Abstract

The Internet of Things has created more impact in the field of health care along with the support and the various features of mobile computing. The role of IoT and mobile computing is playing a significant role and provide a cutting edge. With the use of mobile computing in the health care it has created a new field in healthcare known as m-health (mobile health).  The use of IoT devices, mobile and the network have provided a best solution for healthcare system with low cost and improved quality. IoT is used to provide reliable medical resources that are available which will be more useful for aged patients. IoT helps the healthcare system with various functionalities with remote server. While mobile computing is supports the IoT devices which can be accessed using the mobile apps. It helps to provide a compact service, IP connectivity and require low power consumption. There are numerous applications that are developed based on healthcare system and are categorized into single and clustered condition application. The proposed work provides an implementation of monitoring system based on the internet of thing technology. This implementation offers an enhanced step-in monitoring the health by remote site.  This project employs mobile application as IoT platform towards monitoring by remote site with the patient’s live ECG signal, heart rate, SPO₂, and the body temperature. The signals might be processed and measured by a microcontroller-based gadget.  The primary contribution of this work is to send an electrocardiogram signal to specified smart mobile phone to monitor by healthcare professionals. This supports in diagnosing the heart diseases prior to worst things occurs.

Introduction and Background

The abrupt increase in population leads to numerous challenges in the services of healthcare and also scarce in medical related resources. The Connectivity of IoT, Network, and mobile provides excellent solution to the services of healthcare because of the features easy-to-use and less expensive. The IoT –based health services are providing best experience to the users at cheap rate also enhances the life quality. The primary functions of IoT are to give connectivity to reliable, efficient smart services of healthcare with the available resources to the patients who are suffering from chronic illness. (Shah Nazir, 2019) IoT provides smart system of healthcare with the application of sensors; remote site server and network are focused to monitor the multi-dimensional attributes as well as recommending to basic treatments.

Mobile computing offers healthcare services by utilizing the mobile phone, apps else m-healthcare system in association with IoT.  It contributes different services such as compactness, IP connections, consuming less power and security. Recently many applications are developed which intends to deliver the services to users in medical field using the support of mobile computing.  The applications of Smartphone make the patients to aware about their illness clearly. Some of the application in healthcare using IoT and Mobile-based services are sensing the glucose level, monitoring of BP- Blood Pressure, Body temperature, Oxygen saturation level, ECG and so on.

Background

For the past decades, technologies of communication and computing have been changed very drastically. The computers which are bulky and slow were replaced by the devices which are portable and could complete complicated tasks in very less duration of time. At the same time, landline communications were also replaced by Smartphone as well other technologies of communication which can link the people at anytime and at any place. It could transmit text messages, photographs, and information at a single touch. These kinds of advancement leads to the establishment of mobile –healthcare which utilizes mobile computing and technology of communication in the services of healthcare. This provides numerous applications and facilitates the collection of data and motivates the consumers towards adopting the lifestyle to healthy way by self-managing the chronic situations.

The usage of mobile applications in the environment of IoT is remarkable. Mobile applications offer user-interface towards data collection through several sensors and wearable gadgets. The specified use of mobile app is Personalized Healthcare system (PHS) which has several sensors like accelerometers, gyroscopes, altimeters and less-expensive portable gadgets being linked in the environment of IoT. This concept is used to diagnose, monitor the patients effectively. The mobile computing supports smart healthcare through wireless technology which consumes less power. People with disabilities, aged, living alone is need of special care especially in monitoring of heart diseases. This proposed project helps to those people who are in need of continuous monitoring for their heart functions and treatment in addition with other biological signals monitoring related with heart diseases.

Aims and Objectives

The smart healthcare in support with IoT, which is known as SmartHealthIoT connects Smartphone and patients to monitor anytime either the patients are in comfortable environment of home else in roaming by utilizing the important sensors that are linked with their phones wither with Android or iOS. This is beneficial to the people who need continuous monitoring with care like disabilities, living –alone, children of different ages, people susceptible to sudden rise of BP, heart beat rates, level of stress etc. If emergency happens, location of the patient could be tracked using the coordinates of GPS. Hence the aim is to give utmost healthcare service and care to aged and disabilities at anytime and anywhere using smart IoT healthcare systems and mobile computing by continuous monitoring and sending the signals via sensors and wearable gadgets to physicians to give proper treatment especially to the heart patients. Since heart attack and related issues cause more severity, it is necessary to monitor the patients continuously with the use of this technology in real-time.

