Usage Of The Internet Of Things (IoT) In Healthcare

Introduction

Healthcare is one of the most important applications as there is raising interest seen in people wearing smart watches to monitor their activities during their fitness or athletics. This type of systems not only measures the various readings but also keeps track of daily routine by continuously monitoring and recording the various physiological parameters. This type of data helps the physicians to identify the various problems causing the disease, as the daily routine data is available. Decision support systems can be used for treatment, as early diagnosis can be done for improving the quality of health according to the lifestyle adopted, as these readings are available in the data base. Though lot of wearable patient monitoring systems have come into the market, they have very little effect on the clinician requirement of data for diagnosis. In this work an effort is made to identify the various patient health parameters which are acceptable by medical practitioners. A thing in IOT can be an auto mobile with sensors to alert the driver or any other device that should be connected, can be assigned an IP address, so that it can transfer data over a network.

IOT has evolved to capture data about things in the real world. Most of the people have limited time, attention and accuracy. IOT gathers the data without any help from the user. IOT needs electronics engineers and application developers working on products and systems.

Health Care with IOT:

In medical applications data is collected from various sensors, processed through microcontroller and sent to devices equipped with Wi-Fi, which allows machine to machine communication which is the basis for IOT. IOT devices linked to cloud platform through thingview web services in this work, on which captured data can be stored and analyzed through Matlab analytics.

There will be 37.6% growth in healthcare IOT industry between the years 2015 to 2020. IOT makes people enjoy personal attention of their health requirements; the devices can be tuned to remind their appointments. During the shift in duties of nurses the data collected by the other person make out of sight which makes it difficult to follow up the case of the patient when the doctor comes.

Medical equipment like nebulizers, pumps, wheelchair, scales, defibrillators or monitoring equipment can be connected to sensors so that the equipment can be located easily by IOT. Due to the intervention of IOT, clinicians can find the patients who are recuperating the post anaesthesia care. The patients can be monitored real time environment. The medical staff can access the information of the patient from the cloud as long as they are stored there.

The following health parameters are monitored and recorded

Temperature sensor-DS18b20

DS18b20 temperature sensor is used which has 3 input pins- VCC, ground & DQ. It is a digital sensor with one- wire developed by Maxim. Temperature can be measured in degrees centigrade or Fahrenheit with 9 to 12 bit resolution. This sensor exchanges the temperature reading over one wire interface, a system developed by the Dallas semiconductor. This sensor has a 64bit serial code. This code helps temperature sensor to get connected to one wire bus which in turn helps to access the data using Arduino. The range of temperatures measured by this temperature sensor is -55°C to +125°C. The power to this sensor is given in two ways –One way is using an external power supply to VDD pin and the other in parasite power mode, in which the DQ pin is pulled high allowing the temperature sensor to draw the power. The DQ pin of the sensor is connected to the 12th pin of the Arduino. The sensor can easily be interfaced with Arduino and programmed using one wire and dallas temperature libraries.

Heart rate sensor

When light is scattered or observed, there will be power variation in its path through the blood when the heart beat changes , this is how a sensor measures the heart beat. The amount of light absorbed depends on the blood volume in that tissue. In this work heart rate is measured by using clip type sensor. It works on the principle of photo plethysmograph. The sensor has infrared LED (IR) and light dependent resistor (LDR) placed parallel on either side of the clip. Blood flows in the finger during contraction and expansion of the heart. The patient’s finger is placed inside the clip. When the blood pumps through arteries light is transmitted to LDR from IR sensor .When blood pumps through veins there is no light emitted to LDR. This flow of blood is counted for 10 beats. Arduino has an in built timer which runs continuously. So the reading of the timer is noted when the heartbeat starts and the count is counted for 10 beats. The rate is counted for one beat as

Rate (1beat) =rate / 10.

Generally heart rate is calculated for one minute by doctors. So using the formula

1 min= 60*1000 /rate.

This is how the heart rate for one minute is obtained by the device. The heart rate sensor is connected to the 8th pin of the Arduino along with VCC and ground.

Blood pressure

The blood in the arteries is pumped around the body by the heart by its pressure; this is called blood pressure (BP). When the heart beats, it contracts and pushes blood through the arteries to the rest of the body. This force creates pressure in the arteries. Blood pressure is recorded as the systolic pressure (the beats of the heart) over the diastolic pressure (the relaxation of heart between the beats). The unit which measures this is called Sphygmomanometer.

