An Implementation of IoT for Healthcare Ravi Kishore Kodali, Govinda Swamy and Boppana Lakshmi Department of Electronics and Communication Engineering National Institute of Technology, Warangal WARANGAL, 506004 Email:
[email protected]
Abstract—Internet of Things (IoT) is a computing process, where each physical object is equipped with sensors, microcontrollers and transceivers for empowering communication and is built with suitable protocol stacks which help them interacting with each other and communicating with the users. In IoT based healthcare, diverse distributed devices aggregate, analyse and communicate real time medical information to the cloud, thus making it possible to collect, store and analyse the large amount of data in several new forms and activate context based alarms. This novel information acquisition paradigm allows continuous and ubiquitous medical information access from any connected device over the Internet. As each one of the devices used in IoT are limited in battery power, it is optimal to minimise the power consumption to enhance the life of the healthcare system. This work explains the implementation of an IoT based In-hospital healthcare system using ZigBee mesh protocol. The healthcare system implementation can periodically monitor the physiological parameters of the In-hospital patients. Thus, IoT empowered devices simultaneously enhance the quality of care with regular monitoring and reduce the cost of care and actively engage in data collection and analysis of the same. Keywords - IoT, Healthcare, eHealth, ZigBee
I. I NTRODUCTION Internet of Things means things interact with the Internet by employing sensors, microcontrollers and transceivers for empowering communication and is built with suitable protocol stacks which help them interacting with each other and communicating with the users, thus becoming the constitutive part of the Internet. Nowadays, Internet is impacting the several aspects of the potential user’s everyday life. By keeping these things in view, several applications are developed based on IoT in which every physical object is connected to the Internet by employing sensor devices. The dependency of healthcare on IoT is increasing day by day to enhance the access to care, strengthen the quality of care and finally reduce the cost of care. Depending on an individual’s unique biological, behavioural and cultural characteristics, the combined practice of wellbeing, healthcare and patient support is defined as personalised healthcare. This empowers each and every individual by following the basic healthcare principle of “the suitable care for the right person at the right time”, which leads to more desirable results and improvement in satisfaction thus making c 2015 IEEE 978-1-4673-6670-0/15/$31.00
healthcare cost effective. An efficient healthcare service should deal with prevention, early pathology detection and homecare instead of the high-priced clinical care. IoT ensures the personalisation of healthcare services by maintaining digital identity for each patient. Due to nonavailabilty of ready to access healthcare systems, many health problems have been getting undetected in conventional healthcare systems. But pervasive, non-invasive, powerful IoT based systems have been helpful in monitoring and analysing the patient data easily. In IoT based healthcare, various distributed devices gather, analyse and pass real time medical information to the cloud, thus making it possible to collect, store and analyse the big data streams in several new forms and activate context dependent alarms. This innovative data acquisition paradigm allows continuous and ubiquitous medical device access from any connected device over the Internet. II. L ITERATURE S URVEY In India, a survey was conducted to observe the functioning of different medical centers and the improvement in healthcare delivery with the introduction of information technology. The survey revealed that patient records in many of the hospitals were not managed properly, also the patient referrals among various hospitals were more or less based on paper documents. As facilities were not available to precisely estimate patient’s history, the healthcare quality was inefficient. The survey revealed that healthcare facilities can be improved with the help of Information Technology, mainly using Electronic Health Records (EHRs). According to the survey the usage of EHRs is less in use and prone to failures because of the complexity associated with it. This paper proposed a simple and pragmatic Employable EHR (EEHR) [1] approach also termed as WebEHR. This approach provides the web based connectivity among various healthcare centers, thus simplifying the maintenance and sharing of data. Healthcare is one of the basic needs to any person. However, the physicians are not transparent in terms of care and money with each and every patient. One more problem associated with the healthcare system is the lack of medical facilities to track the patient’s history to provide the effective treatment. Therefore, it is necessary to optimise the healthcare system to make it more efficient [2]. This paper proposes a cloud computing based approach for integrating all the
