Advanced healthcare management system 2024-25

CHAPTER 1

INTRODUCTION

1.1 Prelude

The health care industry has experienced a significant transformation with the emergence of
Internet of Things (IOT) technology. One area that has greatly benefited from this innovation
is patient care monitoring. In traditional health care systems, data collection and monitoring
often rely on manual processes, leading to potential gaps in patient care and delayed
interventions. The Internet of Things (IOT) has significant implications and advantages in the
health care sector, enhancing patient care, improving efficiency, and transforming the way
health care services are delivered. The integration of IOT in health care not only improves
patient outcomes but also contributes to the overall efficiency, cost-effectiveness, and
accessibility of health care services.

IOT based patient care monitoring systems have revolutionized the way health care providers
monitor patients, collect data, and make informed decisions in real-time. IOT devices enable
continuous monitoring of patients' vital signs and health parameters in real-time, allowing
health care providers to remotely track and manage chronic conditions. Wearable devices,
such as smart watches and fitness trackers, can monitor activities, sleep patterns, and vital
signs, providing valuable data for preventive care and early intervention. The current
proposed system aims to explore the advancements and benefits of IOT based patient care
monitoring systems, showcasing how they enhance patient safety, optimize resource
allocation, and improve health care outcomes.

The availability of medical professionals in rural and remote areas differs significantly from
that in urban areas. Safeguarding our health against harmful diseases is of utmost importance
in our daily lives. While it may not be feasible for individuals residing in rural areas to access
health care services, technology is bridging this gap. The Internet of Things (IOT) has
experienced substantial growth in the medical sector, enabling the utilization of various
sensors to monitor different parameters of the human body and facilitate efficient treatment.
The vital signs of patient’s blood pressure, temperature, and heart rate, can be continuously

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monitored by IOT devices. Early identification of possible health problems is made possible
by the real-time transmission of this data to health care professionals. This makes it possible
for medical professionals to act quickly and modify the treatment plan as necessary.

With real-time data on patients' vital signs and other health metrics, doctors can identify and
respond to changes in patients' conditions more quickly and effectively. The project Smart
Hospital Management is built on the principles of providing timely medical assistance to
those living in rural areas where doctors are not always available at the right time. It also
recommends using medicine and predictive analytic to reduce health care costs for both
patients and health care facilities.

The strategy that has been suggested for the rural areas tackles particular difficulties by
providing a patient-centered approach that increases health care accessibility, lowers costs,
and improves the general standard of care for those living in underprivileged areas. These
developments in the health care industry help raise national development and people's quality
of living across all regions. Fig 1.1 shows the "Block Diagram of a Health Monitoring
System Using NodeMCU and IoT".

Fig 1.1:Block diagram

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1.2 Motivation:
The effects of the most recent pandemic have demonstrated how the deprived or rural
communities have been denied access to necessary basic medical care. People in such regions,
who encounter health issues often turn to self-care or self-diagnosis in the absence of
adequate medical support and options for transportation. While this can often address the
issue, it can also have unfavorable effects on one's health and worsen preexisting conditions.
The suggested method can be put into action to prevent such disastrous effects.

1.3 Problem statement:

• To make availability of timely medical assistance for the areas where doctors are not
available in the right time.

• Improving the quality of patient care by providing doctors with real-time data on patients'
vital signs and other health metrics. This can help medical professionals to identify and
respond to changes in patients' condition more quickly and effectively.

• To lower healthcare costs for patients and healthcare facilities, we recommend using
telemedicine and predictive analytics.

1.4 Objective of the project:

• To make availability of timely medical assistance for the areas where doctors are not
available in the right time.

• Improving the quality of patient care by providing doctors with real-time data on patients'
vital signs and other health metrics. This can help medical professionals to identify and
respond to changes in patients' condition more quickly and effectively.

• To lower health care costs for patients and health care facilities, we recommend using
medicine and predictive analytic.

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1.5 Applications and advantages :

➢ Remote monitoring systems make it possible for patients to receive care from the comfort
of their own homes, increasing access to health care services, especially for those in remote
areas.

➢ Health care personnel may communicate more effectively as a result of smart systems,
which enhances coordination.

➢ Smart sensors evaluate environmental factors, lifestyle decisions, and health status to
suggest preventive actions that lower the risk of acute states and diseases.

➢ Remote monitoring ensures prompt assistance in case of crises by alerting caregivers or

emergency services.

1.6 Summary:
This chapter outlines the issues that rural residents experience as a result of inadequate
medical care or health care centers, as well as the motivation for the implementation of the
suggested system, its fundamental idea, and its anticipated benefits for society.

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Chapter 2

LITREATURE SURVEY

2.1 Introduction

The availability of medical professionals in rural and remote areas differs significantly from
that in urban areas. Safeguarding our health against harmful diseases is of utmost importance
in our daily lives. While it may not be feasible for individuals residing in rural areas to access
health care services, technology is bridging this gap. Considering the advancements in health
monitoring systems, we propose the implementation of a smart hospital management system
that addresses the issue of limited access to doctors in rural and remote areas.

The healthcare industry has undergone significant transformation in recent years, driven by
technological advancements and an increasing demand for efficient, patient-centered services.
Advanced healthcare management systems (AHMS) play a pivotal role in addressing these
challenges by integrating technology to optimize patient care, streamline administrative
processes, and enhance decision-making.

2.2 Literature survey:

Kulshrestha et al. [1] Created and implemented a system that may be used in both patient
homes and intensive care units. The suggested system keeps track of the patient's body
temperature and pulse, among other critical health indicators. An instant alarm is sent to the
doctor in the event that these parameters deviate from their typical ranges or in the event of
an emergency or dangerous circumstance. Temperature and heart rate sensors are part of the
system architecture, and a GSM module is used to send the data to the doctor via the Internet
of Things. The LM35 temperature sensor, which offers precise temperature measurements
over a broad range, is the one in use. The pulse sensor is a plugand-play device that uses the
blood's absorption of light to determine heart rate. The microprocessor in the system is an
Arduino UNO, and communication is handled by a GSM module.

