Hindawi

Wireless Communications and Mobile Computing

Volume 2022, Article ID 1191434, 22 pages
https://doi.org/10.1155/2022/1191434

Research Article
Internet of Things- (IoT-) Based Real-Time Vital Physiological
Parameter Monitoring System for Remote Asthma Patients

Khairul Islam ,1 Farabi Alam ,1 Abid Ibna Zahid ,1

Mohammad Monirujjaman Khan ,1 and Muhammad InamAbbasi 2

1
Department of Electrical and Computer Engineering, North South University, Bashundhara, Dhaka-1229, Bangladesh
2
Centre for Telecommunication Research & Innovation (CETRI), Faculty of Electrical and Electronic Engineering
Technology (FTKEE), Universiti Teknikal Malaysia Melaka (UTeM), Melaka 76100, Malaysia

Correspondence should be addressed to Mohammad Monirujjaman Khan; [email protected]

Received 12 November 2021; Accepted 2 February 2022; Published 11 March 2022

Academic Editor: Issa Elfergani

Copyright © 2022 Khairul Islam et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

In this paper, the design and implementation of an asthma patient monitoring system are presented. It can be categorized as an
IoT-based device which can monitor heart rate, room temperature, humidity, air quality, nostril temperature, and oxygen
saturation (SpO2) using an ESP8266 microcontroller and different sensors. All data will be sent to Firebase via Wi-Fi and then
to patients and doctors via mobile applications and websites, respectively. Doctors can access this data via a website and
instruct patients based on their specific needs. An ESP8266 microcontroller, a DHT11 temperature and humidity sensor, a
MAX30100 pulse and SpO2 sensor, a MQ-135 air quality sensor, and an LM-35 temperature sensor have been used for the
proposed system in this research. This system uses an efficient way to store all the data and information about the patient. It
also carries their various test reports. The data is preserved in a proper way, which will help the patient or doctor retrieve any
information in a smooth and swift manner. The software part of the system is divided into two parts. One of them is a mobile
application that was designed by the Android Studio. The second one is the website, and it is also divided into two parts.
HTML (hypertext markup language), CSS (cascading style sheets), and JavaScripts are designed for the front end of the
website, and PHP (hypertext preprocessor) is used for the backend of the website. The device is tested on seven different real
human test subjects, and the accuracy of that device is state of the art. It can measure the heart rate of a person along with
their oxygen saturation with accuracy. Also, this device calculates the humidity properly as it changes the moment wet towels
are put near the sensors and far from the sensors. It also shows the proper air quality as it has been tested with smoke to
measure the extreme difference in the air quality. This system also has video calling and prescription features. Using this
system, patients can consult with the doctor and get a prescription. Using this system, the vital physiological parameters of the
remote patients can be measured and monitored. Any hospital or diagnostic center can be more efficient and organized by
using a system. And patients are also freed from the hustle as they do not need to go and visit the doctor over and over again.
The system is designed in such a way that it can look after the particular needs of a typical hospital or a diagnostic center and
is able to provide easy and efficient storage of information related to patients.

1. Introduction semiconductors and the constant advancement of technol-

ogy, industries are now able to produce sensors and micro-
A remote health monitoring system is an additional part of a controllers at a smaller size, with faster operation, less
hospital where any patient can be monitored from a remote power consumption, and at a cheaper cost.
place. In general, it monitors the vital organs of patients, From the dawn of time until now, health has been a
which can only be seen in a hospital or diagnostic center. major concern for humanity. This sector has always been
Traditionally, these systems are built with massive and com- advancing and growing, from the start till now. There have
plex circuits that require a lot of power. But with the help of been numerous times throughout human history when
2 Wireless Communications and Mobile Computing

