An IoT based low-cost heart rate measurement

system employing PPG sensors

Lena Gohlke1 , Frederik Dreyer1 , Monica Pimiento Álvarez1 , and Jens Anders1
1
Institute of Smart Sensors, University of Stuttgart, D-70569 Stuttgart, Germany

Abstract—In this paper, we present a low-cost system for heart

rate measurements. The device is easily usable without medical
knowledge or training, and it works without prior calibration.
The sensor mainly targets for health monitoring people in rural
areas of emerging countries, who do not have easy access to
medical examinations. While there are already many devices
on the market that can perform heart rate and blood pressure
measurements, the focus of the presented work is on reducing the
cost while maintaining sufficient accuracy and providing online
access to the measured data for medical personnel. The presented
prototype uses commercial PPG sensors and can measure heart
rates between 30 bpm and 200 bpm with an absolute accuracy of
±10 bpm. The total cost of the prototype is below 30 USD.
Keywords—PPG, Photoplethysmography, heart rate measure-
ment, IoT, low-cost medical sensors, telehealth, telemedicine
I. I NTRODUCTION
According to the 2018 census, approximately 11 million
Colombians live in rural areas. Only 17 % of the population
has access to health services due to the poor infrastructure
and large distances to the nearest hospital. Additionally, the
consequences of violence in the country prevent development
in these areas. Overall, this leads to increased health risks and
an unmet medical need in the vulnerable population.
However, in many areas of the country, the project ”vive
digital” [1] provides access to computing and internet infras-
tructure. These access points offer great potential to implement
automated screening tests in rural areas. In the envisioned
scenario, people in rural areas would utilize low-cost point-
of-care instruments, which acquire medical data. Then, these
data are made available online to the medical staff, who
electronically communicate their first diagnosis and treatment
suggestion to the patients.
First-level medical examinations utilize a variety of parame-
ters, including body temperature, blood pressure, heart rate,
and respiratory rate, to examine the general state of health
of the patient [2]. To make the remote assessment of these
parameters widely accessible in rural areas, it is necessary to
measure these four parameters with low-cost, easy-to-use, and
low-maintenance devices that provide an IoT functionality for
an online assessment by a remote physician.
Fig. 1. Measurement setup and operating principle of the PPG sensor.
A. Photoplethysmography
One possible way to measure heart rate and blood pressure
is by photoplethysmography (PPG). PPG is a cuff-less and
non-invasive method to measure changes in blood volume [4].
As shown in Fig. 1, an LED or an array of LEDs is used
to emit light that is partly absorbed and partly reflected by
the tissue. A photodiode (PD) detects the reflected part of the
light, which is a function of the blood volume in the tissue.
Since each heartbeat alters the actual blood volume in the
tissue, the time trace of the absorbed light signal can be used
to monitor the heart rate. Unfortunately, the LED signal is
also reflected by bones, which, together with motion artifacts,
ambient light fluctuations, and tissue deformation, lead to an
increased noise floor and signal artifacts in the measured PPG
signal that complicate the extraction of the heart rate from
the raw PPG data. To measure blood pressure from PPG data,
two spatially displaced sensors are required. Then, the linear
relationship between blood pressure and the speed of blood
traveling through arteries [5] can be used to extract the blood
pressure from the PPG data of the two sensors. Therefore, as
shown in Fig. 1, in the proposed system, we simultaneously
acquire the PPG signals from two PPG sensors, one placed at
the wrist and another one at the fingertip of the patient.

II. H EART RATE SENSING B. PPG sensor details

In this paper, we focus on the development of a heart rate
sensor as a first building block towards a complete toolkit for
medical diagnosis in rural areas in emerging countries. The
resting heart rate is typically between 40 bpm and 109 bpm
[3], establishing the minimum dynamic range of the heart rate
sensor.
Today, there are mainly two types of commercially available
PPG devices: sport watches and finger clips. Sport watches are
used for non-medical pulse measurements and mostly employ
green LEDs. For medical measurements, finger clips with red
LEDs are used to measure heart rate and oxygen saturation
simultaneously [6]. To find an optimal wavelength, one needs

978-1-7281-6801-2/20/$31.00 ©2020 IEEE

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to take both the absorption spectrum of haemoglobin and the raw measured total raw
signal measured signal
penetration depth of the light into account. Here, while blue first half raw
measured signal
and green light are good choices when only considering the PSD +
second half raw
haemoglobin absorption spectrum [7], according to the Beer- digital filter +
measured signal
normalizing
Lambert law, only infrared light can penetrate sufficiently deep
into the tissue to reach the arteries that carry the main pulse ignore peaks
lower than 6 %
signal. In contrast, green and blue light only measure the of the highest
one
capillary pulsation directly underneath the skin. From the light
reflected by the capillaries, the pulse signal is only measurable
indirectly, due to a higher density of capillaries when the
pulse arrives in the artery. Therefore, the signals measured +

with green LEDs contain less information and a weaker signal.