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Ravali et al [2] proposed smart hospital system uses IOT to track and monitor patient health
metrics in real-time. It uses a wireless sensor network to collect data from various medical
and environmental sensors worn by patients. The data is transmitted to a server via GPRS
interface. The system consists of a micro controller, pulse sensor, ECG, temperature sensor,
MEMS accelerometer, and RFID reader. The micro controller updates sensor data on a
GPRS web page and checks for abnormal conditions. The data is then sent to a control
system for doctors and nursing staff.

Kumar et al [3] developed an IOT based model real-time patient monitoring and remote drug
delivery. A vital sign machine with five parameters is attached to the patient, and their vital
signs are transmitted to a cloud-based server in JSON format. A mobile and desktop
application retrieves patient data from the cloud database, allowing doctors to view
physiological parameters in real-time and remotely control an infusion pump. The mobile
application uses Java-based Web Tokens (JWT) to ensure authenticity, allowing doctors to
view the patient's vital signs and order medication injections. This system ensures accurate
patient monitoring and remote drug delivery.

Vippalapalli et al [4] designed a system utilizing the BSN (Body Sensor Network), which is
composed of a number of implants and health sensors that are located inside or outside the
body. A vast number of patients will be maintained and monitored by the suggested system.
The Arduino Uno is equipped with a number of health sensors, including blood pressure,
temperature, and pulse rate sensors. They produced Lab View software in order to gather,
handle, and send the data. The patient's body and the Arduino FIO transmitter are connected,
and the receiver is USB-attached to the PC. Doctors can view all data using Lab View, and
patient PCs can also access data.

Shalini et al [5] has presented a system which guides the patient to take treatment based on
their health parameters using Thing Speak. The suggested system is really basic, consisting
of an Arduino UNO integrated GPS module, blood pressure sensor, heartbeat sensor, and
GSM module. The doctor receives the gathered data. If any problems are discovered, the
patient will receive a diagnosis from the doctor along with a copy of the monitored data. The
patient’s who are old who not care about health and people who care less to their health, The
alert messages are sent to such patient’s that they can take doctor’s consultation when needed.

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Singh et al [6] have developed and smart system to monitoring the patient’s health and smart
medicine box. Two controllers are used in the system's design. The first controller gathers
data from the patient's body, evaluates it, and stores it on a cloud server. The first part of
hardware system consist of different health sensors which are interfaced with Arduino UNO
to collect data and send to doctor for analysis. After the doctor’s feed on seeing the patient
data, The Smart medicine box will contain all data of patient’s medication and schedule of
medication. The medicine box consist of LCD display, Buzzer interfaced with Node MCU.
When the patient misses any medication or the time is scheduled by a patient this system will
display alert message on lcd and turn on buzzer for alarm and the intimation is also provided
via SMS. The web page is also setup for displaying patient’s data and alert messages.

Kurlekar et al [7] have proposed electronic Wi-Fi controller based hospital management
system using IOT. They developed hardware model to collect Patient Id and history of the
patient’s health. Data based model is created using RFID and web server. The patient’s
health information is stored in hospital database. RFID tag is used maintain patient’s name,
Id and records of patient health and test reports as it provides secure data exchange and easy
accesses of data. They created web server using python base. The doctor can easily accesses
all patient’s data and data is considered to treat patient and also the current health report will
be save in same database under patient’s unique Id. The health sensor hardware model
includes the temperature sensor LM35, the pulse oximeter sensor MAX30100, and the RFID
RC522 with an integrated WIFI module and Esp32 microcontroller. The doctor will review
patient’s physical parameters and prescribe a prescription with relevant medicines.

Das et al [8] have over the years produced review papers on patient monitoring systems. In
their study, they detail how the system is put into practice, utilizing intelligent biosensorsto
identify and document human physiological traits, then connecting this data to acomputer
over wireless protocols so that the system may notify physicians about the patient's health.
When these technologies are used together, healthcare will be more effective, less expensive,
and less prone to mistakesin diagnosis and treatment.sensors areused to measure the patient's
body temperature and pulse rate.. The gathered data is transmitted to the controller, which
uses Bluetooth to transform it into a digital signal thatis then transferred to the patient's
mobile application and the LCD display, where the valuesare shown. This helps the patients

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in remote areas to keep in track of their vital signs of their health and in case of any
variations they could approach their doctor.

Boikanyo et al [9] the researchers developed an IoT-based Patient Health Monitoring System
for the elderly, utilizing sensor technology, microcontrollers, and Wi-Fi connectivity. The
system monitors patients' health in real-time, allowing for notifications to loved ones and
healthcare providers. The system uses an Arduino Uno microcontroller, temperature and
cardiac sensors, and an LCD display for data transfer. The technology also allows users to
view their health status through a mobile application, enabling personalized healthcare
messaging and ongoing monitoring of vital signs.

Halikar et al [10] have presented an architecture where the doctor can suggest the feedback
by considering the patient data via SMS alert if any danger is observed. This method gathers
health information from patients in three parts: Transfer the gathered data to the cloud,
whereupon the physician can view it remotely and use SMS alerts to provide feedback in the
event of an emergency. The ESP32 controller, temperature, pulse, and ECG sensors, LCD
display, and GSM module for communication make up the hardware portion. All these
sensors and modules are interfaced with microcontroller. The Sensors will collect the
patient’s physical health data. The patient's temperature, pulse, and heart rate will all be
displayed on the LCD. The WIFI module on the server, that provides rapid and simple
internet access, is used to store this data. The doctor receives the stored information so they
can continuously monitor the patient's health. If the doctor finds anything, they send an SMS
alert via the GSM module.