The objective of these smart health care systems are;  through IoT and mobile computing is to manage the users by themselves in emergency circumstances and to help the users to know about medical status of their health condition and keeping awareness always. To highlights the quality improvements and experience of the user. Using these technologies of Smart healthcare effectively to decrease the cost along with risks of medical process and to enhance the utilization of resources efficiently and promotes the co-operation in various regions and improves the establishment of telemedicine as well as self-services of medical care independently with the support of these smart technologies.

Literature Review

 IoT Impact in Healthcare

The IoT is referred as wireless system which is linked and interrelated with digital gadgets that could collect, send and storing the data through network with no need of man-to-man and man-to- computer or machine interaction. This promises multiple benefits to improve and streamline the delivery of healthcare in terms of predicting the health problems, diagnosing, and treatment as well as monitor the patients either inside or outside of the hospital. Recently it becomes essential in establishing as well as emerging the technologies of IoT to support the healthcare systems in safe and efficient manner. (Jaimon T Kelly, 2020). The author aimed to offer overview of existing technology of IoT in the field of healthcare, and emphasizes the method of enhancing the services of healthcare. The author also briefs about the possible issues caused by IoT-based system that generates and barriers in adopting this technology by the professionals and patients.  Services from Smart healthcare is making use of the technology advancement like  IoT, big data, cloud computing , Artificial Intelligence and machine learning to changeover the conventional services as convenient, efficient and personalized.  This provides chances to connect and monitor the routine activities and offer assistance to make possible transparent, decision making that could shift the pattern of diseases also to raise the citizens’ well-being. The author described that the barriers of healthcare in terms of confidence with acceptability, security and privacy, data storage, controlling, ownership, interoperability and protocols standardization, remuneration etc. Author explains in healthcare perspective that, it is necessary for guidelines on digital health and strong policy about the remuneration of primary as well as secondary services offered via IoT. Also he said, further research is required to determine adoptability and digital knowledge of patients and physicians in utilizing this technology towards enhancing the delivery and experience in the services of healthcare.

Applications of IoT have latest evolution in the field of medical healthcare systems. This is considered as important step in the changes from traditional system of healthcare which needs patient’s physical presence in the hospitals or clinics. (Ameen, 2020)  Technology of internet supports with latest electronic gadget could provide promising outcomes. Based on this, the proposed project uses mobile application and platform of IoT towards monitoring from remote site of live signal of ECG, heart beat rate, SPO₂ as well as the body temperature. The signals are being processed and measured by microcontroller –based Arduino device. The primary function of the proposed project is to send the ECG signal to smart mobile phone which is linked with the doctor who is taking care of the patient. This supports in diagnosing the heart diseases prior to the worst things happens. The results are illustrated with PC and Smartphone to show the effectiveness of this technology. The author verified the results by comparing the measures of the project and the devices utilized by the professionals of healthcare and also these signals were uploaded to the mobile. This creates the professionals to be capable to invigilate and diagnose many parameters simultaneously. Also this mobile app offers a chance to monitor more than one patient simultaneously.

