Chapter 2

REVIEW OF RELATED LITERATURE

In this chapter, the related studies and literature for monitoring health’s patient device

will be discussed. This chapter discusses the previous works of monitoring health’s

patient device in relation of different types of diseases. The group use these studies to

come up with an idea to build a device that is capable of getting the patient in just one

device.

2.1 Related Studies

2.1.1. Health Monitoring System for Patient using Mobile Phone Remote

Growing problem from the poor degree of blood-pressure (BP) manage

among hypertensive patients has brought about research for methods of dealing

with high blood pressure. The goals of this study are to broaden and to test a

home blood pressure control system that actively engages patients with a new and

effective way. According to Alexander G. Logan et al(September 1, 2007), they

describe that the development and testing of a mobile phone–based remote patient

monitoring system to manage and develop the blood pressure control of patients

with hypertension and diabetes. First it was developed in Phase 1, in Phase 1

using an constant process based on comment and criticism of the patients. Next

one is Phase 2, the Phase 2 is responsible to ensure the efficiency in improving the

blood pressure control in patients with uncontrolled hypertension and diabetes.

Also another device is using smartphone and wearable sensors. Priyanka

Kakria et al. last August 10 to November 12 2015, they describe that these

systems are primarily established on advanced wireless technology. These

medical devices are more efficient using high-technology system. The primary

goal of this study is to facilitate the remote cardiac patients in getting modern

technology healthcare services which may not be possible due to low ratio of

doctor-to-patient. The doctor cannot manage to observe the health status of the

patient all the time. It also has a limitation the false alarms can be done due to the

battery issues of the mobile phone and in the sensors but it is still developing and

improving. The system has two interfaces: the first one for patients and other one

is for the doctor. The first interface is the patient interface, it is composed of

wearable sensors that reads the medical information of the patient and goes to the

mobile or smartphone and via bluetooth and then transfers this information to web

server and it will process to transmit to the other interface to the doctor.

Another study who worked by is the use of mobile health services for

patients with chronic diseases is globally accepted as a process of innovation in

healthcare. According to a journal article issued by Shadi Azam and Yan Yang

last January 2013, conducted through a systematic literature review because it

helps for searching selected documents of practical research method in the field.

This design system has been studied to explore the new style of chronic patients’

nursing care. The design of prototype is use for the patient’s treatment,

information access, health surveys, data collection and monitoring records. The

benefits and application of this prototype is to improve the care processes of the

patient, to increase the other homecare technologies and it will reduce costs of

care. The future research could be focus in a certain topic that is related to

mHealth application in chronic diseases management, such as, a particular disease

which is diabetes, cancer, chronic obstructive pulmonary disease or obesity, or a

specific population. According to study, it is indicated that this prototype has

difficulties by obtaining information to the discharged cancer patients from

hospital.

2.2.2. The use of GPS and GSM in Telemonitoring System for Emergency

Patient Transportation

TK. Satyanarayana et al. last August 17 to November 19, 2012, they

observe that the use of telemonitoring patients during the hour of emergencies is

one way to save lives. No one knows what might happen in a persons life. There’s

no specific date or schedule that can tell people that something good or bad things

will happen. In this study, it prioritized the patients who really needs to be

monitored. It helps the doctors and staff on how they manage their patient very

well. This design is way better than any kinds of Patient Health Monitoring. One
 proof of that is this design has its own aspects of the system, The ambulance

which is connected to the microcontroller has its GPS receiver, Modems,

Cameras, Electrocardiogram (ECG), and systems with all peripheral devices. The

prototype that is installed with the patient is connected to the assigned ambulance.

Inside the ambulance doctors and staff can monitor patients heartbeat,

temperature, and blood pressures. The ambulance and the prototype is also

designed to alert doctors if some kinds of emergency occurs, there will be

immediately response on the patients location and will immediately transported in

the hospital if some abnormalities happen.

2.2.3. The Structure of Mobile Patient Monitoring Systems

According to a journal article issued by PravinPawar et al. last March

2012, they aimed of both healthcare and computer professionals. According to

their study, it provides an understanding of practical aspects of the mobile patient

health monitoring systems and also for the highlights by the use of these systems

that are implied in this study. The benefits of this design system is to gain an

understanding of the latest developments in the important latest application area

of mobile patient monitoring systems.