Jeyaraj et al[11] the research paper "Smart-Monitor: Patient Monitoring System for IoTBased
Healthcare System Using Deep Learning" focuses on creating an automated physiological
signal monitoring system for older, ill patients. The system uses deeplearning algorithms and
IoT technologies to provide healthcare providers with quick accessto data and precise
forecasts. The system, which includes an intelligent sensor for signal measurement and a
National Instruments my RIO for data capture, was verified with an average accuracy of
97.2% in prototype testing. The study highlights the benefits of using IoT and deep learning
algorithms in healthcare, and concludes that the Smart-Monitor system can enhance patient
travel and service quality.

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Zeshan et al[12] the paper presents an ontology-based intelligent healthcare framework for
remote patient monitoring, addressing challenges such as data heterogeneity,
contextawareness, and quality of service. The framework uses IoT devices and patient
ontology to manage emergency alerts and compute scores for context-aware and quality of
service attributes. The paper emphasizes the importance of semantic web technologies,
reasoning rules, and ontology-based decision support in patient monitoring and healthcare
frameworks. The framework considers vital signs, patient context, and device suitability to
ensure timely and accurate medical interventions. The paper provides a detailed overview of
the framework's components, ontology engineering process, and effective utilization of
semantic web technologies.

P. P. Marrugo et al [13] study has reviewed platforms for remote monitoring of vital signs in
patients with hypertension, asthma, and chronic obstructive pulmonary disease. Researchers
found Arduino UNO as the most commonly used electronic development platform since
2016. The study also highlighted the growing interest in telemedicine and remote monitoring
systems, emphasizing the need to address challenges related to disease telemonitoring,
medical service application, and networking. The researchers provided recommendations for
overcoming these challenges and improving the development of telemedicine systems,
suggesting practical solutions and prototypes to ensure quality of service. The review offers
valuable insights for future research and development in developing countries.

A. F. Hussein et al[14] researchers have developed an automated remote cloud-based HRV

monitoring system to provide timely and effective healthcare services. The system uses
advanced wearable and wireless sensor technologies to monitor patients' heart rate variability.
The system aims to offer high-quality healthcare services to individuals in remote areas with
limited access to doctors. The system was evaluated using databases like MIT-BIH sinus
rhythm and MIT-St. Petersburg, and data collected from 30 wearable sensor users. The
results showed an accuracy of 99.02%, sensitivity of 98.78%, and specificity of 99.17%,
demonstrating the system's reliability, robustness, and value. The system also generated
warning messages for patients and doctors during critical situations.

W. Lian et al[15] the research on Hierarchical Data Fusion of Intelligent Medical Monitoring
suggests that the future of the healthcare industry lies in implementing an intelligent

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telemedicine system based on the Internet of Things (IoT). This system combines virtual and
physical realms, creating a networked living environment for individuals. In China, the
distribution of medical resources is imbalanced, with major cities having abundant resources
and smaller cities lacking access. Implementing an intelligent telemedicine system can make
these resources accessible to patients in their local areas, optimizing hospital operations and
promoting hierarchical data construction within hospitals.

T. Vaiyapuri et al[16] presented an IoT-based fall detection system for smart homes,
designed to assist elderly and disabled individuals by promptly detecting falls to improve
their survival rates and provide necessary support. The system, termed IMEFD-ODCNN,
employs a deep convolutional neural network optimized for this purpose. It processes video
input from IoT devices through resizing, augmentation, and normalization. Feature extraction
is performed using the Squeeze Net model, optimized by salp swarm optimization (SSO) for
hyperparameter tuning. For classification of events into falls or nonfalls, a sparrow search
optimization algorithm (SSOA) combined with a variational autoencoder (VAE) is used.
Upon detecting a fall, alerts are sent to caregivers and hospital management through
smartphones. The model's effectiveness was tested on the UR fall detection dataset and the
multiple cameras fall dataset, where it achieved high accuracy rates of 99.76% and 99.57%
respectively, outperforming existing methods.

Taimoor et al[17]the healthcare landscape is being transformed by technology like AI, IoT,
and 5G, offering personalized care that considers individual health factors. However, current
approaches often focus on single health conditions, leading to inaccurate diagnoses and long-
term health issues. Healthcare 5.0 aims for fully autonomous personalized care that considers
the interplay of various health conditions. This paper analyzes comprehensive personalized
healthcare services (CPHS) in the context of the Healthcare Internet of Things (HIoT),
defining personalization, proposing a three-layer architecture for IoT-based healthcare
systems, addressing security vulnerabilities, and proposing a methodology for developing
reliable, resilient, and personalized healthcare services. This approach aims to create a future
where healthcare adapts to individual needs and considers the complex interplay of health
factors, ultimately leading to better long-term health outcomes.

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Barata et al[18] the Freestyle Free sensor is a low-cost continuous glucose monitoring (CGM)
solution for diabetic patients. It uses a near-field communication sensor connected to an
Internet of Things card to transmit data to the LibreMonitor mobile app. This allows patients
and caregivers to remotely track glucose levels, enhancing our understanding of diabetes.
The Free sensor and its integrated environment significantly reduce the financial burden
compared to existing market solutions. Comparing the system's glucose readinngs with
official Freestyle Libre software, the positive results indicate that the Free sensor and its
integrated environment offer a viable and affordable alternative for continuous glucose
monitoring of diabetic patients.

Iskander et al[19] the work Through computer simulations on a digital human model infected
with COVID-19, the researchers investigated the CPS's ability to detect lung damage.
Simulated infections as small as 0.9 cubic centimeters were detectable, and the CPS was
most effective in lungs without pre-existing conditions. These promising results suggest that
the CPS, a readily available and non-invasive tool, could potentially offer continuous
monitoring of COVID-19, allowing patients to track their own disease progression and
potentially reducing reliance on resource-intensive imaging tests. Furthermore, the CPS
could provide valuable data for healthcare professionals, enabling them to remotely monitor
patients, make informed decisions about treatment, and ultimately improve patient outcomes.
While further research is needed to validate these findings in real-world clinical settings, the
potential of the CPS as a low-cost, accessible, and continuous monitoring tool for COVID-19
is significant. This technology could revolutionize patient care, especially in resource-limited
settings, offering hope for improved management and outcomes during future pandemics or
in areas with limited medical infrastructure.

