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Wireless Health Monitoring System

Conference Paper · December 2018

DOI: 10.1109/BICAME45512.2018.1570510420

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 Wireless Health Monitoring System
Wordh Ul Hasan, Mohammad Sultan Khaja, Saif Ahmed & Mohammad Monirujjaman Khan
Department of Electrical & Computer Engineering,
North South University, Bashundhara, Dhaka, Bangladesh
wordh.u.hasan@ieee.org, mohammads.k.92@gmail.com, saif.ahmed20@northsouth.edu, monirujjaman.khan@northsouth.edu
Abstract— In Bangladesh many rural areas have as little as
one clinic to help the people. This project aims to help those
with chronic diseases that prolong with aging. This approach is
made by taking basic determinants such as SPO2, ECG,
NIBP & temperatures wirelessly transfer them to an online
server. These data can be observed by doctors/caretakers at
real time from any location being connected online. The
samples of data are acted upon to determine
irregularities of the health conditions of the patient in rest
which are stored on the server every second. Doctors have
access to the server through a web application which enables
them to analyses the data. A wireless health monitoring system
has been developed to solve this problem, for which an
Android and a Web Application was implemented.
Keywords—Patient monitoring, IOT, Healthcare, Wireless
Monitoring, Cardiovascular Disease.
I. INTRODUCTION
The rising epidemic that is known as cardiovascular
disease (CVD) in developing countries is creating a
major challenge for the health sector. From studies found in
[1] & [2] we have observed that there were 1.78 lakh
deaths were caused by strokes, 1.06 lakh by ischemic heart
disease and 28,000 by hypertensive heart disease in 2013
alone in Bangladesh.
Currently available devices are overpriced in the
market, even more so, they are not available in Bangladesh.
The resolution was establish a remote personalized assistive
system which is in need at this moment in this country as
there are an insubstantial amount of doctors in remote/rural
areas. This system can help those areas greatly and doctors
can work remotely taking better care for many patients who
are in need of assistance. On the other hand, ambulances in
Bangladesh is are not properly equipped with any sort
of devices that monitor the health of the patient being
transported, whereas it is a necessity to have a health
monitoring system in ambulances as it gives the doctor
critical insight about the patient. Hence, this system can be
put to good use within ambulances as well. On the other
hand Bangladesh faces a lot of congestion and traffic on the
road and there is no emergency lane for the ambulances to
pass in critical situations. Many patients face serious
consequences for this reason only. So this device can help in
that area severely.
The issue addressed in our study makes use of sensors,
mobile and web technology to develop a more robust remote
monitoring system catered to heart patients. The solution
proposed here engages with real-time monitoring
with sensors that are wearable and generate diagnostic
information on the fly. These diagnostics are then sent an
android smartphone via Bluetooth technology and then
wirelessly transmitted by 3G/Wi-Fi. The patient’s
conditions can be checked at any moment of given time by
nearby relatives, caretaker or a doctor.
II. BACKGROUND OVERVIEW
There are numerous models and with respect to remote
patient monitoring and data observing framework. An early
work on this system has been proposed in [3]. The proposed
framework used to screen the ECG signs of a patient in view
of Session Initiation Protocol (SIP) and a ZigBee
arrange. The framework comprises of a remote ECG sensor,
ZigBee module, SIP Register, a proxy web server, a database
server and other wireless devices. Another remote
patient monitoring system based on power line
communication (PLC) and the ZigBee network has been
proposed in [4]. The framework comprises of
physiological sensors like a ZigBee/PLC portal and
some software. The physiological information are gathered
by the physiological sensor and are passed to a central server
through a ZigBee/PLC passage. The information are put
away and broke down at the central server.
Based on the ZigBee technology, many patients can be
monitored simultaneously using physiological signals, which
have been discussed in [5]. The network load is controlled by
an optimized source routing protocol. Also, in this work
wireless network and power related problem, which includes
energy consumption, network lifetime delivery ratio, etc.
have been improved. In [6], a patient monitoring system has
been developed with a low power microcontroller.
As bedsores are a common problem in hospitals, a resistive
bend sensor is used for it. The system that is proposed can
support continuous monitoring by enabling mobility of
patients location and has the potential to replace wired
system that is available currently
The study in [7] works on a local area network or in a
personal basis for wireless data acquisition system. The
system uses IEEE 802.15 standard for
wireless communication along with Bluetooth technology.
Monitoring patient using the internet is possible because
of the home based monitoring. The remote patient
monitoring system in [8] uses Internet of Things (IoT) and
ZigBee protocol. The real time system can send a report to
remote location once analyzing the data
The system developed in [9] wirelessly takes health
parameters, which are temperature and pulse of a patient. It
is based on ZigBee and has a good accuracy. On the other
hand, the improved system in [10] not only has portable
ECG to monitor patient’s health condition, but also
enables data collection of patient’s real-time walking
acceleration. The system can detect falling of patients after
analysis of data.
Existing system even though working with some using
web server application or mobile application to monitor
the health information of patients they are mostly prototypes
and uses low performing sensors. Some of them operate
using a platform and device dependent monitoring system
based on central controller. Hence, overall cost
increases and portability reduces for the whole system.
Moreover in the developing countries, the system used shares the unique key to another person who is the caretaker
to monitor patients has no portability. Hence, only when of the patient then the caretaker or relative can also be
the patient is on bed, it can be used. Other available systems an assistance for the patient to monitor his or her conditions.
are huge, which also make it not portable and costly too and The entity relationship of the system is shown in figure 2.
are only available in ICU of hospitals. On the other hand, Here the three entity are doctor, assistance which is the
other monitoring systems fail to communicate with the patient’s relatives or nurses and the patient himself. The
doctor, which might cause serious situations as they are patient has ECG, SPO2, NIBP and Temp as parameters to be
based on simple circuitry and low level controllers. The monitored. The doctor can take decisions observing these
proposed system we used is very portable and can be carried parameters real-time.
to one place to another and very easily usable in ambulances.
The system provides real time monitoring with reliable
communication over the internet for both doctors and
patient’s caretakers. In terms of network architecture it uses
very reliable Bluetooth communication between sensors and
android device and 4G/WIFI for server communication.
Most of the systems described above uses MySQL databases
where we used noSQL proper for real-time monitoring and
much faster than the available system