Nowadays, the technology development, communication as well as network bring the exposure of the concept mobile computing and IoT. Mobile computing is utilized in several areas like online purchase, wearable gadgets, and healthcare and so on.  In the sector of healthcare, to offer a remarkable support, mobile computing extends the functionalities of IoT in the environment of healthcare as M-health. Furthermore, the population increase creates emergency requirement to face healthcare needs via healthcare services by mobile applications. The author discussed about the concepts of M-healthcare, impact of employing mobile computing in IoT in healthcare, available types, common issues and services also proposed a framework which is secured and safe for M-health services. (Alhejaili, 2021)

Role of IoT and Mobile Computing in Healthcare

Advancement in ICT leads to the development of IoT. It permits numerous physical gadgets to capture the information and transmit it via internet, by providing numerous information interoperability techniques. At present, IoT serves essential role in communication in addition with monitoring, storage, recording and displaying. So the latest trend of communication in association with healthcare by utilizing the IoT is being adopted. (Himadri Nath Saha, 2017). Continuous monitoring is aggregated and analyzed effectively with the obtained information and brought the positive sign of transformation in the healthcare field. The author says that this project is concentrating on the establishment and incorporation of efficient health care system supported on IoT. This system would monitor the essential parameters related to healthcare and transmitting the data via wireless communication that is again transferred to network through module of wi-fi. So that the data or information could be accessed always to aware of existing health status of patient. If any abnormal things otherwise any important signs are identified, then the medical care professionals and the caretakers are notified at once via message or by audio signal like buzzer. To design effective system of remote site monitoring, security serves an essential part. In order to promote the security, cloud computing and Wi-Fi module which was being protected using password are take care of authentication, security and privacy of patients. Information related to patients’ database are strictly restricted to third party access. Hence it provides valuable and quality services of healthcare to all the people.

Mobile health, the utilization of mobile computing and technology of communication in the services of public healthcare is extending in e-health. There is significant interventions and huge possibility for the mobile-health to have benefits on health services. The devices used in this technologies are mobile phones either Android or iphone, PDA- Personal digital assistants, personal computers, Laptops, tablet PCs and so on. The feature of mobility and light weight makes the people to carry the phone at all the time and to anywhere. Healthcare professionals might send appointment date and reminders to the patients through message using mobile application. (Caroline Free, 2016) The author briefed that, the use of mobile technology –supported photos are utilized for diagnosis in terms of communication betwixt the patients and healthcare professionals.

Heart Disease Monitoring

Mostly heart attack would results in death scenario prior to the treatments of patients due to the conventional mode of health care in many rural and remote site places. The techniques of IoT are emerging to solve these kinds of issues, and change the patient’s caretaking towards technology basis. This technology triggers the services of healthcare supported on physical condition of patients’ in spite of their emotions. To realize the pervasive services of healthcare, remote site monitoring of system is necessary.  The author proposed a pervasive system of monitoring which is able to send the patient’s physiological signals to the site of remote area in real-time.  This system consists of two important segments namely data acquisition and transmission. The system of monitoring is considered as main point of acquisition segment and it was designed by the support of medical expertise. Many physiological signs such as Blood pressure- BP, ECG, SPO₂ heart beat rate, pulse rating, blood fat content and glucose level in blood and circumstantial indicator which is location of the patient, were designed to make samples at various rates in continuous. (Chao Li, 2017) Author described four modes of data transmission such as risk of patients’, need of medical analysis, communication demands and considering computing resources. The given physiological signs are related to heart disease detecting signs which are implemented as prototype to exhibit the system functions.

Nowadays, most of the people are concerning more regarding unexpected heart attack or arrest. With the advancement of wearable smart devices, and IoT technology the solutions are very easy to these issues to save the human life.  The multisensory scheme of IoT system collects the information from Body Area Sensor- BAS and sends to the healthcare providers and facilitates earlier treatment to heart attack. (AKM Jahangir Alam Majumder, 2019) The aim of this paper is to design and establish integrated IoT smart system with a module which consumes less power for communication and to collect the information related to the heart such as heart rate, temperature by utilizing Smart phone on daily life. This project uses the technique of signal processing and Machine learning for sensor information analysis towards identifying the unexpected arresting of cardiac system with greater accuracy. The author prepared prototype to show the results of the proposed system. He collected all the data such as temperature, sampling rate of pulses and the data of ECG. The author analyses the data by filtering, removal of baseline wandering, removal of high-frequency element, feature extraction like heart rate per minute, Intervals between R-R, Segments ST, and algorithm. This study offers users’ a related device which permits to make understand about their ECG patterns. It also defines multiple usages in the detection of people’s behavior with different disabilities.