Yotha et al[20] new non-invasive system for monitoring hypoglycemia in diabetic patients
has been developed. The system uses three biosensors on a wristband to continuously track
pulse rate, skin humidity, and skin temperature variations. The collected data is then sent to a
website, where an algorithm assesses the risk of hypoglycemia. The system can be
categorized into three levels and displayed on a personal computer or smartphone app. The
system is non-invasive, eliminating the need for finger pricks, improving patient comfort and
compliance. It also provides real-time insights into the risk of hypoglycemia, allowing for
proactive intervention. The system also reduces the frequency of blood glucose checks and
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allows for remote access for improved telemedicine and care coordination. The system has
the potential to significantly improve diabetic patients' lives by reducing the risk of severe
hypoglycemia events and promoting better diabetes management.

Alla Rizk et al [21] the model considers both functional and non-functional requirements in
hospital management systems, focusing on IoT devices for data collection, transfer, and
analysis. Healthcare and hospitals are crucial sectors that require attention to SMART
management systems. IoT devices produce data and transfer it to cloud computing for storage
and analysis. However, challenges like security, privacy, device communication, and data
collection and management exist. A reference model for SMART hospital management
systems is being developed to achieve optimal performance.

Akbarzadeh et al [22] considered BLE[Bluetooth low energy] module, BLE indicates its
suitability for simple positioning systems, where accuracy is not a priority. Moreover , BLE-
based systems allow for low power consumption and low implementation cost. The
implemented system worked and provided the desired precision for a restricted set of tests,
the results show that the performance of the proposed system is better than a ranging-based
solution. Moreover, with some slight modifications, it can achieve a performance level like
Wi-Fi-based systems with lower power consumption. In addition, there is a possibility to
enhance the features of the implemented system to check the space occupancy and the
automatic adjustment of the environmental elements like temperature and light for better
energy efficiency use.

Rautaray [23] the research highlights the need for optimized data management algorithms in
smart healthcare systems due to population growth. Modern techniques like artificial
intelligence, IoT, and machine learning are essential for developing these services. AI-based
robots for surgery and medical imaging diagnoses are improving over time. IoT-based
temperature management systems and sensors are also being developed. Researchers are
increasingly interested in smart hospitals and cities, proposing various architectures to
contribute to this development. This paper focuses on AI and IoT-based smart hospital
systems and their role in modern healthcare growth.

Purnavardhan & [24] his study aims to create a computerized hospital management system
that enhances data management and employee efficiency. It includes modules for patient care,
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registration and admissions information, bills of admission and pharmaceutical payments,

and monitoring the pharmacy's medicine stock. The Waterfall Methodology paradigm was
used in the study. The project aims to automate the system through an AI platform,
collaborating software applications and AI structures. This system reduces errors and
improves efficiency, with easily adaptable icons on the web page for even the illiterate.

Kumar et al [25] the objective of this project is to develop a hospital management system
using java and SQL (structured query language). and create a cost effective. and more
efficient model It will also provide separate login for doctors, patients and admin where they
can check their details such as doctors can check time of their appointment with the patients,
patients can check the availability of the doctor, empty beds and many more. It will reduce
the chance of data loss by storing all hospital data records in computer and can have backup
of this data also. This study mainly focused on improving efficiency by avoiding human
errors, reduces the work of documentation and have better audit control.

S. ElHorbety et al [26] this paper shows the importance of Internet of things in health care
sector. As Iot is being used in every sector now this system uses Iot to built a smart hospital
management system. IoT devices produce different types of data and transfer them to the
cloud computing for storage and analysis. The system implements multidisciplinary systems.
That helps in the management of both collecting and organizing the data and designing.
Using Iot in System ensures features such as: access control, integrity, authentication,
confidentiality, network and system security. Iot makes the usage of cloud very easy so that
data transfer and storage is safe and fast.

Q. Batra et al [27] this paper shows the remarkable research done int the punjab region of
India. This paper tells basically answers three important questions (a) Degree of which HMS
has been adopted in hospitals of Punjab. (b) Barriers which are responsible for non-adoption
of HMS in hospitals.(c) Which frameworks and policies that can be offered to boost
implementation of HMS in hospitals. The paper shows a deep analysis on this topic and also
provides valuable solutions for the concerning questions.

Misa et al [28] this paper provides a great insight of an advance version of Hospital
Management System. The system uses modern languages such as PHP, Java script, Html and
My SQL. The system created provides many functionalities here such as room booking,
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appointment with doctors, online billing system etc. System created is very much robust as
shown in the proper SRS documentation provided in the paper. System is able to handle the
backend in a great way. The system provides remarkable services to the users, physicians and
receptionist that makes the system very much efficient.

Kumar et al [29] this paper provides details about a fast, secure and costefficient Hospital
Management System. The system has all the functionalities that are required for an ideal
HMS. The key or extra feature provided in the system is that the patient can download their
report from anywhere and at anytime. Patient needs to login inthe website and can access
his/her report easily. This makes the system very much efficientand quick as it provide great
feature for the patient to download report. In this fast world where each minute has its value,
this system helps users to save a lot of time.

Priyanthi et al [30] this paper provides us with great insight of a module that is well
structured and provides useful features for boosting the efficiency of the module. The system
is well organized and each sub-module is divided as per the need in a well regulated way.
The system additionally provides the appointment for lab tests online along with payment.
For multispecialty hospitals, the Health Board System is created to cover a variety of hospital
administrative procedures. System provides family lab test packs which are very cheap and
helpful. The system enhance productivity and work quality of the hospital.

