A New Healthcare System Supported by GSM and Internet

Transcription

1 European Journal of Scientific Research ISSN X / X Vol. 129 No 4 February, 2015, pp A New Healthcare System Supported by GSM and Internet Mahmoud Shaker Nasr Department of Electrical Engineering, University of Babylon, Iraq mahmoud111957@yahoo.com Samir Jasim Mohammed Department of Electrical Engineering, University of Babylon, Iraq Dr_S_J_Almuraab@yahoo.com Ali Jasim Ramadhan Department of Electrical Engineering, University of Babylon, Iraq ali.j.r@ieee.org Abstract This paper presents a new design for a portable real time patient monitoring / diagnosing system based on E-health, GSM-health, I-health and wireless sensor network (WSN) under ZigBee protocol. The proposed system measures patient biomedical data utilizing a group of sensors, namely patient position sensor (PPS), galvanic skin response sensor (GSR), blood glucose sensor (BGS) and electromyography sensor (EMG). The system is designed to monitor the sleep position and skin conductance (calm indicator) of patients with alarm for abnormal cases in the both base station (BS) and lobbies. The system is supported by GSM to send an alarm SMS to doctor for abnormal cases and to follow up the patient glucose rate remotely. The system is supported by the Internet service using a special designed website. The system uploads patient information and measured glucose data via the special website, so that the doctor can follow up the patient remotely and to write his recommendation to the patient or the hospital staff. Moreover, the system introduces printing and saving patient information facilities for archiving and statistical study. This system was implemented practically under supervision of specialist physicians. The obtained results are very satisfied and promising to offer great services to the human care. Keywords: E-health, GSM-health, I-health, Wireless Sensor Network 1. Introduction Due to their characteristics of being flexibe, low power and low cost, the WSNs are commonly used in different science fields, such as the healthcare [1]. Combination of WSN and GSM will provide valuable real time information which enable the doctors to monitor and analyze current and previous state of their patients [2]. Today, combining of WSN and Internet can integrate healthcare systems to add more important services, such as remotely diagnosing and monitoring [3].

2 A New Healthcare System Supported by GSM and Internet System Description Based on the available facilities the proposed system is designed to have three nodes (lobbies) but it can monitor / diagnose unlimited numbers of patients. Figure 1 shows the overall proposed system Sensing & Data Transceiver Subsystems Each patient is represented by a node, which consists of sensors, processor, transceiver and power supply. Details of these subsystems are explained in the following: Figure 1: The overall proposed system Biomedical Sensors Subsystem The patient node has four sensors, namely PPS, GSR, BGS and EMG. Measurement procedures of these sensors are explained in the followings: I. Patient Position Measurement: A position sensor is a device that is used to locate the position. It can be either an absolute position sensor or a relative one accelerometer or displacement [4]. The accelerometer converts the acceleration from motion or gravity to either analog or digital signal [5]. Digital, capacitive, 3.3v, ±2g and 3-axis accelerometer is selected as sleep position sensor. The offset axis is (3.3v / 2g) = 1.65v/g, and if the axis is above 1.65v it is considered positive, otherwise it is negative. The PPS is packed with digital signal processing (DSP) functions that detect the five sleep positions. The PPS block diagram is shown in Figure 2. The voltage of each axis is calculated and compared with other axes to calculate largest axis voltage that is assumed as 1g in DSP while the others are 0g.

