INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,
MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)
ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XIII, Issue VIII, August 2024
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Innovation of Remote Vital Signs Monitoring and Telemedicine
Systems Using Internet of Things for Rural Health Care
Zyrone Lance D.R. Alejandro., John Louie R. Caluminga., Patrick M. Feliciano and Kristian Carlo B. Victorio
Department of Electrical Engineering, Polytechnic University of the Philippines Sta. Mesa, Manila Philippines
DOI: https://doi.org/10.51583/IJLTEMAS.2024.130826
Received: 31 August 2024; Accepted: 13 September 2024; Published: 24 September 2024
Abstract: The emergence of the COVID 19 pandemic called the attention of the public to the challenges that the healthcare
system in the Philippines needs to overcome. Rural and remote areas that have geographical disadvantages were also affected due
to limited access to healthcare services during the implementation of lockdown in the country. This paper focuses on the
developed remote vital sign monitoring and telemedicine system called PaglauM. It is a device that measures a person’s heart and
pulse rate, blood oxygen saturation, body temperature, heart rhythm, and heart’s electrical activity and comes with an application
that can be used to monitor the user’s vitals and access telemedicine services. This study involved 30 participants for the testing
and evaluation of PaglauM compared to available medical devices. The results of the conducted test showed promising output in
delivering pre- diagnosis of health. With the use of PaglauM, rural areas that struggle in providing health care because of limited
health care facilities and geographical disadvantages can be helped by this cost-effective vital monitoring device that implements
the use of telemedicine, providing a way for rural areas to connect to tertiary hospitals regardless of their distance.
Keywords: Telemedicine, pre-diagnostic, remote patient monitoring, cost-effective.
I.
Introduction
COVID-19 virus is a viral infection that emerged in the Philippines in the year 2020, exposing the deficiencies in the Philippines’
healthcare system. Lockdowns, quarantine, and social distancing were implemented to help in controlling the spread of the virus.
To make up for the distance brought up by lockdowns, online medical methods such as telemedicine became popular.
Telemedicine paved the way for online health consultations, bridging patients and doctors amidst the COVID-19 lockdown. With
this transformative approach to healthcare, telemedicine provider Medgate, one of the leading telemedicine platforms in the
Philippines aside from Konsulta MD, saw an increase in teleconsultation in these platforms by 170-percent in 2020, which
delivered almost 70,000 virtual consultation services to patients across the country
[1]
.
Telemedicine lessens the need to travel far to the health centers for medical assessments, brought up by the insufficiency of
healthcare facilities and personnel to accommodate the needs of different patients, which are commonly experienced by some
places in remote and rural areas. In a data released by Statista
[2]
, tertiary healthcare is commonly found in urban areas, with a
total of 59 tertiary hospitals in the National Capital Region out of 119. It can then be said that most of the tertiary hospitals, having
medical expertise and equipment, that could accommodate the needs of patients are situated in urban areas.
The insufficiency of primary healthcare facilities has brought the patients being referred to a tertiary hospital where the type of
disease can be assessed or observed. Assessments include vital sign monitoring where parameters such as blood pressure, oxygen
saturation, temperature, and heart rate are collected and transmitted using sophisticated monitoring equipment, including wearable
sensors and integrated monitoring devices
[3]
. The monitoring of these vitals will help a medical professional assess a patient’s
well- being, as they provide essential information about your organs
[4]
.
Face-to-face checkups can measure the parameters of vital signs effectively. Being able to monitor vital signs regardless of the
distance is achievable and this process can be done using remote monitoring devices, but it is unaffordable for many as it comes
at an expensive price.
With that in mind, the researchers developed a device named PaglauM, a remote vital sign monitoring and telemedicine system,
which can be used by outpatients for them to be monitored by their doctor regardless of their location. The device developed
includes the following parameters: heart and pulse rate, blood oxygen saturation, body temperature, heart rhythm, and heart’s
electrical activity. In addition to that, it also has an application that can be used to provide parameters and to also conduct
teleconsultation with medical professionals, bridging the problem concerning the distance between both parties.
The development of PaglauM supports the Sustainable Development Goals (SDGs) 3 and 10 in the Philippines. The SDG 3 -
good health and well-being, is aligned to the goal of PaglauM which is to help improve access to excellent healthcare, especially
in rural regions, where gaps exist. Also, this study will help to achieve the SDG 10 – reduce Inequalities by allowing individuals
to have an early diagnosis of health issues, that could contribute to lowering healthcare gaps between urban and rural areas.
II.
Significance of the Study
The outcome of this study will ease the needed continuous monitoring procedure for health care, while maintaining the
confidentiality of the user’s health condition and the data that will be gathered by the system. Furthermore, the application of
INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,
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ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XIII, Issue VIII, August 2024
www.ijltemas.in Page 218
telemedicine will be able to help patients that have time availability and long distance to hospital constraints. Therefore, this study
will benefit aspects including:
Health and Safety as PaglauM will help improve the quality of healthcare in rural areas, making health consultation available
using telemedicine. This will help democratize vital signs monitoring and telemedicine systems, making it an effective way to
help protect the health and safety of people.