2.1.1 Research Gap

 In addition to the previous discussion of the structure of Mobile Patient

Monitoring System by PravinPawar et al. (March 2012) , the design of prototype

is user friendly and it is easy to use for the patients but this prototype has some

technical or error problems because it causes irritation and failure acceptance in

the system. The reason of behind this why this protototype is not capable for the

health’s patient monitoring, because of its lack of necessary solution to ensure the

security and lack of bandwidth to transmit bio-signals data to the patient, by

having delay, and also an unappropriate function of wireless network covered.

2.2 Related Literature

Patient Health

Body Temperature

Blood Pressure

Heartbeat Rate

Figure 2.2 Patient Health Parameters

2.2.1. Patient Health

 According to the article entitled Multi-Parameter Patient Health

Monitoring System, unhealthy foods and lack of physical exercises causes

sickness and probably affects the vital signs of a person such as body temperature,

blood pressure and pulse rate or heartbeat rate.

2.2.1.1 Body Temperature

According to the study of ICSIMA last November 2013, health

monitoring system has been implemented and developed throughout the

year. Implementing the remote health monitoring system benefits not only

the patient but the society as well. The proposed system results a lesser or

cheaper hospital bills and it also minimize the waiting time inside the

hospital. This paper only proposed on body temperature wireless

communication. The recommended device works by the use of

temperature sensors it sends the readings to the microcontroller using

Xbee wireless communication. Wireless Local Area Network (WLAN)

was used to send the real or actual-time data to health monitoring

database. The device was proven working by the help of volunteers. The

trial or test results from the volunteers shows that the body temperature

from the readings at home, and the readings at the remote or doctor’s

computer, are exactly the same with the readings in thermometer

2.2.1.2 Blood Pressure

 An article entitled Blood Pressure Management with data capturing

in the Cloud among Hypertensive Patients, Blood Pressure monitoring is

an important thing to the one who’s responsible for the patient or the

doctor. Blood Pressure is an important vital sign that is related and close to

the heartbeat of a person. It is very delicate to a patient if his/her Blood

pressure didn’t manage or monitor very well. In this study, telemonitoring.

Blood pressure of a patient will be a daily basis for a doctor to manage the

patient very well, The BP data cloud form will monitor the patient’s BP

status and sends through USB hub and connect it to a personal computer.

These applications are very helpful to the doctor and the staffs who

monitor the patient’s vital signs especially the Blood Pressure.

2.2.1.3 Heart Beat Rate

According to the study of Medical News Today, heart rate can be

actually defined as number of heart beats per minute. Based on the article,

heart rate is proportional to the response of our body. As we experience

fear, surprise or a rush on doing something, basically our heart rate

increases that causes adrenaline. Proper nutrients and exercises are

necessary to gain normal heart rate. A normal heartbeat for an adult is

between 60-100 beats per minute. Electro Cardio Graph (ECG) is the tool

used for reading the impulses of a person.

2.2.2 Health Monitoring System

 Health Monitoring System

Temperature Sensor

Sensors
Blood Pressure Sensor

Heart Beat Sensor

GSM

Smart Phone
GPS

Microcontroller

Figure 2.2.2 Health Monitoring System

According to the study of IFSA Publishing, S. L. last 2015, population is

growing continuously every year and a high percentage of the population

especially the elders that are more prone to diseases, will be dependent on others

about their health. Elders are also prone on experiencing more pain and sickness.

However, health monitoring devices are often not affordable for some seniors

during those emergency situations. Basically, caregivers are the ones that take

charge of monitoring the elderly although hiring someone cost a monthly

payment. In order to decrease these service charges, a remote health monitoring

device is proposed in this paper to provide and assist caregivers to keep the senior

citizens being monitored at home and make them healthier. The remote

communication device works through cellular phones and by this way, it will be

now more affordable for the elders. The recommended device will be essential not

only to seniors but to PWD’s as well.

2.2.2.1 Sensors

The data collected from each sensor is input and processed by the

smartphone to established the diagnosis. According to the article of IEE Xplore

last October 30, 2009, the development of the sensor systems for the health

monitoring system has accumulated much absorption from the scientist and

researchers in past years. Using these wearable sensor-based systems in health

monitoring it can continue to develop the wireless communication and potentially

turn the traditional healthcare into a future and advanced health monitoring

systems. The paper attempts to expand the review of present research and the

development of wearable biosensor systems for health monitoring. It has a multi

parameter system designs that give a accurate vital signs measurement with a real-

time conclusion for fast discovery of symptoms of the patient. In present time the

researchers and scientific community still working to study more about wearable

sensors for future research developments.