various epidemics have occurred and resulted in a large power line communication (PLC) and the ZigBee network
number of deaths. For example, the coronavirus attack in that was proposed in [7]. The framework consists of many
China has spread all over the world and many people have sensors, like a ZigBee/PLC portal and some software. The
died because of it. It devastates not only the Chinese econ- information is collected by the sensor and is sent to a cen-
omy but also the global economy. It is always preferable to trally controlled server through a ZigBee/PLC passage. On
use remote health monitoring systems to monitor patients, the central server, this data is stored and broken down.
especially in areas where the epidemic has spread. So, for Many patients can be monitored at the same time by using
the current situation, a health monitoring system based on vital signals based on ZigBee technology, which has been
the internet of things (IoT) could be a very good solution [1]. discussed in [8]. The network load is regulated by an opti-
Asthma is one kind of respiratory disease. It causes mized source routing protocol. Again, for this work, wireless
breathing problems and can make physical activities chal- network and power-based problems, which include energy
lenging for people of all ages. It is a respiratory disorder that consumption and network lifetime delivery ratio, have been
mainly affects the lungs. Asthma is a disease that affects any- upgraded. In [9], a patient monitoring system based on a
one, from children to adults. Furthermore, the recent global low-power microcontroller has been developed. Benders
pandemic of COVID-19, which occurred in China in 2020, are a major concern in hospitals, so a resistive bend sensor
increases the death risk of asthma patients. Also, it is really is used. This system is capable of monitoring patients con-
difficult to get an appointment with a doctor in a metro city stantly with mobility and can replace wired systems. In
because of the traffic congestion and road conditions. For [10], work on a local area network (LAN) or personal wire-
those people who are from rural and remote areas, it is really less data acquisition system has been seen. The IEEE 802.15
difficult for them to consult a doctor. An IoT-based remote standard is used in this system for wireless communication
patient monitoring system is a good solution for this kind with the help of Bluetooth technology. Patient monitoring
of situation. from home is possible because of the internet and the
This remotely monitored system empowers observation home-based monitoring system. The remote patient moni-
of patients outside of customary clinical settings (e.g., at toring system uses the internet of things (IoT) and the Zig-
home), which expands access to human service offices and Bee protocol to monitor a patient [11]. This real-time
brings down expenses [2]. The primary goal of this research system is capable of sending a report to the remote location
is to design and implement a system that can monitor any once it has analyzed all the data. The system developed in
patient’s health using sensors and upload it to the cloud so [12] takes health parameters (temperature and pulse) wire-
that their relatives and loved ones can see their condition if lessly. It is also based on ZigBee and has very good accuracy.
there is a problem. Another goal of this research is to reduce On the other hand, the improved system in [13] has a porta-
healthcare costs by eliminating the need for people to visit ble ECG to monitor and also enables data collection of
doctors or physicians regularly for checkups. It reduces vis- patients’ real-time walking acceleration. After data analysis,
iting fees, hospitalizations, and diagnostic testing proce- the technology can detect patients who are falling.
dures. There are major differences in the framework Whenever a patient goes to any hospital, clinic, or diag-
between short message service (SMS-) based monitoring nostic center, sensors that are used in those devices sense the
and IoT-based monitoring. In IoT-based frameworks, physiological signs, and these signs are then transformed
patient monitoring can be seen by different clients [3]. On into electrical signals [14]. After that, the electrical flag is
the other hand, the GSM-based system is based on utilizing changed to an advanced flag (computerized information),
GSM through SMS. Most rural places do not have much in which will be put on the RFID. Computerized data is trans-
the way of medical facilities for natives [4]. There is a huge mitted to the neighborhood server in these ways using the
ability to ignore any type of minor health concern, which ZigBee protocol. ZigBee is the proper convention for this
is manifested in the early stages by changes in important ele- framework. It has the most cell hubs in the world. It is pref-
ments such as body temperature and heartbeat rate. Once erable to have gadgets that are less expensive and consume
the health problem has progressed to the point that the per- less energy. Information is exchanged with the therapeutic
son’s life is in jeopardy, they seek medical help, which might server from the nearest server through a wireless local area
result in a needless waste of money. This is important to network (WLAN). The medicinal server is built around a
consider, especially when an epidemic spreads in a remote large database. When the data is sent to the therapeutic
area where doctors cannot reach it. To prevent the transmis- server, it checks to see whether the patient has a previous
sion of disease, giving patients a smart sensor that can be medical record; then, the server adds the new data to that
monitored from afar would be a practical solution that could record and sends it to the specialist. If any patient does not
save many lives [5]. have any past therapeutic records, then the server creates a
There are a lot of models that use the remote patient new ID for them and stores the information in the database
monitoring framework. Previous work on this system has [15]. In [16, 17], the authors designed and developed a
been proposed [6]. This framework monitors the ECG (elec- remotely controlled internet-of-things method for asthmatic
trocardiogram) signs of a patient with the arrangement of patients. The IoT asthmatic monitoring program in this
the Session Initiation Protocol (SIP) and ZigBee. This frame- study also includes a cardiac pulse sensor. The paper [18]
work consists of a remote ZigBee module, a SIP register, an presented a higher unit on Arduino with a mobile network
ECG sensor, a database server, a proxy web server, and other (GSM) cover to communicate with the online platform and
wireless devices. There is another system that is based on send a text message wirelessly over the mobile network
Wireless Communications and Mobile Computing 3

Planning stage

Figure Out Problem Analyze the Search Relative Compare

Statement Problem work existing work

Designing Stage

Dashboard Page
Doctor Build a
Real Time
Patient Page Admin Web
Database
Panel Application
Doctor Page
Remote
Patient
Monitoring
External Home Page Build a
Devices Patient
Mobile
Measure Page Admin
Application
Panel
Settings Page

Actual Development Stage

Device That Measure Mobile

(Heart rate, Room Application
Human Body Temperature, SPO2, Cloud Doctor
Humidity, Air Quality Monitoring
Web
and Nostril Temp) Application

Figure 1: Outline of the system.

(GSM) to the user’s device by using the GSM library to the paper [24], they developed an App for electrocardiogra-
establish a connection with the shield without using a cloud phy (ECG) patient monitoring. The authors of the paper
platform to save all the patient’s documentation for examin- [25] offer a cloud-based computer network location method
ing and diagnosing the patient. for healthcare management that includes equipment to cap-
The authors of the paper [19] developed a medical device ture voice and EEG (electroencephalogram) waves in a flex-
using the Arduino UNO framework to learn sensor files and ible, genuine, and cost-effective approach. In [26], the
transmit them to a computer, where they were then pre- authors offer a power implementation framework for
pared, including an app to show a diagram of heart rate. In healthcare devices that takes advantage of medical and resi-
paper [20], they just use the design of a local computer to dential care situations, which are often stationary and static
identify irregular heartbeats via ECG waveform without dis- because individuals’ movement is often limited to a particu-
cussing how legal doctors will be informed in an emergency. lar room. A web-enabled internet-of-things (IoT) patient
As a result, this same information is sent through the online respiration information gathering approach that relies on
platform to a remote computer, so there will be a website to vital signs was established in [27]. The fundamental flaw
enable authorized people or medical specialists to observe with this strategy is the lack of secure transmission. The
the patient’s case and also the alerting process. The authors author of [28] created a moderately monitored gadget for
of the paper [21] developed an “ECG App for Android” that asthmatics. An activity sensor, a gas sensor, and a tempera-
offers users a visual representation of real ECG waveforms as ture and humidity sensor are all included in one gadget.
well as data acquisition capabilities in the meantime. In [22], Doctors can identify the condition of the patient based on
the authors design a routing protocol to handle physical the data collected. The author of [29] sought to connect per-
components and an infrastructure for data gathering, trans- sonal gadgets, mobile devices, a centralized database, and
fer, and analysis to create a much more customizable and stakeholders. In [30, 31], a mobile and web application-
personalized healthcare monitoring program. based online doctor-patient consultation system has been
In the paper [23], the authors demonstrate how to proposed. The authors have not integrated IoT-based
gather, analyze, and collaborate data from IoT devices effec- patient monitoring devices with the system [30, 31]. A tem-
tively, in addition to giving help to emergency medical care perature and humidity monitoring system has been pro-
using a technology network for emergency medical care. In posed in [32]. [33] created an Android-based pulse
4 Wireless Communications and Mobile Computing