However, due to the lower penetration depth, these signals also add peaks from IR and
red signal - choose
contain fewer motion artifacts. In summary, a PPG signal of highest peak
red or infrared light contains more information but also has to
deal with more motion artifacts. calculate heart rate from
red signal of highest
peak
C. Proposed sensor platform
all peaks
The sensing device presented in this paper is illustrated in HR of total
checked HR of second
no signal
Fig. 1. It is, in principle, capable of measuring heart rate, blood half
HRs
yes
pressure, and oxygen saturation. Here, a precise heart rate esti- HR of first half
delete first peak if it is HRf
mation is critical for an accurate blood pressure measurement not the fundamental
[8]. The main features of the proposed sensor are ease of use corresponding to the
second peak and the HRs-10<HR
and maintenance (simple cleaning), low-cost manufacturability second peak is the <HRs+10
fundamental of the and heart rate
and operation as well as IoT compatibility while providing third peak HRf-10<HR yes

sufficient accuracy for first-level medical examinations. The <HRf+10

main component of the presented sensing platform is the
commercial PPG sensor MAX30102 from Maxim integrated
[9]. This sensor employs both red and infrared LEDs for
reflective PPG measurements. To be able to measure both heart
rate and blood pressure, the proposed platform combines two
PPG sensors, one placed at the wrist and a second one at the tip
of the index finger. An I2 C interface transfers the measured
data from the two sensors to a Raspberry Pi. All required
signal processing is performed on the Raspberry Pi, and the
processed data are made remotely accessible via a website.
D. Signal processing
The signal processing is implemented using the scipy pack-
age in Python. Fig. 2 shows a flow chart of the main functions.
First, the power spectral density (PSD) is calculated employing
a flattop windowing function. Next, digital band-pass filtering
of the PPG signal with a passband between 0.45 Hz, and
6.7 Hz is applied. Here, the lower cutoff frequency of 0.45 Hz
corresponds to a heart rate of 27 bpm, and the upper frequency
of 6.7 Hz to 400 bpm. Typically, the first peak in the frequency
domain corresponds to the heart rate. All following peaks
should be harmonics of this frequency. However, due to
interferences, other peaks, which are not correlated with the
heart rate, can appear in the frequency spectrum. Initially,
all peaks are detected and stored in a list. Then the peaks,
unrelated to the heart rate are eliminated by the algorithm of
Fig. 2. Finally, the first peak is checked for consistency by
testing whether harmonics of this peak occur in the spectrum.
This peak is deleted if it is not the fundamental corresponding
to the second peak.
first peak
no
corresponds to measure again
heart rate
Fig. 2. Flow chart of the algorithm used for pulse detection.
III. S YSTEM VERIFICATION ON SYNTHETIC DATA
As a first step, we used a synthetic data set [10] to verify the
algorithm of Fig. 2. This data set consists of 192 PPG signals
with different heart rates ranging from 30 bpm up to 200 bpm.
From each signal, only the first 20 seconds were used for the
heart rate calculation. At first, the python function detects all
peaks in the PSD corresponding to the time series. Every peak
with an intensity lower than 6 % of the highest detected peak
is then discarded since it is most likely caused by noise and
interferences. The threshold of 6 % was empirically chosen.
Subsequently, two peaks that have a distance of less than
0.1 Hz are merged. If three peaks have a distance less than
0.4 Hz, these peaks are likely to have their origin in side lobes
of the windowing function. In this case, only the middle peak
is kept, and the two side peaks are discarded. The frequency
threshold of 0.4 Hz arises from the typical human heart rate
between 40 and 109 bpm. Fig. 3 is used to illustrate the peak
post-processing. In the figure, to be deleted peaks with an
intensity lower than 6 % are marked with a red cross. Peaks
that will be discarded due to the windowing threshold are
marked with an orange cross. Peaks that are not discarded
in this initial sorting step are marked with a blue cross. Next,
the algorithm checks the harmonic relation between the first
peak and the second peak in the list. If the first peak is not

