt is an object-
oriented development tool, which ensures convenient
expansion in cross-platform operations or when the original
program is not well designed.
Issues in practical design
The human–machine interface for ECG signals monitoring can
easily be built with the use of a LabVIEW software module in
the PC-based system. However, in the proposed system, the
human–machine interface that displays graphs and offers
related functionalities can only be designed and integrated
using Linux-supported tools. This is the most difficult task in
system development. This work selected Qt and Qtopia for
displaying graphs as the software can be converted into
commercial versions instantly. Moreover, the support from the
Internet has proven the benefits of Qt and Qtopia for
application with Linux-embedded open source codes [27].
Experimental results
Qtopia V1.7 was adopted to develop the human–machine
interface. The GUIs for individual functions of the 12-lead
Fig. 11 Displaying four of 12-lead ECG simulator signals
567
Fig. 12 Time domain 12-lead ECG signal waveforms obtained from
in vivo experiments
ECG signal monitoring system is described as follows.
Figure 10 shows the human–machine interface of the
proposed system, which comprise (a) initialization of the 12-
lead ECG signal monitoring system, (b) display of ECG
signals, (c) display of ECG spectrums for diagnosis, and (d) a
control bar that enlarges and reduces the size of the window.
The signal simulator from [18] was employed to generate
standard 12-lead ECG signals to verify the effectiveness of the
proposed system. When the 12-lead ECG signal simulator
was on, the ECG signals generated by the simulator were
displayed on the ELP screen. Via the designed human–
machine interface, the display can be switched between
displaying single-lead signals and multiple-lead signals.
Figure 11 presents four of 12-lead (LL-RA, LL-LA, LL-V1,
LL-V2) ECG simulator signals displayed on the ELP.
When using the ECG front end, captured data are delivered
through the DB9 interface to the 12-lead ECG signal
monitoring system. Thus, users can see their ECG-related
information. Furthermore, a series of in vivo experiments was
performed to verify the effectiveness of the proposed system for
real-time ECG signals analysis in the time/frequency domains.
The results are presented in Figs. 12 and 13, respectively.
Fig. 13 Real-time frequency spectrum of four of 12-lead ECG signals
obtained from in vivo experiments
568
The accuracy of clinical ECG signals measured by the
proposed system is evaluated by employing the widely used
percentage root-mean-square difference (PRD) measure-
ment, which is defined as
vffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi
uL
uP
u ðXA ðiÞ  XB ðiÞÞ2
u i¼1
PDR ¼ 100  u
u ð2Þ
t P L
XA2 ðiÞ
i¼1
where XA(i) and XB(i) represent the clinical ECG signals
measured by a commercial ECG monitor [18] and that
measured by the proposed system, respectively; L denotes
the sampled number of ECG signals obtained from in vivo
experiments. In this study, L and its sampling rate are set to
2,000 samples and 250 samples/s, respectively. The obtained
PRD is 4.12%, which demonstrates an acceptable quality of
the clinical ECG signals measured by the presented system
as the highest acceptable PRD value of ECG is 8% [28].
Conclusions
This work presents a portable Linux-based 12-lead ECG
signals measurement and monitoring system. It allows
individuals to self-monitor the health status without time
or location constraints. Furthermore, the proposed system
enables remote diagnosis via an Ethernet interface supported
by the embedded Linux platform. The proposed system is
easy to use due to its fully interactive TFT-LCD touch
screen. The accuracy of the proposed system is verified by
adopting PRD as a benchmark, which is calculated from the
signals generated by a commercial 12-Lead ECG signal
simulator and the signals obtained from in vivo experiments.
Our proposed system has been demonstrated to be able to
provide an acceptable quality with a PRD as low as 4.12%
which is smaller than the threshold (8%). The proposed
system can be installed anywhere and allow people to self-
monitor their health condition at any time. An important
feature of the proposed system is that it is license-free as
open-source code was used in developing the embedded
software, further increasing the potential applications of
the proposed system for personal healthcare. Notably, an
isolation circuit has been added to prevent electrical shocks,
thus significantly enhancing safety of the proposed system.
Acknowledgements The authors would like to thank the National
Science Council of the Republic of China, Taiwan for financially
supporting this research under Contract No. NSC 97-2221-E-027-095.
We would also like to thank TAINET Communication System Corp.
and Biologic Technology Inc. for the paramount collaboration and
commitment to this research.
J Med Syst (2011) 35:559–569
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