3 474 Mahmoud Shaker Nasr, Samir Jasim Mohammed and Ali Jasim Ramadhan Figure 2: The sleep position sensor structure The sensing axis will send the data in the embedded DSP to the MCU (Pin A4) through I²C and the MCU is programmed to display the real position as shown in Table 1. Table 1: Detection of sleep positions X, Y, Z 0, 1, 0-1, 0, 0 1, 0, 0 0, -1, 0 0, 0, 1 Embedded DSP In MCU Supine Left Right Prone Stand or Sit Setting method of the position sensor is shown in Figure 3. Figure 3: Setup of position sensor II. Galvanic Skin Response Measurement: The GSR is one of many electro dermal responses that is a medical term for changes in skin conductance due to a psychological condition [6]. The normal skin conductance is (2 10) μsiemens [7]. The GSR measures the skin conductance by attaching two electrodes on the top of the index and middle fingers. The circuit diagram of the measurement steps is shown in Figure 4. It is vital to isolate the signal using two op-amps (MCP6002) as a buffer stage. Then, the signal passes through the difference op-amps. (TI INA114), followed by a filter to remove high frequency noises, where the GSR is working in low frequency (1-2) Hz signals. The output signal will be fed to the MCU through the pin (A2) to measure the skin conductance. Setting method of the GSR sensor is shown in Figure 5. Figure 4: GSR circuit diagram.

4 A New Healthcare System Supported by GSM and Internet 475 Figure 5: Setup of GSR sensor. III. Blood Glucose Measurement: The glucose is a carbohydrate, which is the source of energy for human body [8]. Glucose meter in this work is based on electrochemical test strips. It is implemented by using PIC16LF178X as shown in Figure 6. Where test strip consists of reference and working electrode [9]. Figure 6: Block diagram of glucose measurement. Measured current is an input to a current to voltage convertor (I\V) and the result is filtered from above 8 Hz signal, and then it is fed to a 12-bit ADC. It starts capturing voltage, storing data in EEPROM and displaying it after less than 7 sec. of placing the blood sample as shown in Figure 7. Figure 7: Measuring blood glucose

5 476 Mahmoud Shaker Nasr, Samir Jasim Mohammed and Ali Jasim Ramadhan IV. Electromyography Measurement: Electromyography is the process of recording and analyzing myoelectric signals that are formed by physiological changes in muscle fiber membranes [10]. EMG block measurement is shown in Figure 8. A surface, gelled, passive electrode and op-amp. (AD8221) are used for picking up the EMG. A band-pass filter of (10 500) Hz is used to remove the heartbeats. After rectifying and integrating the signal, it will be fed to the MCU (pin A0) to calculate the EMG values, where the signal can range from (0-1.5) mv and from (30 300) Hz [11]. Setting method of the EMG sensor is shown in Figure 9. Figure 8: Block diagram of EMG measurement steps Figure 9: Setup of EMG sensor Processor (MCU) Subsystem MCU (ATmega328) is used, and the Arduino is selected which contains ATmega328 that is characterized by being open-source and easy hardware implementation.

6 A New Healthcare System Supported by GSM and Internet Transceiver Subsystem In this work, XBee Series 2 module transceiver is used to connect patient nodes with the BS, where it is configured by using X-CTU program. These XBees (in patient nodes) are configured as End- Devices firmware by using AT command mode. In this work, star topology network is selected because it is working in low power and short delay Power Subsystem A rechargeable battery is used with each patient node. Therefore, there is a limit time for the node operation. To remedy this limitation, the MCU is programmed to enable each sensor that responds from BS to send its data and then disable it, and then use the (SLEEP_MODE_IDLE) that disable the unnecessary functions of the MCU Base Station (BS) Subsystem The base station consists of a gateway (GW), computer (PC) and printer subsystems Gateway (GW) Subsystem The function of the GW is to exchange data between the patient nodes and the PC in the BS. It consists of two components, XBee and its USB explorer, where the XBee is programmed as a coordinator Computer (PC) Subsystem The process of monitoring, analyzing and recording data are implemented at the PC. In this system, LabVIEW software (SW) is used to perform these operations, because it has a graphical user interface (GUI) window which can handle data quickly and do interface easily with external hardware. In the system SW, there are three operations, and they are explained as follows: I. Nodes Status GUI Window Operation: This operation searchs for all nodes in the network and stores the active nodes in a string for the usage by other operations. At any time, the system can update these nodes by starting the search operation. II. Insertion & Update Information GUI Window Operation: This operation is used to save patient information as a Text file in the PC without storing them in the MCU. This will reduce the system complexity and time delay, and increase the security of the personal data and insures keeping them in the system even in the case of empty battery. III. Sensing GUI Windows Operation: There are three GUI windows to sense patient statuses, and they are the major operations which are based on searching and setup operations Printer Subsystem Many cases are needed to provide the patient by medical report. Therefore, in addition to analysis and display sensing data in GUI, the system has ability to print medical reports using VISUAL BASIC (VB) software. The implemented program is saved as exe. file and could recall it from SW GSM Subsystem The GSM subsystem (GSM-health) is used to remotelty follow-up sleep position, skin conductance and glucose level. These services are performed using personal phone without using GSM modem. This method has properties of being low cost, low complexity and short delay time which is achieved by interfacing phone with PC directly via USB and messages sending procedure executed by using SMSs AT commands. The procedure of GSM in BGS window is shown in Figure 10.

