Volume 8, Issue 8, August 2023 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

IoT in Telemedicine: IoT based Human

Vital Signs Monitoring System
Muhammad Zubair , Shiraz Malik, Muhammad Mubarak Ali, Babar Ali
Biomedical Engineering Department
University of Engineering and Technology Lahore, Pakistan

Abstract:- Human Health Monitoring has gained much I. INTRODUCTION

importance in the recent years with the advent of the
new and novel diseases. It has become very difficult to Hospital is a busy place where doctors and nurses work
monitor the vital signs of humans at a regular basis due hard to save the lives and improve the health of patients. In
to the increasing population and the relative number of general, patients admitted to the hospital must be watched by
physicians to deal with enormous population. Our a nurse on a frequent basis to ensure that no adverse events
purpose is to design a device which measures the vital occur, the nurses must supervise an excessive number of
signs of humans and send them to the server for the patients at the same time. Nurses are still required to visit
physician for monitoring. This project will also send a each patient's room one by one to monitor and update their
message containing the location co-ordinates of the current circumstances. To improve the efficiency of the
patient to the caregiver mobile number in the case of nurse's work, a new system must be designed [1].
emergency. For this purpose, we will be using IoT
platform namely ‘Blynk’ to show the vital signs of the According to the World Health Organization (WHO),
patient for the physician to monitor them remotely. IoT hypertension and heart disease are the two most serious
is a technology which transforms the medical data into health hazards. Furthermore, e-health applications can be
insights for smarter patient care. The sensors which we used to support health services [4]. Slow handling in
analyzing the patient's disease situation is one of the
used are temperature sensor, SPO2 sensor, ECG sensor
variables generating increased mortality in heart disease.
along with Arduino Nano. The Node-MCU will connect
the micro-controller with the WIFI so that the data can Despite the abundance of medical facilities, fatal
be transferred to the IoT platform. The GPS and GSM diseases such as heart disease, cancer and pneumonia have
modules will send a message containing the location co- increased dramatically and claimed many lives. Patients'
ordinates to the care-giver mobile number in the case of health is regularly monitored and observed by a huge
emergency. The vital signs are successfully shown on the number of doctors, therapists, nurses, and other
IoT server, OLED and a message is sent to the professionals. Patients with chronic illnesses are routinely
emergency staff or caretaker in the case the patient is in checked and observed [2]. Monitoring vital signs is a
emergency. The monitoring system is successfully primary goal that health care centers must examine in order
developed for the facilitation of the patient as well as the to achieve early prevention and lower mortality rates.
physician. The future work of this project will be giving
the proper and minimum shape to the monitoring system IoT-based vital sign monitoring offers a tool for
so that it can become portable and increasing the improving real-time health services and overcoming the
accuracy of the sensors. limitations of traditional medical equipment [3]. The Internet
of Things reduces medical physicians' burden by reducing
Keywords:- IoT , Telemedicine, patient monitoring and vital hazards and improving overall performance. This
signs. technology can be used by doctors to detect changes in
crucial parameters in COVID-19 patients or patients in an
emergency rooms [4]. IoT role can be seen in Figure 1:

Fig. 1: IoT role [5]

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By focusing on the new and fruitful technologies, we on IoT technology. IoT applications are on the increase in
can better monitor the health parameters of the patients at the different fields of life like home automation and health
their homes or some remote place. For example, during facilities etc. [9]. The IoT platform is Blynk app. This
COVID-19, there is an increase in the monitoring of the platform provides communication channel between our
health parameters remotely so that there is no risk of spread project’s hardware and the Blynk server. This app is
of the disease to the hospital staff. installed and logged in on the emergency response team or
caregiver’s smartphone. So, no one can see the data of
The basic functions of the body are measured using patient except caregiver. In this project the SMS alert system
vital signs. The parameters that show that how the body is and four health parameters are namely SpO2, heart rate,
working, whether the body is functioning properly or not, temperature and ECG are monitored.
are called vital signs. By measuring these parameters, we  This IoT base device can be used in hospitals, clinics and
can monitor the health conditions of the patient and can also rehabilitation centers for real time monitoring of patient’s
predict many diseases that are on their initial stages [4]. health [10].
 This project provides an innovative system for rural
The typical ranges for vital signs vary depending on a
areas. The people living in remote areas (rural areas)
person's age, weight, gender, and overall health. Body
suffer from poor medical care and lack of medical
temperature, blood pressure, pulse (heart rate), SpO2 level
resources. So, this device is beneficial for people who
and ECG are the five main vital signs [6]. The suggested IoT
live in rural areas.
based vital signs monitoring system is projected to reduce
medical personnel's burden and aid in the real-time  This project is effective equipment for patients who are
diagnosis of a patient's disease [7].This project is based on recovering from heart attack or the elderly or disabled
measuring four main vital signs, heart rate temperature, people [10].
SpO2 and ECG with SMS system for sending messages and  This device is easy to use and provide real time
location of patient in emergency situations. information of patient.
 This device provides the location of patient in emergency
A. Objective situation and send message to doctor or caretaker such as
The objectives of this project are as follows: patients with heart diseases need proper health care, so
 The aim of this project is to design hardware system for this device plays a key role in detecting abnormal
measurement of vital signs. situation and alerts the doctor and emergency staff to
 To develop mobile app to transfer data wirelessly. deal with critical situation.
 To design innovative system for accurately detecting the  During an emergency like the COVID-19 pandemic, an
patient’s position and emergency alert system to notify IoT based health management system can improve
medical staff. overall healthcare performance [4].