hospital records from large size to small size and thereby it can maintain the patient’s data under one roof. This approach not only reduces the monopoly of corporate hosiptals, but also ensure that the government run healthcare facilities to be fair to the patient community. For In-hospital patients, clinical deterioration is an important problem [3]. This paper gives the implementation and deployment of wireless monitoring of in-patients inside the hospital premises. The deployed wireless systems gather pulse and oxygen saturation measurements from patients regularly. It also discusses the possibility of WSNs for healthcare in hospitals. The key strength of the Indian healthcare system is due to its well trained medical staff. Certain efforts have been made to improve the quality of healthcare situation [4]. This paper discusses the efforts that have been made to improve the healthcare system and the outcomes. It also provides the lack of medical equipment safety measures and the precautionary steps that need to be taken care to improve the quality of healthcare in India. The increase of elderly population and the wide prevalance of various chronic diseases led to the development of telehealth systems [5]. It gives the comprehensive understanding of wearable technology for the remote healthcare system. The basic idea of this system is to implement a tele-home patient monitoring by making use of wearable devices, wireless communication and multiple sensors. According to the survey, majority of the road accidents in India are due to the driver’s ill-health conditions such as cardiac problems or any other serious health related issues [6]. To prevent the road accidents and to provide the driver with instant medical facility, a smart healthcare monitoring system is suggested. This system measures physiological parameters such as temperature, pulse rate, etc. and transmit the same using smart phone to the Ineternet. If any abnormal values are received from the driver, doctors and transport officers can be alerted about the driver’s location. The technical improvements in low powered network systems and medical sensors enabled the use of wireless sensor networks in healthcare [7]. It gives different application scenarios in healthcare and the challenges involved in WSNs, with respect to healthcare and emphasizes various safeguards related to the privacy of medical data and lists various research challenges. M-Health combines mobile computing, medical sensors and communication technologies [8]. It presents the different wireless technologies used in m-health such as GPRS, WLAN, ZigBee, Bluetooth and addresses some of the challenges and future implementation issues in these areas from the healthcare point of view.
In the recent years, the increase in healthcare applications requiring wearable technologies have been growing considerably. The medical devices available to monitor the human body are not comfortable to wear [9]. It gives the development of comfortable to wear medical devices by integrating ECG, accelerometer and SpO2 sensors in a single device. Internet of Things is a computing process, in which each physical object is associated with one or more sensors, microcontrollers and transceivers for empowering communication and is built with suitable protocol stacks which help the objects or things interact with each other and communicate with the users, thus formng the constitutive element of the Internet [10]. From the perspective of key users Internet of things finds applications like e-health, smart buildings, assisted living, smart metering, security surveillance, smart parking remote monitoring and controlling of data [11]. Internet of things has been revolutionizing the way Internet works. In the near future billions of devices will be connected and communicate with each other without human intervention, generating large amount of data which provides humans with information and be able to control various devices remotely [12]. However, it suffers from two problems: limited battery power and latencies associated. The main objective of the IoT concept is to connect the things information with the Internet [13]. It introduces various descriptive models for the Internet of things based on its features. These models are same for all Internet applications and the same can be used for developing various IoT applications. Internet of things is termed as "Future Internet" [14]. IoT is a system of connecting uniquely addressable physical objects with the Internet. It discusses the different components of IoT, its applications and key benefits to the society. Wireless sensor networks can be used in many applications such as precision agriculture, event monitoring, disaster management, etc. WSN data can be connected to the Internet by using gateways [15]. The Internet protocol (IP) is used to provide the connectivity between the WSNs and the Internet. It presents the work pertaining to standards and solutions for WSNs, in order to make an IoT. ZigBee protocol is widely used in Internet of things for applications such as smart home, healthcare and Industrial automation, etc. Various wireless communication protocols such as 802.11 and Bluetooth already exist. Still these wireless networks are facing some basic challenges such as power consumption, scalability. ZigBee is proposed to overcome the problems faced by WLAN and Bluetooth [16]. Mainly, ZigBee is used for wireless personal area networks having low data rate, and can operate at low power and low cost. This low power consumption is mainly due to the sleep mode operation of end devices. In IoT space there exist many technology based alternatives for healthcare applications. From the available solutions we need to determine the optimal way based on the constraints and priorities of the particular application [17]. It analyses structured system engineering methodolgy to build cost-effective Health-IoT platforms that enhance the corresponding medical