B. S. O. O. E. C. M et al[31] this paper provides an overview of web-based health

management system which is very unique. In this all the the hospitals of the country are
linked together so that in case of emergency all the data of the patient can be easily retrieved.
Like prior medical condition, prescriptions and addictions. This system provides biometric
authentication and API in the coding framework. of the patient that makes this system very
secure and fruitful. The methodology used was Rapid Application Development (RAD). This
system is very much useful in the emergency cases as it provides additional functionalities
based on that.

N. A. Satrio et al [32] this paper is an excellent work that shows the system built to overcome
the problem of interoperability. Many hospital management system does face the problem of
interoperability. Thus blockchain is introduced it is a string that contains a list of transactions
that occur. System integrate the Hyperledger fabric network and then take the changed data
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using debezium connect and Kafka and inserted it into the blockchain. Using blockchain
along with these techniques enhances the system robustness, efficiency and security up to a
great extent.

O. Terzo et al [33] this paper shows an excellent system built known as HAMS. The system
not only provides the information regarding the assets in the hospital but also about the
availability of the hospital during any emergency. The information is not only provided to
internal staff but also to the first responders such as fire fighters etc. The system look after
the incident record to update the hospital availability. The HAMS has SAFECARE Cyber-
Physical Integrated Security System has prevents system from physical as well as cyber
threats. This system is really an advance version of HMS.

Wun-Hwa et al [34] the integration of RFID technology in healthcare is a growing area, with
potential to reduce costs and improve patient safety. A case study in Taiwan demonstrated
the successful integration of RFID in a Location-based Medicare Service project, partially
subsidized by the government, aimed at containing SARS. The project established an
infrastructure and platform for other applications, and the findings have implications for
developing RFID applications in healthcare organizations. The study highlights the
importance of collaboration, device management, data management, and value generation in
implementing RFID technology in healthcare.

Najeh et al [35] the hospital is a center of healthcare services that, nowadays, can be
considered as a very technological corporation. Then, the integration of information and
communication technology (ICT) in the healthcare sector has been one of the important areas
of research since last two decades. The system analysis allows us to describe exchanges of
information among the diverse components of a smart hospital system and to describe the
diverse parameters presented in the constitution of models. This is why the need for a system
approach has been presented. Starting from this study of smart hospital systems discussed in
this paper, work is in progress to extend general strategy for analysis and modeling of a smart
hospital system based on structured methods.

Fatma et al [36] medical equipment is crucial for diagnosing and treating medical problems.
A systemic approach is proposed to analyze various types of medical equipment, including
diagnostic, therapeutic, vital, monitors, and laboratory equipment. The methodology uses
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OOPP and SADT methods to analyze hospital equipment, with a case study of anesthesia
respirators. The hierarchical and structured models ensure effective communication between
system users. The study aims to improve maintenance procedures and spread the system
approach to all hospital processes and equipment, making evaluation and improvement more
efficient and easier.

R. Soman et al [37] the paper presents a novel architecture for scalable hospital information
systems, integrating Electronic Health Records sharing. This system is expected to improve
healthcare resource governance and service delivery across medical facilities. It requires
compliance with healthcare standards for interoperability. Future work includes aggregator
dashboards and interfaces for monitoring healthcare resources, integration with public health
registries for resource sharing, and the development of a Health Information Exchange.
Blockchain-based smart contracts can enhance security and transactional integrity.

Sunitha et al. [38] present a technique for learning-based security testing by rationale
programming on Web-based emergency clinic plan frameworks. This system conquers the
current common spotlight on utilitarian or non-practical necessities just as the necessary
elevated level of security information when performing non-useful security testing. The study
shows the technique’s viability in recognizing vulnerabilities in WBHMS, its incentive in
making programming framework progressively secure. This component forestalls URL, XSS,
and SQL infusion vulnerabilities at the customer side. The approach is useful to understand
the security risk in WBHMS.

Sadik Croock et al [39] this paper presents a web-based e-hospital management system,
following the steps of HMS roles. The system consists of a database and a webpage GUI,
with information stored in the database for use by doctors, patients, and other users. The
GUI-based webpages are designed to provide global accessibility and efficient links between
hospital departments. The system offers advantages such as easy access to data, unauthorized
user access, easy data insertion/updating/deletion, user-friendly interface, enhanced patient
care quality, time savings, decision-making support, and reduced medication errors. However,
barriers such as human and financial obstacles, lack of technical support, training costs, and
low acceptance level may hinder the system's evolution. The database system was built using

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MySQL, while webpages were designed using PHP, HTML, and CSS environments. The
system was tested in various case studies, demonstrating high performance and accuracy.

Abhishek Singha et al [40] the COVID-19 pandemic has led to a shortage of doctors and
healthcare personnel in rural areas, resulting in inadequate treatment. India's doctor-topatient
ratio is below WHO guidelines, with a ratio of 1:1445. Additionally, PPE kits are essential
for handling corona patients, but India still faces shortages. To address this issue, an IoT-
based system has been developed, which uses wearable devices to monitor patient's pulse
rate, temperature, and SpO2 levels. The data can be stored on cloud servers like Thingspeak
or Adafruit, allowing healthcare professionals to provide necessary care.

2.3 Summary :
This chapter presents a literature survey on the implementation of Smart Hospital
Management systems using IOT technology to address limited access to health care services
in rural and remote areas. The following major points are considered from literature survey.

❖ Various studies and systems are discussed, including those utilizing micro controllers,
sensors, wireless networks, and communication modules for real-time patient monitoring and
remote health care delivery.

❖ The proposed systems feature components such as alarm systems, drug delivery
mechanisms, and RFID technology for patient identification, and leverage deep learning
algorithms, ontology-based frameworks, and cloud based monitoring systems to enhance
accuracy and reliability of patient monitoring

❖ The survey emphasizes the challenges, motivations, and recommendations for further
research in the field of remote patient monitoring, highlighting the need for practical
solutions and improved medicine systems.

❖ The survey addresses how semantic web, reasoning rules, and gerontologist can improve
patient monitoring and health care systems, and explores the benefits of IOT based intelligent
medicine for hospital efficiency and medical standards.