B. Significance The findings of this thesis deal with two main

The main contribution of this project is to send the bio- concepts: vital signs monitoring and early identification and
signal to IoT platform and text on SMS to the family interpretation of aberrant vital signs The scope of the project
members and emergency care staff in case of emergency. can be seen in Figure 2:
This project provides an experimental model to achieve
portable, real time remote monitoring of bio-signals based

Fig. 2: Scope of project

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ISSN No:-2456-2165
II. LITERATURE REVIEW information and enthusiasm for vital sign changes and their
suggestions for patient consideration [16]. The significance
A. VITAL SIGNS of observing vital signs in clinical practice is
Vital signs defined as the monitoring of most basic unquestionable, however how-to best screen and decipher
functions of the body of humans. These vital signs play an them. In case of chronic diseases, the remote health
important role in the life of human beings. There are monitoring system has great quality and ability to improve
different methods to measure the vital signs and most the quality of the life of patients. And nowadays these
important vital signs recommended by the healthcare techniques are becoming popular all over the world. Remote
specialists are [14]: Health Monitoring device uses sensors which are required to
 Temperature measure the vital signs of human body that collects the
 Pulse Rate physiological data from the body and send it wirelessly to
 Oxygen Saturation IoT Platforms. . The term ‘vital’ in vital signs is because
 Blood Pressure they influence medical decision making. Vital signs can be
 ECG measured by the medical staff or can also by the individual
himself. Oxygen saturation, pulse rate, respiration rate,
Today, Vital signs play an important role in ICU blood pressure and temperature are the simplest and
(Intensive care unit) and on the wards, to determine the important vital signs and also the most necessary
range of danger to the patient. Despite the fact that it is information stored by the patients admitted in hospitals.
precisely anticipated by essential sign changes, clinical Although they have been introduced in the medical field for
crumbling frequently goes unrecognized or isn't more than a century ago but unfortunately only few attempts
distinguished until it is past time to treat. This is chiefly have been done on it. Vital signs have become most active
brought about by deficient recording of imperative signs or area in the medical field in last few decades [15] .
because of an improper reaction to unusual qualities. Among
medical caretakers and specialists, there is lacking Vital signs monitoring is shown below:

Fig. 3: Patient Monitor

 Temperature The Standard temperature of the body is 37℃.A person

The most important vital sign of the human body is with body temperature above than standard temperature has
temperature. Keeping the body temperature in safe range is condition called fever and the person having temperature
very important for survival. If body temperature is out of the less than standard temperature like below 35℃ is considered
safe range, then the human body is unable to perform normal hypothermia. The condition that occurs when the body
functions. So, measuring body temperature is necessary for temperature produces more heat than its capacity is called
monitoring human health. Thermoregulation is a process in hyperthermia [19]. Low body temperature causes
which body attains the normal temperature. This process is vasoconstriction thermogenesis, shivering, piloerection [20]
very beneficial to lead homeostasis. Many enzymes work at (hairs on skin stand up) and curling up while high
specific temperature to catalyze the biochemical reactions in temperature causes vasodilation, sweating, pilorelaxation
the human body. If the temperature is below or high from [21] (hair flatten) and stretching out.
the specific condition then, these enzymes cannot do their
work properly and the whole human body disturbs and  Oxygen Saturation (Spo2)
human feels uncomfortable. High temperature causes Oxygen saturation or SpO2 is the amount of oxygen
dehydration and low temperature causes shivering of body. which is traveling with the red blood cells through the body.
Temperature has most important influence in human body Normal range of Oxygen Saturation is from 93% to 100%.
because it determines physical state of water. When the body Below this percentage the person need immediate medical
temperature is too high then, body sweats due to this sweat care because below this level the organs, cells and tissues of
body lose fluid and blood vessels dilate to increase heat the body are not getting required amount of oxygen to
dissipation and consequently sweeting. Due to this process function properly. The oxygen saturation conditions begin
human body can drop its blood pressure in most cases. with the microscopic structures present in the lungs called
alveoli. There are millions of these alveoli in the lungs and