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 the fundamental corresponding to the second peak, but the
second peak is the fundamental corresponding to the third
peak, the first peak is likely to originate from interferences
and is therefore discarded. The first peak of the list after this
last verification step is used for the heart rate calculation. The
peak found by the algorithm in Fig. 3 is marked with a green
circle.
1.0
PSD
0.5
0.0
1 2 3 4 5 6
frequency [Hz]
Fig. 3. Illustration of the peak postprocessing algorithm on synthetic data.
This algorithm has been applied to the synthetic data set. In
this experiment, no false heart rate detections due to selecting
the wrong spectral peaks occurred, and the maximum deviation
from the specified heart rates was ±3 bpm. Here, it should be
noted that commercial pulse monitors display a deviation of
up to ±5 bpm [11].
IV. M EASUREMENTS
In this section, we have applied the sensor of Fig. 1 for
measuring the heart rate of human beings in vivo. Reference
measurements have been performed using a commercial blood
pressure and pulse measurement device (Medisana BU-92E)
with a heart rate measurement accuracy of ±5 bpm [11]. To
measure the heart rate, we have recorded time traces of 50 s
with a sampling rate of 400 Hz/channel, using both the infrared
and the red LED signals from both the wrist and the fingertip
sensors, i. e. a total of four signals per measurement. Since
it was found that the fingertip signals are less affected by
motion artifacts, we continued to use only those for the heart
rate estimation. Thanks to the availability of both the red and
the infrared data, we could extend the algorithm of Fig. 2 by
the blue and purple blocks, in which the two PSDs of the
individual time traces are added after the signal processing
described in section III. Example PSDs of measured data of
all four individual signals and the sum of the PSDs of the
fingertip sensor data are shown in Fig. 4.
1.00
infrared finger
0.75 red finger
infrared hand
PSD
0.50 red hand
infrared and red signal added - finger
0.25
0.00
1 2 3 4 5 6
frequency [Hz]
Fig. 4. PSD of the four measured signals.
The raw data of one data set, the filtered raw data, and the PSD
can be seen in Fig. 5, clearly highlighting the interferences in
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the time domain signal that are, however, spatially separated
from the heart signal in the PSD. In this case, the highest peak
of the PSD signal corresponds directly to the heart rate.
1.00
reflection
0.95
0 10 20 30 40 [s] 50
1
reflection
0
0 10 20 30 40 [s] 50
1
amplitude
0
1 2 3 4 5 6 [Hz] 7
7
Fig. 5. Time signal after measurement (top), filtered time signal (middle) and
PSD of processed signal (bottom); red curve - red light, blue curve - infrared
light.
To avoid the effect of short term disturbances and thereby im-
prove the robustness of the heart rate detection, we performed
three individual heart rate estimations. In a first estimation,
we used the entire time signal of 50 s to calculate the heart
rate (HR) according to Fig. 2. Then we split the time signal
into two parts of 25 s each, and reran the algorithm of Fig. 2
on these shorter time signals. If HR is within ±10 bpm of
HRfirst (HRf) or HRsecond (HRs), the heart rate measurement
is considered valid, and the result is displayed. Otherwise, the
user is requested to remeasure.
In approximately 70 % of all measurements, the algorithm
calculates a heart rate within ±10 bpm of the reference value.
In 62 % of all measurements, the deviation from the reference
value was better than ±5 bpm. Due to patient motion during
the measurement, in about 29 % of the cases, the algorithm
requested the patient to remeasure. In only 2 % of the cases, a
wrong heart rate outside a ±10 bpm window of the reference
value was displayed. A total of 45 data sets was recorded and
analyzed.
measure again (28.9 %) wrong heart rate (2.2 %)
heart rate within +/-5 bpm (62.2 %) heart rate within +/-10 bpm (6.7 %)
Fig. 6. Results of the heart rate calculation applied to data recorded from 45
healthy patients (average age: 25 years (21 years to 31 years), average weight:
74 kg (58 kg to 100 kg), average height: 1,78 m (1,62 m to 1,95 m ))
V. C ONCLUSION AND OUTLOOK
In this paper, we have presented a sensing platform that is
capable of measuring the heart rate, blood pressure, and blood
oxygenation. The total cost of a prototype system including
the PPG sensors, the Raspberry Pi, and the 3D printed parts is
less than 30 USD. The functionality of the device in measuring
7 the heart rate using a custom developed algorithm has been
successfully demonstrated on data recorded from 45 patients
with a very good agreement between our low-cost system and
a medical device. Our next steps will be to incorporate blood
pressure and blood oxygenation measurements before we will
deploy the device in field studies in Colombia.
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