Social as it will also raise social awareness about health and safety by bringing easier telemedicine access to people. People will
have a better understanding of the condition of their health, giving them the knowledge they need to bring awareness and to
encourage them to maintain and improve their well-being. The device will also bring peace of mind to people as they gain a better
understanding of their health status, especially for elderly people and their loved ones.
Economic as the device will be able to help patients in pre-health diagnosis through vitals sign monitoring and telemedicine,
contributing to the assessment of their health concerns. Ethics as individuals will have the opportunity to assess their health
condition as this device has monitoring and telemedicine systems that can be used in early diagnosis, even if they are in the rural
or urban areas.
And lastly, Public Government as the development of PaglauM aims to democratize the remote monitoring of vital signs and
telemedicine systems. It will help improve the monitoring and tracking of common health conditions including heart-related
diseases, especially in rural areas.
The Problem
Rural Healthcare Unit’s insufficiency of medical equipment and professionals leads to patients being referred to tertiary hospitals.
The effect of it includes limited access to healthcare and an increasing number of heart-related diseases, hindering the
democratization of health care.
Scope and Limitations
The researchers developed a device named PaglauM, a remote vital sign monitoring and telemedicine system that provides data
parameters and health information to the user itself. It gives people a way to assess or remotely monitor their blood oxygen
saturation, body temperature, heart rhythm, heart and pulse rate, and heart’s electrical activity in a cost-effective manner. Sudden
health changes that can lead to emergencies can be better monitored with the help of this device, making it helpful in providing
continuous health care.
The prototype PaglauM is only tested to young adults, approximate ages of 18 to 26 years old, since the prototype is not
applicable for the use of all ages, considering that infants and toddlers, along with senior citizens have fragile bodies, in addition to
their smaller size and build. Moreover, the parameters that are measured by the prototype to assess the medical condition of the
user are only limited to the patient’s blood oxygen saturation, body temperature, heart and pulse rate, heart rhythm, and heart’s
electrical activity. These vitals can be monitored and recorded manually to remotely observe one's health condition at a cost-
effective manner.
The application of PaglauM is limited only to providing accessibility to the prototype’s operation and conducting telemedicin e.
Vital sign measurements of the patient can be recorded using the application, while telemedicine features include sending
recorded vital measurements to doctor, and teleconsultation that uses third- party application for audio and video conference. The
speed or strength of internet signal that could affect the telemedicine features of the system is not on the extent of this study.
Furthermore, the prototype is for pre-diagnosis and vital signs reading only and will not be intended to replace and compete with
the specification, design, and capabilities of high-end or much more expensive and accurate devices being used for admitted
patients in tertiary health care.
Lastly, the components, sensors, and other objects used by the researchers are commercially available materials at the time the
device of PaglauM is being developed. With that in mind, as technologies develop, further enhancements can then be done by the
future researchers of the prototype.
III.
Methodology
The researchers used a quantitative research approach in designing a cost-effective remote vital sign monitoring and telemedicine
system using internet of things for rural health care. The quantitative approach was employed to achieve the objectives of this
study, with its method that uses data and mathematical computations based on the results to assess the variables tested for the
study.
Comparison of PaglauM’s result to medical devices was done to measure the sensors in providing vital sign parameters of blood
oxygen saturation, body temperature, heart and pulse rate, heart rhythm, and heart’s electrical activity, a series of tests are
conducted. The study involves 30 participants from 4th year Electrical Engineering students at PUP College of Engineering. The
researchers performed vital sign checking on each of the participants to evaluate the prototype’s reliability and accuracy.
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Table 4: Percentage Difference Analysis Equations
Assessment of power consumption of the device was done with the use of INA219 component, which was interfaced with the
Raspberry Pi Pico core, while the telemedicine was evaluated according to the indicated basic requirements applicable to
telemedicine services mentioned in the telemedicine survey paper done by Ong, et.al (2023) in the Philippines.
IV. Analysis & Discussions
The test was conducted at Our Lady of Fatima University Antipolo Campus using medical devices and PaglauM device to acquire
the parameters of heart and pulse rate, blood oxygen saturation, body temperature, heart rhythm, and heart’s electrical activity.