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their function is to exchange Oxygen and carbon dioxide Every blood cell contains 270 million molecules of
molecules to and from the blood stream. When the hemoglobin and any condition that reduce the ability of
molecules of oxygen pass through these sacs, they bind with body to produce red blood cells results low hemoglobin
the molecule hemoglobin present in the blood. After this as levels and due to this reduction, the amount of oxygen also
hemoglobin circulates in the body the oxygen molecule reduced. Circulatory problems, blood disorders and some
detached with the hemoglobin and a molecule of carbon lung diseases may cause the reduction in absorption and
dioxide is attached from the tissues and this CO2 is transportation of oxygen by hemoglobin which results in
transported back to the alveoli and the cycle is completed. lower blood oxygen level. There are some conditions that
Some diseases decrease the ability of hemoglobin to bind can affect the oxygen saturation level includes [34]. The
Oxygen [33]. Figure 4 presents SpO2 of blood:

Factors on which level of oxygen in blood depends is

given
 Amount of Oxygen breathe in
 Ability of alveoli to swap CO2 for Oxygen
 Amount of concentrated hemoglobin in red blood cells.
 Ability of hemoglobin to attract Oxygen.

Fig. 4: Blood Oxygen Saturation (Spo2)

 ECG Prize in Physiology or Medicine in 1924. The initial

ECG is an electrical signal of heart which provides us electrodes were rinsed-out cylinders of electrolyte solution.
the electrical activity of heart. It can be recorded with In 1908, Sir Edward Schafer purchased the first ECG
placing the electrodes on the surface of the body of patients. machine and a string galvanometer electrograph for
Due to the action potential of cardiac cells, changes in therapeutic usage [27].
voltage occurs and it is measured by these electrodes. This
results in propagation of heartbeat and produces series of The three-lead electrocardiogram became more
waves [23]. popular in the first three decades of the twentieth century,
especially after advancements were made to make it more
In 1842, the electric current produced by every portable [23]. Sir Thomas Lewis used the ECG to determine
heartbeat of the frog was firstly observed by Dr. Carlo the clinical diagnostic of abnormal and irregular heartbeat
Patitucci [24]. Augustus Waller, a British physiologist, is the (Delirium Cordis'), which was caused by the fibrillation of
first person who measures the human electrocardiogram atria in 1909. After myocardial infarction was recognized as
(ECG) by using the capillary electrometer and placing the a clinical entity in 1910, ECG patterns indicating ischemic
electrode on the chest and back of the person. He also heart disease were attempted to be recognized. By 1930, the
proved that this electrical activity occurs right before the ECG had shown its value in distinguishing non-cardiac chest
ventricular contraction [25]. The tri-phasic electrical activity pain from cardiac pain. . This conduction system's electrical
of the heart is determined by William Bayliss and Edward activity is as follows [29].
Starling in 1891 using an improved capillary electrometer.  The conduction system is in a condition of rest.
Improvements were made to make the string galvanometer  SA node is made up of bulk of myocardial conducting
electrocardiograph more practical as it became available for cells which are responsible for production of cardiac
clinical usage Waller previously recorded rhythm. Hence it starts the electrical activity and sinus
electrocardiograms using five electrodes. Einthoven reduced rhythm.
these number of electrodes to just three, which he considered  The impulse passes from the SA node to the left atrium
produced the lowest yield. Einthoven's triangle was built and then to the AV node through the Bachmann's bundle
using the three leads On his work and production of (interatrial bundle).
electrocardiographs [26]. Einthoven received the Nobel

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 Impulse then approaches AV node and it is delayed to left papillary muscle. The left ventricle, on the other
ensure that this blood is effectively pumped through atria hand, lacks a similar moderator band [30].
to ventricles.
 The conduction system is in a condition of rest. The ventricles begin to contract, pumping blood to
 After some delay, the impulse goes to the Purkinje fibers one’s body or lungs to be oxygenated. The ECG waveform
via the bundle branches. Then, through the moderator can be seen in Figure 5:
band, it reaches the right papillary muscle.
Approximately at the same time, the impulse reaches the

Fig. 5: QRS complex [31]

III. METHODOLOGY taking information from the patient i.e. ECG sensor,
temperature sensor and SPO2 sensor. Then these data send
A. Block Diagram to the processor for further processing. processed data being
The project is based on two steps i.e. information and shared to family and to the website also shown on the OLED
intervention. the information is taken by the patient by using [14]. All these are shown in the Figure 6:
different sensors. in our project we used three sensors for