services, clinical care and remote monitoring to respond to new challenges. The dependency of healthcare on IoT is increasing day by day to improve access to care, amplify the quality of care and most importantly to limit the cost of care [18] . It discusses the applications of IoT in personalised healthcare to achieve excellent healthcare at minimum cost. This work explained in brief how IoT functions and how it is used in conjunction with wireless and sensing techniques to implement the desired healthcare applications. IoT based healthcare systems play a key role in the growth of medical information systems. To enhance the healthcare system tracking, tracing and monitoring of patients are essential. However, due to the inadequate healthcare situation, medical technologies the available tools cannot meet the same accurately [19]. In this paper mainly the role of IoT in healthcare system, the participation of IoT between the useful research and present realistic applications have been discussed. Medical care is one of the many applications in which IoT can be used [20]. It discusses the technological improvements in IoT based healthcare and reviews different network platforms, applications and industrial trends in IoT based healthcare. Further, it also discusses the different security issues and proposes an intelligent security model to minimise the security risk. In market, there exist a number of solutions for connecting medical devices to an open network like the Internet [21]. But the problem here is how to preserve the security of medical data. It also presents the limitations and opportunities of implementing IoT based eHealth services. This paper lists various wireless communication technologies available for clinical environments, with each one having specific purpose related to mHealth and eHealth [22]. NFC is used to check the current health status. Bluetooth is used to collect data from same room. 6LowPAN is used to check the status of any room in a hospital using any IPv6 device. Various wearable devices such as tablets, smart phones, watches, etc. play a key role in IoT based healthcare [23]. A wearable device based healthcare system is developed for two applications namely firemen monitoring and sportsman performance in an indoor scenario. The advantage here is this system can be used in different application environments with minimal required modifications and the end user can interact with it using devices like smart phone. In order to measure the physiological parameters of an Inhospital patient on a periodic basis, a health care professional is required. IoT eliminates the need for a health care professional by providing ubiquitous monitoring system using sensors, gateways and cloud to analyse and store the data and communicate it wirelessly to medical professionals for further analysis [24]. Thus, IoT empowered devices simultaneously enhance the quality of care with regular monitoring and reduces the cost of care by putting an end to the need for
a medical professional come by at regular intervals to actively engage in data collection and analysis. III. H ARDWARE
DETAILS
A. Intel Galileo Generation 2 Intel Galileo Generation 2 board acts as gateway to process the received data and it runs a web server in order to communicate the data with the cloud. It is provided with 400MHz, 32-bit Pentium architecture based single core, single threaded Intel Quark microprocessor and supplied with a 7-15 volts battery and consists of 256 MB of RAM. Figure 1 depicts Intel Galileo Generation 2 microcontroller board and Table -I provides features of the board.
Fig. 1: Intel Galileo Generation 2 board The Arduino IDE, which is running on top of the Linux software stack, is used to develop the required sketches called programming applications for the Galileo generation 2, which is acting as gateway and are installed into the gateway by connecting the 6 pin FTDI serial cable on Galileo to the available USB socket on the host system. To work with the Galileo, FTDI drivers need to be installed. After developing and downloading the programmed application into the Galileo, the sensor networks configure themselves and route the data to the gateway, which is connected to the Internet by running the web server, so that remote users can access the data. TABLE I: Intel Galileo Generation 2 Specifications Parameter RAM Flash Memory EEPROM Clock Frequency Supply voltage TX current consumption RX current consumption
Value 256 MB 512 KB 11 KB 400 MHz 7 to 15 V 25 mA 25 mA
This board supports 10/100 MB Ethernet interface to connect the gateway and to the web server. USB 2.0 client port is connected to the host computer to program the board and USB 2.0 host ports are used to support devices like key board and mass storage devices. USB to 6 pin FTDI serial cable is used to access the Linux terminal on the host computer. Mini
Peripheral Component Interconnect Express (PCIe) socket is provided on the bottom side of the board to attach Wi-Fi cards to the board easily. It contains an AD7298 12-bit ADC converter. This sensor node is integrated with Real Time Clock (RTC) including an optional 3V coin cell battery to operate between the power cycles. On board reset button is used to reset the sketch running on the Galileo node without rebooting the firmware. Reboot button is used to initialize the operating system running on the Galileo node.
TABLE III: XBee Series 2 Features Parameter Transmit Power Receiver Sensitivity Indoor Range Outdoor RF LOS Range Firmware Analog input pins Digital input/output pins
Value 3 dBm -96 dBm 40 m 120 m ZigBee mesh 4 11
B. XB24-B XBee S2 Modules In order to form mesh network, XBee Series 2 XB24B modules, which support ZigBee mesh protocol, are used. These XBee modules are connected with temperature sensor in order to sample the patient data using the 10- bit ADC. ZigBee protocol operates at 2.4GHz unlicensed ISM band, 2 MHz bandwidth with 16 channels and each channel is separated by 5 MHz. These modules consists of microchip EM250 from Ember Networks combines 12 MHz, XAP2b 16bit microcontroller and 2.4 GHZ IEEE 802.15.4 compliant RF transceiver which is manufactured by Maxstream. The XBee Series 2 modules are shown in the Figure 2.