monitoring system. Using this system, only the heart rate of Humidity
the patient can be measured, and the data is also seen in the
Air Quality Room
mobile application [33]. According to the literature review, it Temperature
is noticed that different authors have presented different sys-
tems. Some authors have designed the system with a limited Heart Rate
number of sensors and features. Some systems have only Nostril
web or mobile-based doctor-patient consultation systems, Hardware Temperature
and some have only IoT-based systems with a limited num- Spo2
ber of sensors and features integrated with their systems.
The main objective of this paper is to develop an internet
of things- (IoT-) based real-time vital physiological parame-
ter monitoring system for remote asthma patients. The
major contribution of this paper is to develop an internet Firebase
Database
of things- (IoT-) based real-time physiological parameter
monitoring system for remote asthma patients. This system
can measure and monitor the real-time heart rate, SpO2,
nostril temperature, room temperature, air quality, and
humidity. Mobile application and web application have also
been developed in this research study. After developing the Take Data
Mobile and Web
Send Data
whole system, it was tested on different real-life human test application
subjects.
The novelty of this research is that it shows a system that
has more features than any other paper reported in the liter-
ature review section. The novelty of this paper is to combine
the IoT with telemedicine to develop a real-time vital phys-
iological parameter monitoring system for remote asthma Video Call Website View Report
patients. This system has a mobile application, a web appli-
cation, a video calling option for consultation, a prescription
feature, and more sensors. There are some papers which
show the very detailed work of real-time monitoring sys- Pescription
tems. However, they are unable to display the measured
values in the mobile application. This paper uses a system Figure 2: Block diagram of the web system.
that can show the value of the mobile application. Besides,
other papers have communication systems that are lacking,
as those systems are not able to connect patients and doc- in this section. Figure 1 shows the complete outline of the
tors. But this paper describes a system where there are sepa- system. The whole project will be divided into three parts.
rate accounts for both doctors and patients where they can They are the planning stage, the designing stage, and the
create accounts and communicate with each other. For addi- actual development stage. During the planning stage, prob-
tional security on the patient account, the OTP (one-time lems will be identified and analyzed and related work will
password) is used to authenticate the user. Besides, doctors be sought. In the designing stage, the whole work is shown.
can monitor the vital organs of patients in real time and This is the main stage of the project. In this part, the device,
can also communicate with them via video calling. At the the application, and the website were built. In the final stage,
end of the session, doctors can also give prescriptions to the device is applied to a human body for testing.
the patients. This paper has both IoT-based systems with
the integration of web and mobile applications. This is 2.2. Block Diagram. The block diagram of the entire system
how this research beats the state of the arts. is shown in Figure 2. The entire system is divided into three
different parts. Those are the hardware parts, the Android
2. Methods and Methodology application, and the web application. The hardware part
consists of various sensors, such as MAX30100, MQ-135,
2.1. Introduction. The methods and methodology that are DHT11, and LM-35, which can measure SpO2, heart rate,
used to achieve the goal will be discussed in this section. air quality, humidity, room temperature, and nostril temper-
The main focus of this system is to monitor a patient ature. All of those devices are connected through system
remotely so that they do not need to go to a doctor or a diag- hardware. There are some important metrics to monitor in
nostic center regularly for a checkup. Instead, they can mon- an asthma patient, like heart rate, SpO2, body temperature,
itor their vital organs and consult with a doctor online. The and nostril temperature. Some external factors, like humid-
first subsection shows a basic block diagram of the system; ity, room temperature, and air quality, which can trigger
after that, the design of the interface for both web and asthma patients at any time, are also added. It is an IoT-
mobile applications and the hardware implementation of based system that can work with both mobile and web appli-
the system, including the cost breakdown, will be discussed cations. These devices will be attached to the patients’ bodies
Wireless Communications and Mobile Computing 5

name phone
name
phone
username
email password id
id
Registration email

otp validation Log in has

password Doctor coalification

Can has id specialist

Has
password
id
name password
Patient Has Admin Can
blood group
age
email name id
phone phone
email
humidity room Can Name
temperature Registration
id
email
has

specialist phone
Measure
password
Spo2 nostril
temperature

heart rate air quality

Figure 3: ER diagram of the web system.

Asthma patient monitoring system

Registration

Log In

Doctor
Log Out

View
Extract
Patient Report
Data

Pescription
Send
Data
Register
Doctor

Update
Info

Admin
Manage
Doctor

Figure 4: Use case diagram of the web system.