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❖ The survey reviews remote monitoring systems, guiding future research, especially in
developing countries, and highlights challenges in disease telemonitoring, medical
applications, and technical infrastructure.

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Chapter 3

PROPOSED SYSTEM

3.1 Introduction:

Currently the system used for patient monitoring is the fixed monitoring system which can
be used only when the patient is on bed. The available systems are bigger in size and only fits
in the hospitals in ICU . Understanding previously created technologies and concepts is the
review's primary goal. Through SMS warnings and Alarms, all systems implemented thus far
provide patients help from doctors . There isn't a system in place to treat people, particularly
those who leave villages and Remote locations. The proposed system makes use of a variety
of sensors and a website to help those living in rural and isolated places. If a video call is
required, the system will establish the video connection if not, it will recommend medication
to address the patient's health issue.

All of the sensors in this system will collect data about the patient's health. This sensor is
more affordable, quicker, and small. It can be used to take the body temperature, heart rate,
and oxygen saturation level. The system continuously monitors the data gathered from the
patient's body, and if any problems are identified, it will provide the patients the proper
tablets or prescriptions. In situations where a patient needs medical support, the system will
initiate a video call so that doctors can provide remote assistance to the patients.

3.2 Advantages
Remote monitoring: Real-time remote monitoring via connected IOT devices and smart
alerts can diagnose illnesses, treat diseases and save lives in case of a medical emergency.

• Prevention: Smart sensors analyse health conditions, lifestyle choices and the environment
and recommend preventative measures, which will reduce the occurrence of diseases and
acute states.

• Improved treatment management: IOT devices help track the administration of drugs and
the response to the treatment and reduce medical error.

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• Improved health care management: Using IOT devices, health care authorities can get
valuable information about equipment and staff effectiveness and use it to suggest
innovations.

3.3 Workflow of the system

Data Acquisition

Various sensors (Pressure, Temperature, ECG, Heart Rate, and Oximeter) collect patient
health parameters.These sensors send real-time data to the NodeMCU microcontroller for
processing.

Data Processing & Communication

The NodeMCU processes the collected sensor data.Data is displayed on an LCD screen for
local monitoring. The I2C protocol ensures smooth communication between multiple
components.

IoT-Based Data Transmission

The processed data is transmitted via WiFi to cloud storage.The system uses Blynk Cloud for
remote monitoring and real-time analysis.

Remote Access & Alert System

Healthcare professionals and patients can access real-time health data through a mobile app
or web dashboard. In case of abnormal readings, the system triggers alerts/notifications to
doctors and caregivers.

Decision Making & Response

Doctors can analyze data trends and make informed decisions. Automated emergency
responses, such as calling an ambulance or alerting nearby hospitals, can be integrated.

Data Logging & Analytics

The system stores historical health data for trend analysis and predictive diagnostics. AI-
driven analytics can provide insights into patient health patterns and potential risks.

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3.4 Methodology:

Step 1: Initial Setup

As shown in circuit-diagram all the sensors are connected to the main body of the project that
is ESP32.All the power supply is connected through esp32 to all the components and GSM is
given power supply separately .On lcd screen its shows 3 indication on it like pulse rate,
temperature , ECG. There is range for each value up to which the system will consider as an
healthy value and beyond that value it will consider it as an abnormality and will send an
alert message to the patient doctor or to the close person.

Step 2: Sensor Interfacing

The system comprises of multiple sensors such as temperature sensor, oximeter , ECG sensor
and blood pressure sensor are interfaced with the ESP-WROOM-32 DEV KIT V1.Dev Kit
v1is open source development board , it contains WIFI , Bluetooth modules in single chip .
Power to the Esp32 Dev Kit v1 is supplied via the on-board USB Micro B connector or
directly via the “Vin” pin.

Step 3:Data logging

Collecting and storing the data over a period of time in order to analyze specific trends or to
record the data based on different conditions is very important in this system. The accurate
data which is time tagged collected from multiple sensors are independently data logged. The
range for each value is specified in the program so as for normal heart rate of a human body
lies between 60 to 100bpm beyond these values you get and alert message. Similar for all
other sensory system there is fixed range for it. It is an wireless system as it can send signal
from any part of the world.

Step 4: Database

A web database can be accessed from a local network or the internet instead of one that has
its data stored on a desktop or its attached storage. The data logged from each node is further
pushed to the web server with the help of internet connection through Wi-Fi and also the
same is stored in the cloud interface as a backup. Over a period of time the data is updated to
the server in real-time. The real-time data collected from multiple nodes are aggregated by
performing some mathematical operations to ensure accuracy.

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Step 5: Web development

The analyzing of the data collected from the sensors is important which makes it easier for
the doctor to understand the data. Through IOT (Internet of Things) devices and sensor
networks, this data is continuously collected and transmitted to a centralized database for
storage and analysis . Once collected, this wealth of data becomes accessible to health care
providers through a user-friendly web application. Doctors can seamlessly access patient
information in real-time during consultations, aiding in clinical decision-making and
treatment planning. The data is presented in visually intuitive formats, such as charts, graphs,
and dashboards, enabling quick interpretation and actionable insights. This integration of
sensor data into the consultation process enhances the efficiency and effectiveness of patient
care delivery.

3.5 Summary
The chapter discusses the methodology of the proposed system and it briefs about the
hardware and software control flow. It also provides some information about the data
acquisition process from multiple nodes. The work flow of the system is explained step by
step in this section. The software implementation process of the system is explained briefly .

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Chapter 4

HARDWARE REQUIREMENTS

4.1 Introduction
This chapter gives brief idea about various hardware and software tools/components used in
Design and Implementation of Smart hospital management system. The explanation to
various parts for the project implementation is given below.

4.2 Block Diagram

Figure 4.1 Block diagram of the proposed system

The Figure 4.1 shows the block diagram of the proposed model that represents a node for a
whole system. This node senses and accumulates all the data with the help of various sensors
interfaced with the NODE MCU.