III. METHODOLOGY
The system we have developed takes NIBP,
Body Temperature, ECG and SPO2 values through the
sensors attached with the patient. The Sensors are connected
with the module PM6750. The Module sends the data via
Bluetooth to an Android app that we have developed
using the SDK provided by SH Berry Med. The android Figure 2: Entity Relationship Diagram
app needs to be registered by the user and logged in to use The android application was developed using android
the device. After login with the app it searches for the studio and java programming language. We developed
PM6750 module. When connected the app instantly start the API to process the data received by patient
receiving the data and visualize them on the android app monitoring sensors. First we received the data we sorted
also in real time the android app is connected to the server. the data as separation, format conversion and calculation to
We used firebase server for our system for both login display the parameters and waveforms. The system software
authentication and database storage. The firebase server is architecture is shown in figure 3
updated with the data sent via android app over the internet.
The web app developed for this system can be used by the
caretaker or the doctor to monitor the patient’s condition
any given time. The web app pulls the data from the
database. The flowchart has been shown in figure 1. The
details of the system architecture, data flow and components
are explained as follow.

Figure 1: Flowchart of the system

A. System Architecture
There are two entities primarily. Doctor and Patient.
A unique key by the patient shared with the doctor the doctor
can add that patient under his observing conditions. One or
more patients can be observed by one doctor. If the patient Figure 3: System Software Architecture
 The android application receives the data in the network
layer using Bluetooth communication. In this network layer
we also have checksum to check if the received data is
corrupted or valid. The data package then forwarded to data
packet bus.
In Data processing layer data is received by the data
parser we developed which filters out noise and forwards
valid data for parsing and de-multiplexing into ECG
Package, SPO2 Package, NIBP Package and Temp Package.
These packages then sorts the data in waveforms and
parameters to display. All of these data then put into context
bus. All the data are kept in a buffer queue with maximum
capacity of 256.
The Application layer runs drawRunnable class to get the
waveforms from context bus and display in the android
application. It also displays all the other parameters to the
android application. While displaying the processed data the
application layers also forwards this data to firebase server
database where web apps can receive the data and display.
The web application and server does not process any data
it only receives the data real-time and display it. The decision
maker of those data and interpretation is basically the doctor
viewing data from the web portal.
B. System Communication
The system will have 3 kinds of users. The main and
prior users are patients which are connected with the sensors.
The sensors will send data over Bluetooth the android app
and the android app will parse those data into a server and
store them and visualize them. The data is stored in the
firebase database. The data is sent from android to the
database using firebase user authentication and uploading the
data via internet to the firebase database under the user’s
individual tables.
Figure 4: Wireless Communication System
The Stored data can be viewed real time by the assistive
persons and the doctors. They can view these data using the
web app which pulls the data from the firebase via an
Angular web app. The web app uses the internet to connect
and login with the firebase database. Given the valid
credentials the data is shown in the browser of the assistive
person or doctor. Based on the data doctors can give further
instructions. The instructions can be given by the web portal
as well. And previously given all the prescription and
instructions are also stored in the database from where it
is visible to the web portal. The system communication is
shown in Figure 4.
C. Handheld Patient Monitor
Figure 5: Handheld Patient Monitor
For the Patient monitoring module a Multi Parameter