7 478 Mahmoud Shaker Nasr, Samir Jasim Mohammed and Ali Jasim Ramadhan Figure 10: Process of implemented GSM / BGS system Click On Send Notification To Doctor Mobile Button Open USB Port Send AT Send AT+CMGF=1 Send AT+CMGS=" Pho. No. " Send Message Data Send 1A Close USB Port End Processing To understand the GSM operation, each process in Figure 10 will be explained in detail as follows, and then (PPS & GSR) GSM implementation will be discussed. Click on "Send Notification To Doctor Mobile" button in the BGS GUI window and the Labview executes automatically the following steps. Open the mobile phone device serial port. Send "AT" command to attend the mobile phone to a new process. Send "AT+CMGF=1" command to attend the mobile phone that the message format is a Text. Send "AT+CMGS" command to attend the mobile phone about the selected doctor's phone number. Send "Message Data" by recalling the last and previous glucose readings from the strings that these two readings are displayed in the BGS GUI window and they are considered as the message data. Send "1A" command to end the process, [CTRL+Z] is equivalent to [1A] in ASCII code. Close the mobile phone device serial port. The differences in the implementation of GSM in (BGS) and (PPS & GSR) as follows: In BGS, the process is performed manually, while in PPS/GSR it is performed automatically, that means there is no "button" to start the process in PPS/GSR. In BGS, required data are the last and previous glucose readings, while in PPS/GSR the data are the position or the skin conductance Internet Subsystem The Internet subsystem (I-health) is used to follow glucose levels remotely. It is performed by designing a website using VB.NET and ASP.NET. The process of the Internet based system is shown in Figure 11. User login features are introduced to protect privacies of patients and feedback comment features between doctors and patients to take important guidance. Creating a website is accomplished by two programs, the first one is (Upload Program) which combines measured data with patient

8 A New Healthcare System Supported by GSM and Internet 479 information in one Text file and uploads it to website link. The second one (Download Program) which loads the Text file and publishs it on the website GUI, and they are saved as exe. file. The download program consists of two pages, namely slave and master. The function of the slave page is to receive and store the Text file that was uploaded by the first program from BS, while the master page displays all data that was stored in the slave page. 3. Overall System Operation In case of multi mode monitoring of PPS and GSR, perform touring in three seconds for each lobby. If a PPS or GSR alarm case happens, alert the user in BS and the concerned MCU node is turned on it's buzzer and red PPS or GSR LED and also alarm SMS is sent to doctor's phone. For BGS followingup, the user sends the glucose rate as SMS to the doctor and uploads it to the special website to allow the doctor following up the patient status. The overall implemented system is shown in Figure 12. Figure 11: Process of internet based system. Click On Upload Blood Glucose Data Button Call The Main Programs That are Saved as Locate The Saved Text Files In The PC Save The Text File As a String Add The Patient's Information To The String Save The String As a Text File Upload The Text File To The Web Site Link Load The Text File In The Web Site Split The Data By Utilizing The Special Characters Before Publication It In The Web Site Publishing And Display The Data In Specified Fields As Values and Graphically In The Web Site End Processing