Technologies and Resources

Figure 1:  IoT and Mobile computing in healthcare (Shah Nazir, 2019)

The above picture shows the basic structure of IoT and Mobile computing in healthcare. The system depends on low –power communication with independent movements in the physical actions of the user. Sensors are kept at the patients’ or susceptible peoples body in the form of light-weight smart IoT devices either in wrist or chest. In order to make integration of the sensors, the output of the sensors is embedded to execute, evaluate and discriminate the patterns of heart rate betwixt normal and abnormal. The patients must wear or hold the embedded sensors such as ECG, and temperature, Oxygen saturation level, which constantly gathers the heart parameters of the people, is leading their normal life. After receiving the data through a communication channel, the Smartphone would process the obtained information to discriminate if the user’s status is normal or abnormal.  Here quantitative analysis of heart rate is executed in the Android platform that gives the users to view the real-time plots of ECG signal, SpO₂ and body temperature.

In order to determine the abnormalities in the patterns, it is necessary to develop a criterion to usual heart rate. Quantitative analytics of stability heart rate as well as pulse symmetry would produce series of aspects such as heart rate, RR intervals which is defined as the duration betwixt two successive R peaks in the signal of ECG, ST segments which is defined as the flat part of the signal ECG betwixt the end of S and starting of T wave.  Actually it denotes the interval betwixt Ventricular repolarization and depolarization. Then we would design an early alerting system to monitor the above said parameters for the sign of heart attack in the activity. The system continuously monitors the patterns of ECG and triggers the alert signal, in case the pattern of ECG, body temperature and Oxygen saturation level of the patient reaches specified threshold point or level, the signal will be sent to the doctor or physicians and the care taker for further assistance. The device continuously gathers the data from user and sends to Smartphone and through this, the data will be sent to the healthcare professionals, to take immediate action and the device itself creates the warning or alert signal to emergency. The proposed system would continuously monitors and collects the information from IoT embedded sensor and this would be sent to the professionals of healthcare, the caretakers and the user’s Smartphone if found nay abnormalities in the pattern of heart rate, SPO₂ and temperature.

Figure 2 Standard ECG signal

                 Figure 3 Proposed Architecture    

Resources Required

Hardware requirement

• Low power Bluetooth chip – RN42
• Arduino Uno- based on Microcontroller ATmega328P
• Pulse sensor- MAX30102
• Temperature Sensor- LM 35
• ECG Sensor Single-lead AD8232, 3.3 volt
• Smart Phone with Android or iOS
• Smart wearable IoT device

Software requirement

• Interface in Smartphone to receive as well as analyze IoT device
• Bluetooth communication channel – to transmit the data from sensors to Smartphone
• Smartphone with Android software
• Internet connectivity
• PuTTy Software – to extract the ECG signal from microcontroller
• Cloud server

The technology used is IoT with mobile computing to detect the heart rate patterns. The required resources are listed as above.

Method and Work Plan

Data Collection and Analysis

After the system finalization, we would retrieve perfect results and we have to test the patients. As we could not test our systems with real patients who are having chronic heart disease, we need to collect statistical data of persons of different age groups to collect the data.  This process would be divided by two segments such as data reading from sensors and sending to Smartphone and to doctor. First segment data is collected from the sensors such as temperature, pulse and ECG, and it is analyzed, plotted on screen of the devices. Data collection interface supports with obtained information from wearable device and sensors with Smartphone.

Testing the data

The collected data from the sensors are subjected to test with different activities of the person while he/she is sitting, walking and upstairs climbing. By this activity the pattern of heart rate can be tested. Temperature data does not require more analysis. But it should give accuracy of +/- 0.5. The data collected from ECG sensor can be tested and analyzed with the use of MATLAB. The unwanted signals like noise, high frequency component, smoothing can be done using MATLAB to get accurate results.