6 Wireless Communications and Mobile Computing

Heart Rate Sensor

Power Supply

Spo2 Sensor

Humidity Sensor

Air Quality Microcontroller Cloud(Firebase) Mobile/Website

Sensor

Nostril Temperature
Sensor

Room Temperature
Sensor

Figure 5: Hardware design of the system.

Table 1: Description of components.

Components Description Picture

ESP8266 is a cheap cost Wi-Fi microcontroller with full IP (internet protocol) stack. This
ESP8266 microcontroller
microcontroller can connect to Wi-Fi network and make simple IP connection.

Dth11 temperature and

The Dth11 is a low-cost digital temperature and humidity sensor.
humidity sensor

MAX30100 heart and SpO2 The sensor is an integrated pulse oximetry (SpO2) and heart-rate monitor sensor solution. It is
sensor run by 1.8 V and 3.3 V power supplies.

The LM-35 is used to measure temperature. It is a temperature sensor that can precisely
LM-35
measure temperatures ranging from -55°C to 150°C.

The MQ-135 is a sensor that can measure air quality. It is capable of detecting NH3, benzene,
MQ-135
CO2, and alcohol.

Breadboard A breadboard is a construction base for prototyping electronics.

AC power source To power the microcontroller’s functions.

Flexible wire with connectors at both ends which allows wire to connect to other jumper wires
Jumper wire
or a pin header without the hustle of soldering.

Plastic box A box which contains all the components together.

and monitor the activity of their vital organs. After that, all data. The doctors use web applications to see the patients’
the measured values will be sent to the cloud (Firebase data. On the other hand, the patient uses the mobile applica-
real-time database). Firebase works as a bridge between the tion to see their measured data. After viewing this data, the
hardware part, mobile application, and web application. All doctor prescribed for the patient. If any doctor needs to talk
the data will be sent to the Firebase from the device first. with any patient, the system has a video calling option.
Then that data will be sent to the mobile application and Using this option, a doctor can communicate with his or
web application. The patient and doctor can both see this her patient.
Wireless Communications and Mobile Computing 7

Table 2: Cost of components.

Component Model Quantity Price/unit (BDTK) Price (BDTK)

Microcontroller ESP8266 1 220 220
Temperature sensor DHT11 1 85 85
SPO2 sensor MAX30100 1 480 480
Temperature sensor for nose LM-35 1 80 80
Air quality sensor MQ-135 1 300 300
Jumper wires Generic 3 (20 per unit) 35 105
Breadboard N/A 2 90 180
Plastic box N/A 1 100 100
Total cost 1170

Homepage

Sign Up Sign in

Patient Doctor
Cloud

General info General info Admin

Verification

Figure 6: Software design of the system.

2.3. ER Diagram. The ER diagram of the complete system 2.4. Use Case Diagram
is shown in Figure 3. There are two users and an admin
panel. The two users are a doctor and a patient. A patient 2.4.1. Use Case for Patient. In Figure 4, the use case diagram
can open an account with his or her name, email, phone is shown for the system. Here, patients can open an account
number, and password. A patient can open their account with their name, phone number, and password. After open-
only once. And the relationship between the registration ing their account, they need to create their profile. To create
and the patient is a one-to-one relationship. After opening a profile, a patient needs to fill in some basic information like
the account, he/she can measure heart rate, SpO2, nostril their full name, age, weight, and email address. The mobile
temperature, room temperature, humidity, and air quality, number and password will be taken from the patient’s regis-
which will be available in the measurement table. And the tration table when he/she has been registered in the system.
measurement’s relationship to the patient is a one-to- After creating a profile, they can measure their vital organs
many relationship. Doctors can also open an account. To using external devices. And this measurement data goes to
open the account, a doctor needs his or her name, phone Firebase, which is a real-time database via Wi-Fi. They can
number, email address, qualification, and password. All are also visit any doctor and get advice from them. Also, they
stored in the doctor’s registration table, and the relation- can communicate with them via video conference.
ship between registration and doctor is a one-to-one rela-
tionship. To open the account, they need additional 2.4.2. Use Case for Doctor. To open an account for doctors,
verification, which will be directly handled by the admin they need to take some additional steps. First, a doctor needs
panel. To monitor these two users, there is an admin to register themselves in the system using the sign-up form.
panel. The admin panel tracks all the activities of the users For registration, a doctor needs to fill in some important
and can regulate them when needed. information, such as name, phone number, email address,
8 Wireless Communications and Mobile Computing

LM-35

Dth11 NodeMCU Esp8266 MAX30100

MQ-135

Figure 7: Block diagram of the devices.