2.2.2.1.1 Temperature Sensor

According to all about circuit the temperature sensors is one of the

most commonly used sensors. Almost all of equipment use

temperature sensors, it used for computers, cars, air conditioners, and

home appliances. Thermistor, Thermocouple, RTDs (resistive

temperature detectors), Digital thermometer ICs, Analog thermometer

ICs are the top five most common type of temperature sensor.

2.2.2.1.2 Blood Pressure Sensor

According to the Vernier, Blood Pressure sensor is a non- invasive

sensor that is designed to measure the human blood pressure. It also

measures the parameters such as systolic, diastolic and mean atrial

pressure which utilize the oscillometric technique. In this type of

sensor, Pulse rate is also included.

2.2.2.1.3 Heart Beat Sensor

 A study implements a program that simply displays the pulse rate

of a patient in beats per minute through the use of sensors. A Heart Beat

sensor simply implicates that it measures a person’s heartbeat, it will be

very important for a doctor to monitor the heartbeat of the patient because

it is a major vital sign that is important to a person’s life. The sensor shows

a light lobe and it can see it as very small LED then measures the light and

the transmission is shown. There are some important features of a

Heartbeat Sensor, one important thing is that it provides a direct output

signal that is connected to the microcontroller and it currently works on a

5 Volts DC. Heartbeat sensors works through the LED and it is supposed

that the intensity works brightly.

2.2.2.2 Smart Phone

An article from Springer last November 16, 2013, Smart phones is a big

factor in our present time. Communication through mobile phones has become an

important device for health professionals in technological era. The latest invention

of smart phones can now compare to computers, the development of new features

in health related field. In some smart phones it has feature for fitness and nutrition

that can count your footsteps and compute the calories you’ve been burned in

your walk or jog every day and keeping a food diary for people who are in a

dietary program. In advanced technology the smart phones we can say that in our

future there is no impossible in creating and innovating things that can help to
develop the lives of everyone. Smart phones are turned to be a necessity of every

people. It can be a camera, a navigator, a messenger; it can be health assistance

and many more features.

2.2.2.2.1 Global Positioning System (GPS)

According to the research of YI TingHua et al (June 2010), GPS

consist of three parts which are satellites that orbit the Earth from outer space,

second part the control and monitoring the Earth’s stations and lastly the GPS

receivers that are owned by the users. GPS positions can be calculated using the

principle of triangulation which is known as the position of satellites overhead to

know GPS receiver or antenna’s exact position. Each satellites transmits

constantly over the current time as well the formation of the current position

(x,y,z) in its orbital path. This can be projected onto a local coordinate system that

is predefined in every region.

2.2.2.2.2 Global System for Mobile Communications (GSM)

A journal from International Journal of Mathematics and Computer

Research [March 2, 2013], the proposed project works by using GSM

modem that acts as the transmitter and receiver. The information which is

the parameters of the patient is transmitted to the registered number which

is the recipient or the doctor of the patient by SMS through prepaid load.
 The transmitter for this project will be the microcontroller that reads the

vital signs of the patient while the receiver is the doctor. In case the vital

signs of the patient goes abnormal or goes beyond standard level, a

continuous message will be sent to notify the recipient that an urgent

emergency response is needed.

2.2.2.2 Microcontroller

According to the Ch. Sandeep Kumar Subudhi and S.Sivanandam

from their article titled by Intelligent Wireless Patient Monitoring and

Tracking System, a microcontroller defines an embedded chip which

consists of a controlling CPU with secure of a certain amount of memory

such as RAM, ROM and EPROM, several devices such as serial port,

parallel port, timer or counter, interrupt controller, ADC, DAC, and other

everything combined on to a single silicon chip. This product does not

mean that any micro controller must have all the above said features on

chip. It would be depend on the area of application for which it is system

designed and the chip might not be included some of the sections. The

microcontroller device will take an input of blood pressure sensor,

hearbeat sensor, and temperature sensor of the patient. This device will

send an alert message through GPS and GSM modem when it is necessary.

The microcontroller is programmed by using a embedded C language.

This program C language is commonly used for processors or controllers.

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