9 480 Mahmoud Shaker Nasr, Samir Jasim Mohammed and Ali Jasim Ramadhan 4. System Features Portable, wireless, real time, low power and low cost system. Monitoring / diagnosing system and supports alarming and printing subsystems. Combines E-health, GSM-health and I-health fields together. GUI window is easy to use and can operate the SW on any computer system. Can be expanded by adding several other necessary sensors. Performs searching and storing processes. Figure 12: The overall implemented system 5. Results 5.1 Searching Results Once the system starts the searching operation, the active nodes will be displayed in the specified field as 1,2,3. If any of these nodes is not active e.g. node 2, the window displays only nodes 1 and 3. Figure 13 shows the window of searching operation. Figure 13: Searching results.

10 A New Healthcare System Supported by GSM and Internet Setup Results After selecting any patient lobby, e.g. no.1, the data are filled as shown in Figure 14, then click on "Save" button to store the data in a Text file. Figure 14: Setup results 5.3. Monitoring PPS & GSR Results User can select harmful sleep postions. In the following, the user selects left and prone postions for a patient in lobby no.1. The actual results are shown in Figures 15 & 16. Figure 15: Single mode monitoring results with PPS alarm case

11 482 Mahmoud Shaker Nasr, Samir Jasim Mohammed and Ali Jasim Ramadhan Figure 16: Single mode monitoring results with GSR alarm case Where the alarm SMSs are shown in the Figure 17. Figure 17 a) Alarm SMSs of the patient's sleep position, (b) skin conductance Following-Up BGS Results If the user selects the lobby no. 2, for example, the results will be as shown in Figure 18. The SMS of last and previous measured glucose is shown in Figure 19. As explained previously, the user must login the website and if he selected lobby no.2, as example, the results are displayed as shown in Figure 20. The hard copy report of the patient's glucose status is shown in Figure 21.

12 A New Healthcare System Supported by GSM and Internet 483 Figure 18: BGS sensing results Figure 19: SMS notification Figure 20: Website page.

13 484 Mahmoud Shaker Nasr, Samir Jasim Mohammed and Ali Jasim Ramadhan Figure 21: Glucose rate report 5.5. Diagnosing EMG Results The results in GUI and hard report are shown in Finger 22 and Figure 23 respectively. Figure 22: EMG sensing results

14 A New Healthcare System Supported by GSM and Internet 485 Figure 23: EMG diagnostic report 6. Conclusions This paper presents a novel portable healthcare system to measure PPS, GSR, BGS, and EMG which has a great importance in the human healthcare. It serves in efficient communication between the hospital and the patient doctor using the Internet and GSM to monitor and track the patient condition and then provide urgent recommendations. The novelty of the proposed system is manifested from being able to perform monitoring and diagnosing the patient in real time, fast, accurate results and supported by alarming system. The system was tested with different medical cases and the results of searching, storing and printing of the measured data were found accurate. A new patient (node) could be added to the system without any intervention of the user because the new node is detected automatically during the searching process. All the sensed values were tested and compared with the calibrated instruments and the obtained results were found accurate. The system can serve as a home care system since the sensed data can be sent via internet and the patient can receive the doctor recommendations according to his health condition. The system was tested and evaluated by physicians and they found it active and promising in the development of electronics and remote health monitoring. References [1] Ismail B., Salvatore D. and Ravi S. A survey of intrusion detection systems in wireless sensor networks, IEEE Communications Surveys & Tutorials, Vol. 16, pp , [2] Nitin P., Preeti N. and Trupti P. An embedded, GSM based, multiparameter, realtime patient monitoring system and control - an implementation for ICU patients, IEEE Information and Communication Technologies, Vol., pp , [3] Prabakaran C., Vijayakumar P. and Suryaprakash R. Web based patient monitoring system using ARM9 processor, IJEEDC, Vol. 1, pp , [4] Ajay K. An integrated sensor system for early fall detection, MSc, Purdue University, Indiana, 2013.

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