qualification, and password. They have to show their papers, base and capable of receiving data in real time. From Fire-
such as their license for practicing, as evidence. And after base, it is sent to the mobile application and the website.
verifying them with the admin panel, they can see the vital Patients and doctors can see those values from there.
signs of a patient. They can consult with them and also pre- The system is designed, implemented, and manufactured
scribe the desired medicine for their patient. at a low and affordable price, as it is demonstrated in
Table 2. The system’s overall cost comes down to 1550
2.4.3. Use Case for Admin. Admins are the guardians of the BDT (Bangladeshi Taka), which is not more than 20 dollars.
system. We also call them “super users” of the whole system. Implementation of the system is inexpensive, primarily
They can monitor everything in that system. Without the because the innovation in the design of the system is at the
verification of them, no doctor can open an account. The software level, not the hardware. Table 2 lists the breakdown
same is applicable to users as well. They can monitor all of the cost of the components required to develop the sys-
the activity of the system. They can ban or regulate any doc- tem. The system was built affordably, coming in at TK
tor or user if they violate any of the guidelines of the system. 62650, which when converted to Taka, comes out to less
than 80 USD (United States Dollar).
2.5. Hardware Design. The hardware system implementation
is demonstrated in the block diagram in Figure 5. The phys- 2.6. Software Design. The software part consists of two parts.
ical system has a breadboard, different sensors, microcon- The mobile application part and the web part. The mobile
trollers, and a computer. To measure heart rate and SpO2, application was designed in the Android Studio. The web
MAX30100 is used. DHT11 is used to measure humidity part is designed with HTML, CSS, and JavaScript. There is
and room temperature. MQ-135 is for air quality, and LM- a sign-up and sign-in option for both the doctor and the
35 is for nostril temperature. Every single sensor is con- user. If they do not have an account, they need to open an
nected with a microcontroller ESP8266, which is capable of account. After being verified by the admin, they can open
connecting to a WI-FI (wireless fidelity) network and mak- and operate their account. All the information of both the
ing a simple IP connection. The system’s components are user and the doctor will be preserved in the cloud. Detailed
demonstrated and described in Table 1. The microcontroller information about the design of the mobile app and website
is connected to sensors using jumper wires and is also pow- is given in the following.
ered by USB. The device uses an AC power supply. Sensors
take the values from the environment and patients’ bodies, 2.6.1. Design of Android Application. To develop Android
and, with the help of the microcontroller, the measured applications, Android Studio software is used. Android Stu-
values are sent into the Firebase, which is a real-time data- dio is the official integrated development environment (IDE)
Wireless Communications and Mobile Computing 9

(a) (b)

(c)

Figure 8: (a) Prototype of the hardware of the system and (b, c) testing the prototype of the system on different people.

for Google’s Android operating system. It supports all the it is used to beautify web pages by giving them colors and
programming languages IntelliJ offers, such as Java, C++, emphasis. A website is a collection of web pages. JavaScript
and Python. The XML format is used to design the applica- is a programming language that is used to define what the
tion. Java is used for the backend. The application is con- elements on a webpage will do, such as what happens when
nected to the Firebase SDK (software development kit), a a button is clicked, animations, or even how data is fetched
real-time database. Firebase is used to store and collect data as required by the website.
from the mobile application. Firebase also generates an OTP
(one-time password) and sends it to the user’s mobile. (2) Backend Tools. The backend of a website makes it
dynamic. It allows the website to save data or perform mean-
2.6.2. Design of Website. The website is made for doctors. To ingful functions. The backend also structures all the web
design a website, HTML and CSS are used for the front end, pages and transforms them into a website where data can
and PHP is used for the backend. Detailed information be sent, saved, or received. The system is built with PHP
about the website is described in the next section. and Firebase. The full form of PHP is Hypertext Preproces-
sor. PHP handles all the functionality of the backend of the
(1) Frontend Tools. HTML, CSS, jQuery, bootstrap, and system. Figure 6 shows the software design of the system.
JavaScript are the technologies used in the frontend. The full
form of HTML is hypertext markup language. It is a script- 3. Results and Analysis
ing language made up of tags that can give structure to web
pages. Using this, users may create and structure sections, In Figure 7, the block diagram of the device is presented.
paragraphs, headings, links, and block quotes for web pages DTH11, along with MAX30100, MQ-135, and LM-35 sen-
and applications. CSS stands for cascading style sheets, and sors, is used here to measure the room temperature,
10 Wireless Communications and Mobile Computing

(a)

(b)

Figure 9: Testing heart rate and oxygen saturation using MAX30100 sensor.

(a) (b)

Figure 10: Testing room temperature and humidity using DHT11.

Wireless Communications and Mobile Computing 11

(a) (b)

Figure 11: Testing air quality using MQ-135.

(a) (b)

Figure 12: Testing nostril temperature using LM-35.

Table 3: Average range of temperature, heart rate and SpO2, and It supports RTOS and operates between 80 MHz and
air quality. 160 MHz. It also has 128 KB of RAM and 4 MB of flash
Measurement Average normal range memory for storing and preserving data and programs. It
has built-in Wi-Fi, which helps transmit data from the sen-
Temperature (20-25°C)
sor to the Firebase. It can be powered by any external source,
70-100 BPM (6-15) such as an alternating current or a power bank. The MQ-135
Heart rate
60-100 BPM (18 and over) is used here to measure the air quality. It is a gas sensor that
Nostril temperature 2-3°C more than room temperature. can detect carbon dioxide, sulfur, ammonia, and many
SpO2 95 to 100% harmful gases. It also detects smoke. This sensor has digital
Humidity 30-70% based on temperature and analog output pins. In this device, it is connected to
Air quality 50 ppm the A0 pin of the NodeMCU, which is an analog port. Again,
to measure heart rate and oxygen saturation, MAX30100 is
used. It has a photodetector and a low-noise signal process-
humidity, heart rate, oxygen saturation (SpO2), air quality, ing feature to detect pulse and heart rate signals. It is con-
and nostril temperature of the patient. The main part of this nected to the D1 and D2 pins of the NodeMCU. To
device is the ESP8266 microcontroller. All the sensors are measure nostril temperature, LM-35 is used. It is a tempera-
connected to the ESP8266 by jumper wires. The ESP8266 ture sensor that can operate between 55 and 150 degrees
is a development board that includes the ESP-12E module. Celsius. It is connected to the A0 pin of the NodeMCU.
12 Wireless Communications and Mobile Computing

Table 4: Result of the asthma patient monitoring system.