Fig. 3: XBee adapter port. After connecting the XBee modules to computer using an adapter, FTDI drivers need to be installed. D. LM35 Temperature Sensor
Fig. 4: LM35 Temperature sensor Fig. 2: XBee S2 sensor node The specifications for the XBee Series 2 modules are given in the Table II.
TABLE II: XBee Series 2 Specifications Parameter RAM Flash Memory EEPROM Clock Frequency Supply voltage TX current consumption RX current consumption
Value 5 KB 128 KB 11 KB 400 MHz 2.1 to 3.6 V 40 mA 40 mA
Table III provides the features of the XBee Series 2 modules [25]. C. XBee Adapter The XBee adapter is shown in Figure 3. Before using, the XBee modules need to be configured with suitable parameters. As XBee modules are made to be connected to the breadboard, an adapter is required to connect it to the computer’s USB
LM35 is an accurate IC temperature sensor providing its output comparable with the temperature. It provides an edge over linear temperature sensor calibrated in degree kelvin, because it is not essential to deduct a particular constant voltage from the output in order to get the celsius temperature. The characteristics of the temperature sensor are shown in Table IV. TABLE IV: LM35 Temperature sensor specifications Sensor model Manufacturer Supply Voltage Accuracy Operating temperature Sensitivity Output max current Output impedance
LM35 Texas Instruments 4 to 30 V ±0.5 ◦ C −55 ◦ C to +150 ◦ C 10 mV/ ◦ C 10 mA 0.4 Ohm
Operation Temperature sensor is used to estimate the hotness or coldness of any body. In health care, using temperature sensor data, the patient health condition can be estimated. If the temperature crosses particular threshold, the physician can be alerted regarding an appropriate treatment of the paptient.
•
Basic principle to calculate Temperature: Temperature sensor is a p-n junction diode, manufacured with ISFET by employing CMOS technology. The forward current for the p-n junction diode is represented by equation 1 qVf
If = exp nkT
(1)
The voltage drop across the p-n junction diode corresponding to the temperature is given by equation 2. When the temperature sensor is subjected to a constant current source, the generated voltage is proportional to temperature. Vf = ln (If )
nkT q
Fig. 6: Patient monitoring system (2)
Finally the temperature measured proportional to the generated voltage is given by equation 3 Vf T =q× nk × ln If IV. F UNCTIONING
OF
(3)
H EALTHCARE S YSTEM
Temperature sensors are connected to the XBee modules using ADC pin and the temperature is sampled by 10- bit ADC according to the configured sample rate and the same is transmitted to the gateway at every 5 seconds (sample rate). These transmitted samples are collected by the gateway through UART and required calibrations are performed to get the temperature value corresponding to the transmitted ADC value. Then, this gateway runs a web server to serve this temperature data to the cloud. The experimental set up for the IoT device is shown in Figure 5. This set up consists of XBee module interfaced with LM35 temperature sensor.
A. In-Hospital Patient Monitoring System In order to measure the physiological parameters of an In-hospital patient on a periodic basis, a health care professional is required. The IoT eliminates need for a health care professional come by at regular intervals by providing ubiquitous monitoring system using sensors, gateways and cloud to analyse and store the data and communicate it wirelessly to physicians for further analysis. A physician can access the patient’s data from any where using any Internet enabled device like PC, tablet or samrt phone, analyse it and can prescribe an appropriate medical management. The web page, which is accessed by a physician is shown in Figure 6. Thus, IoT is not only enhancing the quality of care with regular attention but also reduce the cost of care by putting an end to the need for personnel engaged in data collection and analysis. VI. R ESULTS
AND
D ISCUSSION
IoT based medical device is a combination of XBee S2 module interfaced with LM35 temperature sensor. Intel Galileo Generation 2 board connected with another XBee S2 module acts as gateway for the over all healthcare system. This gatweway is used to gather, analyse, store and communicate the medical data to the cloud over a secure connection. VII. C ONCLUSION
Fig. 5: Experimental setup for a healthcare based IoT device V. H EALTHCARE A PPLICATION As part of the healthcare application, IoT based In-Hospital patient monitoring system is implemented.
IoT is a combination of various technologies that empower a diverse range of appliances, devices and objects to interact and communicate with each other using different networking technologies. So far, much of the information found on the Internet is supplied by human beings. In case of IoT smart objects provide the information. There exist a wide variety of applications based on IoT, including healthcare, which is the primary focus of this work. Healthcare systems makes use of interconnected smart devices to establish an IoT network for healthcare analysis, patient monitoring and automatically identifying situations where a physician involvement is needed.
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