Monitoring blood pressure at home is important for many people, especially if there is high blood pressure. Blood pressure is not the same every time, it changes according to the body needs. It is affected by various factors like body position, breathing or emotional state, exercise and sleep. It is best to measure blood pressure in a relaxed and sitting position or lying down position. This physiological parameter gives an early indication to start the treatment. A fall in the BP is a sign prior to cardiac arrest. High blood pressure usually does not have any symptoms, so there is a need to check blood pressure on regular basis.

The systolic and diastolic hypertensive readings must be <90 and <60 mmHg. The desired readings for normal blood pressure are systolic (90-119 mmHg) and diastolic (60-79 mmHg).

Hypertensive crisis is ≥180 mmHg systolic and ≥110 mmHg diastolic. The sensor reading consists of 15 bytes at 9600 baud rate. The output reading is 8-bit value in ASCII format from 000 to 225. The readings can be seen using terminal software.

The blood pressure varies according to the age and type of activity done by the patient. The various blood pressure values for different age groups are as follows

Age Systolic/diastolic Bp

20-24 120/79

30-34 122/81

40-44 125/83

50-54 129/85

60-64 134/87

Table 3.1 Blood pressure readings

The BP measurement device used in this work is developed by sunrom technologies. It gives 13 byte ASCII code readings after measuring the systolic, diastolic and pulse rate values. The ASCII start code is OD and stop code is OA along with comma and space codes. The systolic value of decimal 124 is obtained in ASCII as 31, 32, 34. So using the program the ASCII values are converted to decimal values. Example 124, 82, 74.The 1st reading is systolic value of BP, 2nd reading is diastolic value of BP and 3rd reading is pulse rate value.In the present work systolic and diastolic values of BP are taken.

The BP sensor is on when the ON/OFF button goes from high to a low pulse (float mode). To achieve this, relay is connected between the BP sensor and Arduino. The BP on/off switch output is connected to the common; NC(normally closed) to ground and NO (normally open) are left open. The other side of the relay is connected to ground, VCC &A3 pin of Arduino.

When Arduino A3 pin is zero BP sensor is ON and when A3 pin is logic 1 BP sensor is OFF. For transferring the program from PC to Arduino, RX pin of Arduino is disconnected as this pin is used by USB cable. BP sensor is a serial communication device. Arduino has only one set of TX and RX which is connected to ESP8266 (WI FI). The 10th and 11th pins of Arduino are made to operate as RX and TX pins using software program.

4 MEM’S SENSOR-ADXL335

ADXL335 is an accelerometer sensor which is used to monitor tremors in hand. X, Y, Z are three axis in which X-axis identifies front and back movement, Y-axis up and down movement. The analog read instruction is used to read X, Y values and wait for 50 ms. These values of X,Y are read for 50 ms, which is repeated for hundred times. This helps in identifying valid tremors as it waits for 5 seconds, if there is continuous change in the values of X, Y. If a significant change is not obtained then it is just a hand or body moment and they are not tremors. The output is displayed as tremors occurred or not occurred on LCD and graphically represented as zero or one value using think speak web site.

5 ESP 8266 (Wi-Fi)

ESP8266 is a Wi-Fi module which interferes between Arduino and IOT. This module sends data using serial communication at a rate of 115200 band rate. It operates at 3.6 volts and has self contained SoC with TCP/IP protocol stack integrated. It has 4 pins VCC, ground, RX and TX. It helps in accessing a Wi-Fi using the microcontroller. It has a pre programmed attention (AT) commands that helps in acting as an interface between Arduino and android app. It is cost-effective and can easily be integrated to sensors on one side through Arduino and on the other side using its GPI0’S, it connects to application specific devices. The AT commands of ESP8266 makes it more easily to use this Wi-Fi (Ethernet shield) module to transform into IOT solutions. The disk size of ESP8266 is 1 MB. The Interface used to connect ESP8266 Wi-Fi module with Internet is thing speak website. This web site has developed an android app. also.

IMPLEMENTATION

The following steps are needed to obtain the sensor data on the mobile app , thing speak has to deliver the data onto the Internet.

ESP8266 has 3 modes of operation, Mode 1-host, Mode 2-client, Mode 3-both.In this work mode 3 is used. The AT command is AT+ CW MODE=3.The next step is find whether Wi- Fi is connected or not.

For ESP8266 to identify the SSID, AT command is AT+CWJAP“SSID”, to find which Wi-Fi has to be connected to and once it gets connected it will ask for the password.