Name Age Sex Room temp. (°C) Air quality Nostril temp. Heart rate SpO2 Humidity
Ahnaf 20 Male 25 50 ppm 28°C 80 BPM 98% 65%
Insaf 30 Male 29 52 ppm 32°C 85 BPM 99% 65%
Farabi 24 Male 26 54 ppm 29°C 77 BPM 98% 55%
Mim 18 Female 25 51 ppm 29°C 70 BPM 98% 42%
Din 13 Male 26 48 ppm 28°C 86 BPM 97% 70%
Rumana 17 Female 28 50 ppm 32°C 72 BPM 99% 74%
Ruman 26 Male 26 56 ppm 30°C 72 BPM 96% 52%
Average 26 50 ppm 30°C 77 BPM 98.85% 60%

(a) (b)

Figure 13: Patient sign-up page in the mobile app and doctor sign-up in the web app.

DHT11 sensors are used in the device to measure room tem- body. After that, it will be on the Firebase real-time database
perature and humidity. It has two parts. One is a humidity via ESP8266. The result will be displayed on a serial monitor,
sensor, and the other one is a thermistor. It has a tempera- which is seen in Figure 9(b).
ture range of 0 to 50 degrees Celsius and a humidity range In Figure 10(a), the DHT11 is displayed, which is capa-
of 20 to 50%, with a precision of 1 degree Celsius and 1%. ble of measuring room temperature and humidity. It also
It is also connected to the A0 pin of the NodeMCU. The has an LED (light-emitting diode) light that shows it is turn-
value is sent into the Firebase database from the NodeMCU. ing on and it can take input from the environment. It is con-
And after that, patients and doctors can see the measured nected to the A0 pin of the ESP8266. It is also tested with a
value on a mobile application and website. All the sensors match stick, and the temperature and humidity change as
are run at 3 V, and only the MQ-135 air quality sensor needs the fire reaches the sensors, which is shown in
5 V to operate. A real-life prototype of the device and the Figure 10(b). The values of SpO2 and heart rate are already
testing of the system on different human test subjects are stored in Firebase since they were tested right before this
shown in Figures 8(a)–8(c). testing, which is the reason those values are also shown in
Figure 9(a) shows the MAX30100 sensor testing on the the application.
human body. The sensors are connected to the D1 and D2 In Figure 11(a), an MQ-135 is displayed, which is capa-
pins of the ESP8266. It measures the heart rate and oxygen ble of measuring air quality. It also has an LED light like the
saturation of the body. When the device is turned on, it DHT11 and MAX30100. It is also connected to the ESP8266
shows a light, which means it will take data from the human on pin A0 with ground and VCC. When the light is on, it
Wireless Communications and Mobile Computing 13

means it is capable of receiving data from the environment.

As soon as the smoke was near the sensor, the value
increased. The value decreased as soon as the smoke went
off, which is seen in Figure 11(b). The values of SpO2, heart,
room temperature, and humidity are already stored in the
Firebase since they were tested right before this testing,
which is the reason those values are also shown in the
application.
In Figure 12(a), the LM-35 temperature sensor is pre-
sented. It is capable of measuring precise temperatures. It
is used to measure nostril temperature. It is connected to
the ESP8266 with the A0 pin. It can measure the tempera-
ture of the exhaled breath of a human being and calculate
its temperature. Unlike the other three sensors, it has no
LED light. The results can be seen on the serial monitor,
which is displayed in Figure 12(b). The values of SpO2 and
heart rate, room temperature, humidity, and air quality are
already stored in the Firebase since they were tested right
before this testing. This is the reason those values are also
shown in the application.
In Table 3, the average range of temperature, heart rate,
SpO2, nostril temperature, humidity, and air quality have
been shown. Taking this as a standard, the device is tested
on some people to see its accuracy. The average room tem-
perature should be 20–25°C. The normal heart rate of an
adult person is 60-100 and 70-100 for an underage person.
Air quality is very important for asthma patients, and the
ideal air quality is 50 PPM (parts per million). These are
the ideal scenario cases, and the test results are shown in
Table 4.
In Figure 13(a), the sign-up page of the mobile Android Figure 14: OTP to verify the sign-up in the mobile app.
app has been shown. Here, any person can open an account
by writing their name, phone number, and adding a pass-
word. After that, they need to click the submit button. After there. If any patient has not registered yet, they can register
that, the data will be uploaded into the real-time data server from there. Besides, if someone forgets their password, they
of Firebase and an OTP (one-time password) will be sent to can retrieve their account by clicking “forget password.”
their mobile. Putting this one-time password together, a Figure 15(b) also shows the doctor’s web app log-in
patient can register and create his or her account. In page. It only needs his or her email and password. After
Figure 13(b), the doctor’s sign-up page for the web app has his/her email and password are submitted, they will be sent
been shown. Here, they need their name, email, and phone to Firebase. If all this data is correct, then they will finally
number. They need to set a password as well. After clicking be able to enter the website. There is an option to “remember
the sign-up button, all the data will be stored in the real-time me,” so there is no chance to log out in case of closing the
database of Firebase and their registration will be finally windows. There is another option, which is “I forgot my
approved by the admin panel. password,” which is used to recover a password if there is
In Figure 14, the OTP verification page of the mobile app a chance of forgetting the password. Also, there is another
is displayed. After finishing sign up, a one-time password option named “Register a New Membership” that leads a
will be sent to the user’s phone by SMS (short message ser- doctor to a sign-up page where they can register themselves
vice) as the mobile authentication of Firebase is enabled. to create an account.
Firebase randomly produces OTP, and after putting the In Figure 16(a), the home page (left) for patients of the
value of the OTP in the password section, Firebase will verify mobile application is displayed. There is a welcome message
the verification code. If the verification code is matched, along with the logo of the company. There is also a home
then people can finally be able to enter the mobile button, and besides that, there is another button on the left.
application. All the features that the app has will be shown after clicking
In Figure 15(a), the log-in page for patients in the mobile that button. There is another white button on the top right.
app is shown. It will require a user name and password, and By clicking that button, anyone can log out of the
after clicking the submit button, this data will be sent to Fire- application.
base. If this data matches with the data that is stored in the All the features of the application (left) have also been
Firebase, they can log into the main application; otherwise, displayed. In the top left corner, there is a picture of the
it will show an error. Besides, there is a register button down patient or user, his or her name, and contact number. After
14 Wireless Communications and Mobile Computing