Major phases of the project

It consist of four major phases which includes

• Initiation phase – It includes data collection and analysis
• Planning phase – Evaluation of the solution and hardware ,software requirement and selection analysis
• Execution phase – Testing and training of the system also it involves in analyzing the risks – (technical and unexpected non technical such as time, budget etc) evolved in the system and mitigation process of risks.
• Implementation and documentation phase – It includes implementation of the project and collecting feedback from stakeholders and if required redesign and reframing of the system is done. Later documents preparation regarding this project is to be done. All the records and documents related to this project are to be preserved for future use.

The Work planning and execution chart is given below for quick reference.

 Approximately it will take 4 months to complete this project. This may starts from 1^st July and ends at October 4^th as per plan. The work plan and the scheduled date are explained in the above chart.

Discussion – Ethics and Data Protection

Ethical analysis is primary component for adopting the new technology in medical field. Ethical issues of IoT related healthcare impact on medical and social care. The equipments are designed to function in the environments of private as well as public like residents, clinics or hospitals. (Mittelstadt, 2017) In every stage of data collection regarding the users’ health as well as behavior can be hacked by third party. The user’s lives could be digitized recorded and analyzed by third party that creates data sharing, mining etc. This system subject to; along with the benefits there is a chances for violating the expectation of personal as well as informational privacy of the user. The healthcare professionals, physicians are must follow strict rule that they should not reveal any information regarding patient to anybody without the knowledge of the patients and the caretakers.

At present, patients personal information , that includes health related and personal details are to be treated as SPDI – Sensitive personal data information under IT practices of security and procedures of rules 2011 and its accorded greater protection than personal information. (Neetika Gandhi, 2021)

Some of the standards for data protection are;

EHR records- the standards of EHR 2016

ISO 13940- Health informatics- Concepts to continuity of care,

ISO/TS 22220:2011- Identification of healthcare for storing basic id of patients

DICOM- PS3.0-2015 images, waveform, audio, video files

ISO/IEC – coding of audio-visual objects format.

We must follow the standards and security measures in the device handling and protection of data in safe manner in order to provide trust and reliability to the people regarding healthcare due to technology advancement.

References

AKM Jahangir Alam Majumder, Y. A. E. R. Y. a. D. R. U., 2019. An Energy Efficient Wearable Smart IoT System to Predict Cardiac Arrest. Advances in Human-computer Interaction, pp. 1-16; 2019.

Alhejaili, A. D., 2021. M-health Concept, Services and Issues. IEEE, pp. 1-10.

Ameen, M. A. A.-S. a. I. A., 2020. Design of Mobile Healthcare Monitoring System Using IoT Technology and Cloud Computing. s.l., 3rd International Conference on Sustainable Engineering Techniques (ICSET 2020), pp. 1-18.

Caroline Free, G. P. L. W. L. G. L. F. P. E. V. P. A. H., 2016. The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis. PLOS Medicine, pp. 1-15.

Chao Li, X. H. ,. L. Z., 2017. The IoT-based heart disease monitoring system for pervasive healthcare service. Elsevier – Procedia Computer Science, pp. 2328 -2334; 112.

Himadri Nath Saha, D. P. S. C. S. H. R. M., 2017. Internet of Thing based healthcare monitoring system. s.l., IEEE, pp. 1-9.

Jaimon T Kelly, K. L. C. E. G. ,. P. S., 2020. The Internet of Things: Impact and Implications for Health Care Delivery. Journal of Medical Research, pp. 1-20; 22(11).

Mittelstadt, B., 2017. Ethics of the health-related internet of things: a narrative review. Ethics and Information Technology , pp. 157-175 ; 19.

Neetika Gandhi, S. K. a. S. N., 2021. Data protection and management, s.l.: https://www.lexology.com/library/detail.aspx?g=0fdcef36-61a8-4e00-9bed-8abcf6866c96#:~:text=Currently%2C%20a%20patient’s%20personal%20information,is%20accorded%20higher%20protection%20than.

Shah Nazir, Y. A. N. U. a. I. G.-M., 2019. Internet of Things for Healthcare Using Effects of Mobile Computing: A Systematic Literature Review. Wireless Communications and Mobile Computing- Hindawi, pp. 1-21.