Module PM 6750 Patient Monitor System was used that was
developed by Shanghai Berry Electronics. This Bluetooth
patient monitor OEM module includes four parameters ECG,
NIBP, SPO2 and Temperature and can be used with the said
operating systems such as Windows, Linux etc. For our
project we are using the device with Bluetooth 2.0 with
android application. An electric oscillator is used for
measurement of NIBP and has a cut off time of less than 15
seconds. With a bandwidth of 0.05Hz-100Hz (3dB), the
ECG has total 6 leads I, II, III, aVL, aVR, aVF
and V1,V2,V3,V4,V5,V6. Carbon dioxide at end of
respiration is used to measure respiratory rate and
temperature is measured from vascular or surface
temperature. On the other hand, scanning speed is 50mm/s
for the diagnostic mode 1=40Hz monitor mode and 0.1-25Hz
Operation mode is used and the heart rate is monitored
250 times/minutes. Measurement scope for SPO2 is 35%-
100%.
D. Database Design of the System
For this application we have designed the database not
with traditional relational database but with noSQL
database. Previously seen all the other implementations that
we have seen designed database is using MySQL database
but for this project we implemented with Firebase Database
with noSQL Model. The reason we used noSQL because it
can address several issues that is not easily solved using
relational database. As Patient monitoring system has lots
of data volumes rapidly changing unstructured data. noSQL
is better to address these issues.
noSQL database is best for real-time monitoring
specially in a project like this where we have to deal with
lots of data very fast. According to [11] NoSQL is designed
to address:
 Large volumes of rapidly changing structured, Semi-
Structured and Unstructured data.
 Agile sprints, quick scheme iteration and
frequent code pushes.
 Object-oriented programming that is easy to use and
flexible
 Geographically distributed scale-out
architecture instead of expensive, monolithic
architecture.
 Electrocardiogram and SPO2 with respect to time. The
visualization is done with High Charts Library.

Figure 6: Database of the System

In figure 6 we see the database of the system

Figure 7: User Health Information on the web
designed in noSQL. Under the user we have patients and
under patient with each patient’s unique key all the
In figure 8 it shows the portal of the doctor from where
parameters and history of previous prescription prescribed
he can prescribe medicine and exercise to the patient and it
by the doctor is visible. The prescription is stored with
stores in day to day log. The patient history can be viewed
respect to the date they were prescribed. Another reason
by the doctor and the patient portal as well. The details how
we used firebase database here because it uses data
the data is stored is shown in figure 6 and discussed in
synchronization every time data changes instead of typical
database design of the of the system
HTTP Requests and updates everything within
milliseconds and it uses disk to persist data as even if we
are offline firebase can be responsive and once
reconnected to the internet it receives the changes and
synchronizes with current state
E. Web Interface
The web app is implemented using Angular 5, Node.JS,
Bootstrap, HTML, CSS, Typescript, High Charts
and Firebase. The IDE used was Visual Studios.

The web app has two kinds of login authentication

system. One for the patient and another for the doctor. The
patient or the close relative of the patient who is taking
care of the patient can observe the patients conditions
using the patient login also he can have a doctor account and Figure 8: Portal for the doctor to create the report
login and use the key provided by the patient to view the
patient’s condition. The Doctor can get multiple keys for
multiple patient and monitor them using his profile in the F. Android App
web app. In the web app the data is pulled from the At first the users are prompted to register/login on the
firebase database real time and displayed in this table app so they could be indexed as a patient/doctor on the
manner. The doctor can monitor Heart Rate, High Pressure, platform. When the device is set up on the app receives all
Low Pressure, mean Pressure, Pulse rate, Resp. Rate SPO2 the data from PM6750 Module via Bluetooth and displays
and Body temperature. the information to the user.