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The proposed model of smart hospital management system majorly has the following
hardware components:

• NODE MCU

• Temperature Sensor – DS18B20 waterproof sensor

• Pulse and heart rate sensor – Oximeter Max30100/30102

• ECG Sensor – AD8232

4.3 NODE MCU

It's designed to make it easy to create Wi-Fi-enabled projects. It combines firmware and
hardware, allowing for rapid prototyping of IoT devices. These are Wi-Fi-enabled
microcontrollers from Espressif Systems. The NodeMCU utilizes these chips. The ESP8266
being the older version, and the ESP32 being the newer more powerful version. The
NodeMCU firmware is open-source and allows you to program the microcontroller. It was
originally based on the Lua scripting language, but it's now very commonly programmed
using the Arduino IDE with the ESP8266 or ESP32 core. Both the hardware and software
designs are open-source, which encourages community development and sharing. It is very
common to program a NodeMCU using the Arduino IDE.

NodeMCU was created shortly after the ESP8266 came out. On December 30,
2013, Espressif Systems began production of the ESP8266. NodeMCU started on 13 Oct
2014, when Hong committed the first file of nodemcu-firmware to GitHub. Two months later,
the project expanded to include an open-hardware platform when developer Huang R
committed the gerber file of an ESP8266 board, named devkit v0.9. Later that month, Tuan
PM ported MQTT client library from Contiki to the ESP8266 SoC platform, and committed
to NodeMCU project, then NodeMCU was able to support the MQTT IoT protocol, using
Lua to access the MQTT broker. Another important update was made on 30 Jan 2015, when
Devsaurus ported the u8glib to the NodeMCU project, enabling NodeMCU to easily drive
LCD, Screen, OLED, even VGA displays.

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Figure 4.2 NODE MCU

Fig 4.2 shows the outlook of NODE MCU module. There are different versions of
NodeMCU boards, so specifications may vary slightly. It is very important to check the
pinout of the specific nodeMCU board you are using, as pin numbering can be confusing.
The prototyping hardware typically used is a circuit board functioning as a dual in-line
package (DIP) which integrates a USB controller with a smaller surface-mounted board
containing the MCU and antenna. The choice of the DIP format allows for easy prototyping
on breadboards. The design was initially based on the ESP-12 module of the ESP8266, which
is a Wi-Fi SoC integrated with a Tensilica Xtensa LX106 core, widely used in IoT
applications (see related projects).

4.4 SENSORS

Sensor is an electronic device that is used to measures quantity or quality of a parameter that
it is desired to measure. There are mainly two types of sensors based on the type of output
the sensor gives, they are Analog sensors and Digital sensors.

❖ Temperature Sensor – DS18B20 waterproof sensor

❖ Pulse and heart rate sensor – Oximeter Max30100/30102

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❖ ECG Sensor – AD8232

4.5 Temperature Sensor

This sensor is a high precision temperature sensor. It is a digital sensor which uses single bus
to acknowledge and receive the temperature. The principle used by this series of temperature
sensor is that the resistance of the conductor decides the temperature in surrounding.

One must use One Wire protocol for acknowledge and receive the temperature data. The
sensor is encapsulated with waterproof high-quality stainless steel which helps to protect the
conductor from external factors and also avoids rusting of conductor. DSB18B20 takes
3.0V~5.5V to power up. It has 3 connections, red wire (VCC), white wire (Data) and black
wire (GND). It comes with the 9-12 bit select-able resolution. It has a high accuracy with +/-
0.5°C temperature ranging from -55°C to +125°C. The One Wire bus system uses a single
bus master to control one or more slave devices. The DS18B20 is always a slave. When there
is only one slave on the bus, the system is referred to as a “single-drop” system; the system is
“multi drop” if there are multiple slaves on the bus.

Fig 4.3 Temperature sensor

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Fig 4.3 shows the model of the temperature sensor which helps in detecting the temperature
and humidity of the human body.

Fig 4.4 Temperature and data relationship

Fig 4.4 shows the relationship between temperature and data. This table lists various
temperature values in degrees Celsius (°C) and includes both positive and negative
temperatures. Represents the digital equivalent of the temperature measurement. Uses a 16-
bit signed binary representation (Two’s complement format).

The DS18B20 output temperature data is calibrated in degrees Celsius, but Fahrenheit
applications require a lookup table or conversion routine. The data is stored as a 16-bit sign-
extended two's complement number in the temperature register, with sign bits indicating
positive or negative temperatures. If configured for 12-bit resolution, all bits in the register
contain valid data. For 11-bit resolution, bit 0 is undefined, while for 10-bit resolution, bits 1
and 0 are undefined, and for 9-bit resolution, bits 2, 1, and 0 are undefined. The DS18B20
uses Maxim's exclusive 1-Wire bus protocol, which requires a weak pull-up resistor due to its
connection to the bus via a 3-state or open-drain port.

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4.3 Pulse and heart rate sensor – Oximeter Max30100/30102

MAX30100 is a multipurpose sensor used for multiple applications. It is a heart rate

monitoring sensor along with a pulse oximeter. The sensor comprises two Light Emitting
Diodes, a photodetector, and a series of low noise signal processing devices to detect heart
rate and to perform pulse oximetry. The MAX30100 is an integrated pulse oximetry and
heartrate monitor sensor solution. It combines two LEDs, a photodetector, optimized optics,
and low-noise analog signal processing to detect pulse oximetry and heart-rate signals. The
MAX30100 operates from 1.8V and 3.3V power supplies and can be powered down through
software with negligible standby current, permitting the power supply to remain connected at
all times.