(a) (b)

Figure 15: Patient log-in page in the mobile application and doctor log-in page in the web application.

(a) (b)

Figure 16: Feature page of the mobile app and dashboard page for the web app.

that, there is the home page, which we discussed before, and body, the data will be measured and sent to Firebase. After
the profile of the user. There is a feature called “Doctor.” that, they can see it from their mobile phones.
They can see which doctor is available and can also consult Figure 16(b) shows the admin’s dashboard page for the
with them. The user or patient can see the prescription web app. Here, the admin can see how many doctors are
which is provided by the doctor in the “Prescription” feature active on the site. And how many patients are there to be
and gallery where all the photos will be preserved. Patients treated? They can also see the patient list and their basic
can live monitor their vital organs’ signs by getting into the and detailed information. They can also see all the informa-
“monitor” feature. When they connect the device to their tion about the patients and doctors too.
Wireless Communications and Mobile Computing 15

Figure 17: Doctor page in the web app.

Figure 18: Admin panel in the web app.

In Figure 17, the list of doctors is displayed in the web mation about the doctor and the patient. And admins have
app. Here, anyone can see the list of doctors and their qual- the power to remove anyone from the site at any time.
ifications. And they can make an appointment with them by In Figure 19(a), Firebase is used to connect the applica-
clicking on the “take treatment” option. tion with the website. Firebase is a platform developed by
In Figure 18, here is the option for the admin panel in Google for creating mobile and web applications. Here, Fire-
the web app. Here, which admin is present now to control base is used to connect websites and apps and also handle
the site at the backend will be seen. It can also be handled the database. The data, which is measured by the device, will
by multiple admins at the same time. They can update infor- come to the Firebase first, and after that, it will go to the
16 Wireless Communications and Mobile Computing

(a)

(b)

Figure 19: Firebase (real-time database for web and mobile apps).

mobile application and the website as per need. Figure 19(b) tors can communicate with patients through video calls in
depicts the measured value of a patient in the Firebase real- the treatment option. Doctors can also write prescriptions
time database. for patients.
In Figure 20(b), the information, along with the mea- In Figure 21, the video call option is shown. Both
sured value of a patient’s vital organ, is displayed in the patients and doctors can communicate with each other via
web app for a doctor. video conference. It would be really beneficial for both the
The information, along with the measured value of a patient and the doctor. Patients can show their problems
patient’s vital organ, is displayed in the web app for a doctor directly to the doctor, and doctors can also understand the
in Figure 20(b). All the measured values will come from condition of a patient by watching their conditions live.
external devices via Firebase. A doctor can view all of a Using the video call option makes the session between the
patient’s vital organ data here. Also, doctors can see the basic doctor and the patient more live and dynamic. Patients can
information about a patient, such as their blood group and consult about their medical condition with their preferred
age. All this data will be fetched from the Firebase. Also, doc- doctor using the video call option of this proposed system.
Wireless Communications and Mobile Computing 17

(a)

(b)

Figure 20: Measured value readings in the mobile app and patient page with measured value in the web app.

Figure 21: Video call between doctor and patient.

18 Wireless Communications and Mobile Computing

(a)

(b)

Figure 22: Prescription for a patient in web application and prescription in mobile application.

To create a video conference, the doctor needs to enter patient can view their prescription here, which was provided
the site, and after that, he has to share the URL link with by the doctor they saw.
the patient. And when the patient clicks on that link, he or In Figure 23, this is the landing page of the website.
she will be able to communicate with the doctor. It is a There is some basic information about the site. Also, if a
third-party system, and it is completely free. The site is patient does not have any accounts, they can still consult a
hosted on 000webhost, which is completely free and sup- doctor. By visiting the URL of the website, anyone can get
ports PHP and JS, which are used to develop the video con- treatment and consultation from the doctor.
ference site.
Figure 22(a) shows a prescription for a patient that will 4. Comparative Analysis
be provided by the doctor using a web app. Whenever a
patient consults a doctor, the doctor can write a prescription Table 5 shows the comparative analysis of software and
for the patient. Doctors can write reports about the progress hardware with other papers. The proposed system in this
of the patient. Also, they can write medicine names. They study establishes a remote health monitoring system for
can also put their signature and date there. Patients can also patients with asthma. In [16], the authors designed and
collect the prescription through their app. In Figure 22(b), developed a remotely controlled internet-of-things method
you can see the patient’s prescription in mobile view. A for asthmatic patients. The IoT asthmatic monitoring
Wireless Communications and Mobile Computing 19