If the doctor wants to view individual patient’s condition These data related to patient’s health can be accessed by
he can just click on the patient and view the data shown in both the doctor and the patient or their relatives/attendants.
figure 7 it shows the visualization of the data of However, to ensure security of these information both the
doctor and the patient has to login to the app using their
email address and password. The doctor can monitor the
patient’s health condition using the app, however, the app
also uploads the data to the server so that it could also be
accessed using the website.
Figure 9: Patient Parameter Reading in android app
Here in figure 9 we can see the ECG, SPO2, Temp and
NIBP values displayed in the android app from a patient’s
readings from the sensors.
Figure 10: Android app to view patient old history
prescribed by doctor
Figure 10 shows the patient history and old prescriptions
by the doctor.
IV. TESTS AND RESULTS
We were able to test our device on some volunteers and
monitored the data to check whether there were
any discrepancies in passing the data from the app to the
server. We kept the test subject in a home and connected the
sensors. The android app that received the data was in the
same room and was connected via Wi-Fi. The web portal
was accessed from 5 kilometer away from the test subject by
a doctor. Data was successfully transmitted in real time.
Doctors were able to participate and remotely check the
conditions of their patients from any location given that they
were connected to Wi-Fi/4G networks. We have
tasted with analogue monitoring systems and also our
developed system. There were no significant delay that we
could notice however we checked the time delay provided
by the specifications of the system used and it says from
android to firebase and firebase to angular web app it takes
around 200 to 300 milliseconds of time delay. Tested with
other systems we found the Heart Rate accuracy ±2
time/minute and SPO2 accuracy: ±2% in the range of
90%~100% ±3% in the range of 70%-89% for the NIBP
measurement accuracy is static pressure ±3mmHg. In figure
11 we see the testing subject whose data is visible in all the
other figures we used in this paper.
Figure 11: Testing the system
One of the major contribution we did in this project what
is missing in all the other projects we have discussed before
is the use of Bluetooth and Wi-Fi instead of Zigbee network.
It helped major way in transmission of data and real-time
monitoring
Technology Data Frequency Sensitivity Transmission Link
Rate Power budget
Zigbee 250 2400MHz -98dBm 8dBm 106dB
kb/s
Bluetooth 1MB/s 2400MHz -85dBm 7dBm 92dB
Table 1: Difference between Zigbee and Bluetooth
In table 01 we can clearly see Bluetooth performs better
for real-time monitoring of data.
Also in comparison with noSQL database with relational
database this system outperforms other systems in handling
robustness of data the detail comparison is discussed in
database design chapter of this paper.
The total system costs only 270 USD that also taken the
consideration that the system is not any prototype but
hardware is industrial grade embedded system designed by
the Berry SH in china unlike other systems we have
discussed in this paper and the application developed for the
system can simultaneously handle thousands of patients
concurrently without any delay. From [12] we know firebase
can handle 100,000 simultaneous connections and
~100,000/Second simultaneous responses send from a single
database. The available patient monitoring system in the
market doesn’t come with web portals and also very pricy
ranging from on average 400 to 1000 USD seen on ebay and
alibaba stores.
 V. POTENTIAL APPLICATION AREA
There are many potential application areas for this
system in Bangladesh. Primarily in Bangladesh Traffic jam
is very severe and our ambulances does not have any kind of
patient monitoring systems. Many heart patient dies on the
way to hospital because they couldn’t get the immediate
attention they needed. Our approach with this project is to
install these systems in the ambulances so that for these kind
of patient doctor can immediately monitor patients
remotely and prescribe necessary actions to save lives.
name and age on web interface and Patient prescription
history.
ACKNOWLEDGMENT
We would like to express gratitude towards
NSU, Electrical and Computer Engineering Department,
Berry Med for helping us to receive the handheld monitoring
system and providing us with the Software development
kit for the module. Our faculty advisor Dr. Mohammad
Monirujjaman Khan for guiding us through this project.

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