Some features corresponding to oximeter are: Complete Pulse Oximeter and Heart-Rate
Sensor Solution Simplifies Design

• Integrated LEDs, Photo Sensor, and High-Performance Analog Front -End

• Tiny 5.6mm x 2.8mm x 1.2mm 14-Pin Optically Enhanced System-in-Package Ultra-Low-

Power Operation Increases Battery Life for Wearable Devices

• Programmable Sample Rate and LED Current for Power Savings

• Ultra-Low Shutdown Current (0.7µA, type) Advanced Functionality Improves

Measurement Performance

• High SNR Provides Robust Motion Artifact Resilience

• Integrated Ambient Light Cancellation

• High Sample Rate Capability

• Fast Data Output Capability

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Fig 4.5 Oximeter Max30100/30102

Fig 4.5 shows the model of the oximeter Max30100/30102. MAX30100 is a seven pin sensor
module with an enabled I2C communication protocol to interact with the microcontroller.
The MAX30102 is fully adjustable through software registers, and the digital output data can
be stored in a 32-deep FIFO within the IC.

The FIFO allows the MAX30102 to be connected to a microcontroller or processor on a

shared bus, where the data is not being read continuously from the MAX30102’s registers.
As we know oxygen enters the lungs and then it gets is passed on into blood. The blood
carries oxygen to the various organs in our body. The main way oxygen is carried in our
blood is by means of hemoglobin. During a pulse oximetry reading, a small clamp-like
device is placed on a finger, earlobe, or toe.

Small beams of light pass through the blood in the finger, measuring the amount of oxygen.
It does this by measuring changes in light absorption in oxygenated or deoxygenated blood.
Oxygenated blood absorbs more infrared light and passes more red light while deoxygenated
blood absorbs red light and passes more infrared light. The light emitted gets absorbed by the
oxygenated blood and the rest of the light is reflected through the finger and falls over the
detector whose output data is then processed( I2C communication protocol) and read through
a microcontroller.

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Another important feature you may notice is that the MAX30100 sensor module consists of
two LDO regulators. This is because the MAX30100 IC requires 1.8V and the LEDs require
3.3V to function properly. With the addition of the voltage regulators, we can safely use
microcontrollers that use 5/3.3/1.8V level input/outputs. The heartbeat rate is the ratio of time
between two consecutive heartbeats. Similarly, when the human blood is circulated in the
human body then this blood is squeezed in capillary tissues. As a result, the volume of
capillary tissues is increased but this volume is decreased after each heartbeat.

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CHAPTER 5

SOFTWARE REQUIREMENTS
5.1 Introduction
This section provides an overview of the programming, source code editing, and
programmatic design processes involved in interfacing the NodeMcu to sensors and
presenting the sensor data in a web application. In order to guarantee that the system is
functional and satisfies requirements for quality, it also specifies how the system
programming design should be constructed. The following set of tasks illustrates the process
of creating software processes, algorithms, or graphical models.

5.2 Arduino IDE

The Arduino IDE (Integrated Development Environment) is essentially the software you use
to write, compile, and upload code to your Arduino board.t's a software application that
provides the tools necessary to program Arduino boards. It offers a text editor for writing
code, tools to compile that code, and a way to upload it to the Arduino hardware.

Code editing: You write your Arduino programs (called "sketches") in the IDE's text editor.

Compilation: The IDE translates your code into a language that the Arduino's microcontroller
can understand.

Uploading: The IDE transfers the compiled code from your computer to the Arduino board.

Serial communication: The IDE allows you to communicate with your Arduino board via the
serial monitor, which is useful for debugging and displaying data.

Text editor: Where you write your Arduino code.

Toolbar: Contains buttons for common actions like verifying, uploading, and opening the
serial monitor.

Message area: Displays feedback and error messages.

Console: Provides detailed information about the compilation and upload process.

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Fig 5.1: Code for compiling

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CHAPTER 6

EXPERIMENTAL RESULTS

6.1 Introduction

In this section the results are discussed for Advanced health care monitoring System. The
data is obtained from health sensors and the data is being stored in the IOT Cloud.

6.2 Website outcomes

Fig 6.1: Code for compiling

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Chapter 7

CONCLUSION AND FUTURE SCOPE

7.1 Conclusion

The project is known as Hospital management System. Most of the work are done through
computer system these days so, this application contains modules like patient accounts,
doctors accounts, as primary users. This will help patients to book an appointment without
visiting to hospital physically through online mode. This application contains various records
like doctor availability, medicine availability, medical history of patients. It is true that
Hospital management System have completely changed the health care system. It is flexible
we can make any changes by adding more features according to the new needs in health care
fields.

Then, the integration of information and communication technology (ICT) in the health care
sector has been one of the important areas of research since last two decades. The system
analysis allows us to describe exchanges of information among the diverse components of a
smart hospital system and to describe the diverse parameters presented in the constitution of
models. This is why the need for a system approach has been presented. Starting from this
study of smart hospital systems discussed in this study, work is in progress to extend general
strategy for analysis and modelling of a smart hospital system based on structured methods.

The website for online hospital management system was successfully designed and tested for
real time data. It can be easily used by the patients for requesting appointments and they can
also mention for their time preference. It will help to solve problems like queuing for hours
or having excessive crowd in hospitals The validation for hospitals and doctors are done for
giving safe and secure health care treatments from best doctors. This project is both hardware
and software - based project and can run on any platforms like PC, tabs, laptops, mobiles
which is connected to internet. Our project is helpful for patients and hospitals to solve their
problems or least minimize them so that the health care will be improve.

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7.2 Future scope

In the future, the proposed system can be made more useful by adding additional capabilities
that can be involved. This project in future may be more desirable by adding following
features:

➢ This system will be updated with many more features in future.

➢ This system will have inbuilt AI to enhance patient care.

➢ In future with increasing in digitalization of health care we should also have to address the
evolving cybersecurity challenges.

➢ Further developments include adding more modules to this application for more benefits.

➢ Future developments will focus on ensuring interoperability and standardization of real-

time patient monitoring systems, enabling seamless data exchange between different
healthcare providers and systems, thus improving care coordination and patient outcomes.

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