Figure 23: Landing page of hole system.

program [16] also includes a heart rate sensor. It has [10] a cation, video calling, and prescription features. After logging
system that is remarkably similar to this one but misses out in to the system, a patient can also consult with the doctor
on the SpO2 and nostril temperature sensors. It also does not and get a treatment plan. The vital physiological parameters
have doctor-patient consultation and prescription features. of the remote patients can be monitored in real time.
Only humidity, air quality, and an activity sensor were used A comparative analysis of sensors with other papers is
in [10], and it is also an IoT-based system. On the other shown in Table 6. Analysis shows that some papers have
hand, Ref. [14] uses merely a pulse, humidity, and air quality worked with one or two, maximum of three sensors, and
sensor. It is also an IoT and app-based system. From Table 5, some have only worked with application-based or web-
it is noted that our proposed work has more features com- based sensors, but this system has worked with mobile apps
pared to other available systems in the open literature. Our and websites with six sensors. It can monitor more parame-
system is IoT-based and has web application, mobile appli- ters compared to the other systems reported in Table 6.
20 Wireless Communications and Mobile Computing

Table 5: Comparative analysis for software and hardware with other papers.

No. Reference IoT ZigBee Mobile app Web app Video calling
1 This paper Yes No Yes Yes Yes
2 Ref. [16] Yes No No No No
3 Ref. [27] Yes No No Yes No
4 Ref. [28] Yes No No No No
5 Ref. [29] Yes No Yes No No
6 Ref. [30] No No Yes Yes Yes
7 Ref. [31] No No No Yes Yes

Table 6: Comparative analysis for sensors with other papers.

No. Reference Heart rate SpO2 Room temp. & humidity Air quality Nostril temp. ECG Body temp.
1 This paper Yes Yes Yes Yes Yes No No
2 Ref. [16] Yes No No No No No No
3 Ref. [27] No No No No No No Yes
4 Ref. [28] No No Yes Yes No No No
5 Ref. [29] Yes No Yes Yes No No No
6 Ref. [30] No No No No No No No
7 Ref. [31] No No No No No No No

5. Conclusion exposes privacy and information quality concerns. In this

paper, a framework for secure remote health-monitoring
In this paper, the design and implementation of an IoT- systems is given. It has a health monitoring architecture
based asthma patient monitoring system are discussed. that leverages a special monitoring unit that plays the cen-
Asthma is a lung disease that can be very dangerous for a tral role in security by providing critical security services
patient. It inflames and narrows the airways, making it hard including authentication, one-time password (OTP), and
to breathe. It cannot be cured fully, but with constant mon- key management. For future work, implementation of the
itoring, it can be controlled. An asthma patient monitoring framework and evaluation in a real setting are planned.
system is a solution for constant monitoring of a patient. It By using this system, the pain and hustle of asthma
is a system that allows an asthma patient to monitor their patients can be reduced. They do not need to go to the
vital organs and surroundings. This measured data is doctor regularly for checkups as the system provides a
uploaded into cloud storage, and from there, doctors can means to communicate with the doctor virtually. There
see that data from a website. Doctors and patients can com- will be huge benefits for people, especially for senior citi-
municate with each other via video conference. Doctors can zens and those who live in rural and remote areas, as they
also make prescriptions for patients. It is a system that is reg- will not need to go to the doctor on a regular basis.
ulated by multiple admins. In this system, patients can book Besides, in this pandemic situation, it will be best to avoid
an appointment with a doctor. Also, if a patient does not going out often. So this system could be very useful for the
have an account, they can still consult with a doctor by vis- people of Bangladesh.
iting the URL of the website. This proposed system can mea-
sure in real time the heart rate, SpO2, and nostril
temperature of the human body. It can also measure the 6. Future Work
air quality, room temperature, and humidity of the room.
The device works very well and shows pinpoint accuracy There are four sensors used in this device that can measure
throughout the testing period. The proposed system has heart rate, oxygen saturation, room temperature, nostril
been tested on different people to show the accuracy of this temperature, air quality, and humidity. However, more sen-
device, and the accuracy was near perfect. It was also tested sors capable of measuring blood pressure, ECG, and blood
with fire and wet towels to measure the extreme difference in glucose levels can be added to this system in the future.
temperature and humidity. Also, smoke is used to measure
the extreme difference in air quality. Although advance-
ments in information technology and mobile computing Data Availability
provide numerous potential for providing timely healthcare,
the use of unreliable devices for remote health monitoring No data was used to support the findings of this study.
Wireless Communications and Mobile Computing 21

Conflicts of Interest national Conference on Wireless Communications, Networking

and Mobile Computing, pp. 1–4, 2009.
The authors declare that they have no conflicts of interest to [13] T. Lan and X. Li, “Gait analysis via a high-resolution triaxial
report regarding the present study. acceleration sensor based on ZigBee technology,” in 2013
ICME International Conference on Complex Medical Engineer-
Acknowledgments ing, pp. 697–702, 2013.
[14] Internet of Things (IoT), “Number of connected devices
The authors are thankful for the support from North South worldwide from 2012 to 2020 (in billions),” Available:
University CTRG Research Grant (CTRG-21-SEPS/24), https://www.statista.com/statistics/471264/iotnumberof-
North South University, Bashundhara, Dhaka-Bangladesh. connected-devices-worldwide/.
[15] P. Chavan, P. More, N. Thorat, S. Yewale, and P. Dhade, “ECG
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