ESP8266 to interact with Internet needs user ID and password. So an intermediate interface is used in this work, which is thing view website.

So the first thing required is the IP address (Internet protocol address). After getting the address all the values are delivered to this address.

The IP address is sent to the android App using Arduino program . The IP address used by the android app is AT+ CIP START =. Hence the IP address of the thing view is 184. 106. 153. 149, 80.This address connects the hardware board to Internet using TCP/IP protocol.

The next step is identification. The user should have authority to store in that website. So a password is given using API keys. The thing view website gives the password to enter into that website, once we login through the user ID and password.

To upload data a channel has to be created and it has to be given a name. The name given for this work is Patient Monitoring System. There are 8 fields where in 8 sensors can be connected.

In this work only five fields are used heart beat (field 1), temperature (field 2) , systolic(field 3), diastolic(field 4), tremors (field 5).

Once the Address is obtained, password is given by API keys. Copy the API key and write in arduino program (16-bit key).

Once the API key is sent it will ask how much quantity of data is going to be sent and what is the length of the string.

String for field 1 heartbeat

String for field 2 temperature

String for Field 3 systolic

String for field 4 diastolic

Spring for field 5 tremors-(0=no tremors & 1=tremors).

On confirmation the string of data is sent to FIELD 1 heart beat , reading 83 and so on. Thing speak has created an android app along with the website uploading.

SYSTEM ARCHITECTURE

The following are the steps used in the study

obtaining data from various sensors-Data acquisition

processing it and displaying the results-Data transmission

Displays on the android app using IOT-Visualization

Data acquisition:

The sensors are placed on the human body and the acquired data is processed through Arduino.

Data transmission: The results obtained through Arduino are transmitted to Liquid crystal display (LCD) and through Ethernet shield to android app.

Visualization: The doctor can read the patients data sheet using android app. The physiological parameters data of the patient can be read by the patient relatives also. When the mobile device is not in the vicinity of the Arduino it is stored in cloudlet. A cloudlet can be a desktop which access local processing unit through the Wi-Fi network. Cloudlet not only allows temporary storage before communicating the data to the cloud, but it is also used for running different tasks of patient’s data. This type of application can be used when there is no energy in the mobile.

The various parameters like heart rate, temperature, blood pressure and tremors are sensed and monitored using IOT. The amount of hardware required to design the circuit is very less which makes it simple.

RESULTS

Telemedicine is convenient since at times patients are not able to move to hospitals, clinics or to the doctor’s room. So using this option the patients can receive quality care which they need. Regular visits to the hospital can be costly specially in remote places where the travel expenses become more ,so video conferencing can be opted as one of the measures to reduce the cost significantly .Moreover telemedicine can save time both for the patient and the practitioner. It can be used to streamline the work flow in hospitals and clinics as the attributes of a patient can be obtained quickly. It also improves the communication between the patient and doctors, to share their expertise for improved health care services for the patient. A goodbye to the extended treatment hours and patient calls, which are not monitored for treatment from anywhere anytime. The vital parameters like temperature, pulse rate and blood pressure are monitored by sending the readings at regular intervals for proper care of the patient. This research helps to identify such problems and monitor the patient’s in hospital ward environment also. Using the thing speak web site the reading are measured and recorded.

Conclusions

This work is useful for doctors to know the patient parameters from their desk only, instead of checking the charts written by nurses pertaining to the patient parameters throughout the day in the hospital. It can be used by patients relatives who are not nearby, this can be achieved by choosing the option public in “thing speak” web site. All the readings of the parameters are uploaded into the website and by using the Matlab analytics the graphical representation of the physiological parameters are displayed along with a time of measurement and the values at that time. Generally nurses measure the patient parameters three times in a day. So these readings can be remotely monitored by the doctor and accordingly monitor the patient.

In this a MEMS sensor is used with minimal effort, profoundly convenient device and can be utilized for remote applications, further the goal is to obtain and analyse tremors for those affected by this disease. This work helps the specialists to screen patients who are in coma and doctors going for vitreo retinal surgeries as gentle developments in the body or hands can be distinguished and sent on to the specialists Personal Computer.

The above conclusions are related to real-time physiological information, parameters representation and interpretation methods. The overall system is developed in such a way that every module works independently and integrates itself for the well-being of patients. The proposed system is sensible, accurate and reliable in predictions. The system is tested along with a physician to check its accuracy, stability and complexity. Designing, developing, testing, validation and enhancement were done.