Fig. 6: Block Diagram

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ISSN No:-2456-2165
B. Flow Chart module, Wi-Fi module and Arduino nano. The other one is
The flow chart that is shown in the figure 6 is described used to give the 5V to SpO2 sensor, Arduino mini, OLED
the methodology that utilized to complete our project. The and temperature sensor [69]. We are also using buck
project starts with the sensor’s integration and data converter that gives 3.7V to GSM module. The RX of GSM
acquisition from the patient. The data that is acquired from module is connected with the TX of Arduino nano it means
the patient then send to the processor for signal processing. Arduino nano transfer the data and GSM module receive the
the processed data is then classified using features or the data. While the TX of GPS module is connected with the RX
nature of the data. All these results are being displayed on of Arduino nano it means GPS module transfer the data and
LED and website and is shared to the family in emergency Arduino nano receive the data. The Arduino mini also send
situation. the data to Arduino nano and Arduino nano is connected to
the Wi-Fi module that will send the sensors data to the IoT
C. Final Circuit Diagram platform namely Blynk application [17]. The circuit diagram
We used bridge rectifier that convert AC to DC. After can be seen in Figure 7.
that we use two voltage regulator that give 5V to all the
components. One voltage regulator gives 5V to GPS

Fig. 7: Final circuit diagram

D. IoT Integration We receive an email from the Blynk app containing the
The IoT platform that we have used is ‘Blynk’ mobile authentication token number. We put this specific number in
application. This app needs to be modified according to our our code part so that our hardware sends data to the Blynk
requirements. We added 3 ‘Gauges’ and 1 ‘Super Chart’. layout that we set. The hardware of the project is connected
The Super Chart is for the display of the ECG waveform and to the server through Wi-Fi module named ESP8266. This
the 3 gauges are for displaying the value of the temperature, Wi-Fi module will send the data to the Blynk server so that
SpO2 and heart rate. The input we used for the ECG the provided data can be seen on the app.
waveform is V4. The input we used for the temperature,
heart rate and SpO2 are V0, V1 and V2 respectively. The IV. RESULT
Blynk app is now set for receiving and displaying our data.
Result of our project like temperature, heart rate and
oxygen concentration are shown on the OLED

Fig. 8: OLED

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We took the temperature values of a person and fluctuating between 96.8-98. As the normal temperature of
presented them as a graph. As we can see in the graph that the human body is 98.6F, we can see that the temperature of
the person’s temperature is approximately at 97F that is the the person is in the normal range. We plotted the
normal range of temperature of a human body. When we temperature of the person with respect to the time on the x-
started to take the values of temperature of the person, the axis as can be seen in the Figure 9:
temperature first appeared to be 96.8F and it keeps on

Fig. 9: Body Temperature Graph

We took the SpO2 values of a person and presented on fluctuating between 95 and 96. As it is the normal range
them as a graph. As we can see in the graph that the person’s of SpO2 of a healthy person so we can conclude that the
SpO2 level is approximately at 96% that is the normal range person is healthy. We plotted the SpO2 level of the person
of SpO2 of a human body. When we started taking the with respect to the time (on x-axis) and shown it in the
values the person’s SpO2 level was 95%, and then it keeps Figure 10:

Fig. 10: SpO2 level of a person

We took the heart rate values of a person and presented time it keeps on fluctuating between 70-76 BPM. So, we can
them as a graph. As we can see in the graph that the person’s conclude that the person is healthy and BPM is in safe range.
heart rate is approximately in the range of 70-80 that is the We plotted the heart rate of the person with respect to the the
normal range of heart rate of a human body. When we time (on x-axis) and showed it in the Figure 11:
started taking the BPM values, it appeared 73 BPM and with

Fig. 11: Heart rate of a person

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We can see in the figure that there is firstly P wave, that we are using local electrodes to measure the ECG
and then QRS complex and at the end there is T-wave. There signal.
is a little noise in the ECG signal shown above, it is because
of the low accuracy of the sensor and also due to the fact The Figure below presents the ECG on the serial
plotter:

Fig. 12: ECG waveform on the serial plotter

A. On Blynk App  Temperature Value in Celsius

After the ESP8266 is connected to the Wi-Fi, its blue  SPO2 Level in %
LED that was blinking before will turn off and it will start to  Heart Rate (BPM)
send the data to the Blynk app [11]. The parameters it will
send to the Blynk app are: The screenshot of the Blynk app showing all these
 ECG Waveform parameters is attached in Figure 12.

Fig. 13: Blynk app showing all parameters

All parameters namely temperature, heart rate, SpO2 the blynk is not showing the proper ECG waveform due to
and ECG are clearly can be seen on the Blynk app. The its duration of showing the signal value.
reason the ECG waveform is not correctly shown on the app
is that the Blynk app shows the value of the variable after The message will be sent through the GSM module.
every 1 second and the normal duration of one ECG The message will contain the location coordinates of the
waveform is 0.4 sec in males and 0.44 sec in females. So, patient as shown in Figure.

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Fig. 14: Location coordinates

V. CONCLUSION REFERENCES

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