Table 5: Comparison Of Blood Oxygen Saturation Test Result
Patient Number
Blood Oxygen Saturation (%)
Percent Difference
Pulse Oximeter
PaglauM
(%)
1
98
97
1.02
2
99
98
1.01
3
98
98
0.00
4
98
98
0.00
5
98
98
0.00
6
99
99
0.00
7
99
97
2.02
8
99
99
0.00
9
98
98
0.00
10
98
98
0.00
11
98
97
1.02
12
98
98
0.00
13
98
98
0.00
14
98
98
0.00
15
98
98
0.00
16
98
98
0.00
17
98
98
0.00
18
98
98
0.00
19
98
98
0.00
20
99
99
0.00
21
99
99
0.00
22
98
98
0.00
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23
98
98
0.00
24
99
99
0.00
25
99
97
2.02
26
94
96
2.13
27
98
98
0.00
28
98
98
0.00
29
99
99
0.00
30
99
99
0.00
Mean Difference
0.31
Table 6: Comparison Of Heart Rate Test Results
Patient
Heart Rate (BPM)
Number
Pulse Oximeter
PaglauM
1
73
72
2
67
67
3
78
78
4
98
96
5
89
89
6
94
94
7
80
79
8
70
65
9
85
81
10
78
80
11
76
75
12
69
71
13
84
84
14
87
87
15
69
72
16
103
102
17
76
76
18
63
65
19
88
74
20
80
66
21
80
80
22
71
84
23
86
86
24
74
79
25
77
69
26
78
78
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27
86
85
28
82
82
29
68
68
30
60
63
Mean Difference
The blood oxygen saturation and heart rate showed a mean difference of 0.31 percent and 3.56 percent from PaglauM results,
compared to a pulse oximeter
Table 7: Comparison of Body Temperature Test Results
Patient Number
Body Temperature (
o
C)
Percent Difference
Pulse Oximeter
PaglauM
(%)
1
36.4
36.4
0.00
2
36.7
36.7
0.00
3
36.2
36.2
0.00
4
36.3
36.3
0.00
5
36.0
36.1
0.28
6
36.6
36.6
0.00
7
35.6
35.5
0.28
8
35.3
35.5
0.57
9
36.4
36.4
0.00
10
35.9
36.0
0.28
11
35.4
35.7
0.85
12
36.2
36.3
0.28
13
36.7
36.7
0.00
14
36.3
36.3
0.00
15
35.9
35.9
0.00
16
35.7
35.7
0.00
17
35.7
36.0
0.84
18
36.4
36.4
0.00
19
36.2
36.2
0.00
20
36.9
36.9
0.00
21
35.8
35.8
0.00
22
35.5
35.5
0.00
23
36.9
36.9
0.00
24
36.6
36.6
0.00
25
36.6
36.6
0.00
26
35.6
35.5
0.28
27
35.7
35.5
0.56
28
36.2
36.2
0.00
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29
36.0
36.0
0.00
30
36.3
36.3
0.00
Mean Difference
0.14
The body temperature results from PaglauM showed 21 out of 30 readings matched results from thermometer, showing less than
1.0 percent difference.
Fig. 38 Electrocardiograph Result from PaglauM
Lastly, PaglauM’s electrocardiograph acquired 21 out of 30 readings assessed results. Among these, 15 matched the presence of
the PQRST sequence seen in the ECG machine’s readings, while the remaining 6 results showed a 20 percent difference as only 4
out of 5 waves appeared in the PaglauM’s readings. This electrocardiograph results from PaglauM acquired a 94.29 percent
accuracy, excluding the results that could not be assessed.
In terms of PaglauM’s reliability of operation, the run time of a fully charged battery of PaglauM, having a battery capacity of
2,000-mAh, discharging at an average current of
61.52 mA is estimated to last approximately 32.51 h as a power source. On the other hand, With the use of a 1.0-A charging pin,
PaglauM takes an approximately two hours to fully charge its battery with a capacity of 2,000-mAh.
Table 13: Paglaum’s Application Speed
PaglauM's Functions
Time Delay (s)
Android
Version 14
Android
Version 12
Android
Version 11
Android
Version 8
Average
Opening of App
1.33
1.30
1.65
9.16
3.36
Device Connecting to App
9.22
9.84
10.57
11.29
10.23
App to Zoom App
3.40
5.40
6.12
7.08
5.50
App to Google App
1.94
3.20
3.41
6.57
3.78
App to Teams App
1.68
2.20
2.77
3.94
2.65
The researchers also evaluated the telemedicine application of PaglauM. The system application was tested using four versions of
Android mobile phones. During the trials, the time to open the telemedicine application and display its homepage averaged 3.36 s.
Connecting the PaglauM device to the application averaged 10.23 s. Furthermore, the transition from PaglauM’s application to the
Zoom application averaged 5.50 s, 3.78 s to the Google Meet application, and 2.65 s to the MS Teams application.
Table 14: Ram Usage of Paglaum’s Telemedicine Application
RAM Usage (MB)
Android Version 14
Android Version 12
Android Version 11
Android Version 8
Average
48.00
8.90
10.50
5.60
Maximum
298.00
188.00
100.00
99.00
The telemedicine application averaged 5.60 MB to 48 MB, and a maximum of 99 MB to 298 MB among the four Android mobile
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phone versions. Overall, the telemedicine system of PaglauM demonstrated minimal usage across the measured modes compared
to the four versions of Android mobile phones.
V. Conclusion
The researchers, with the assistance of a medical practitioner who evaluated the results, concluded that PaglauM was reliable for
pre-diagnosing an individual’s vital parameters including blood oxygen saturation, body temperature, heart and pulse rate, and
heart rhythm and electrical activity. PaglauM consistently showed matched and nearly matched values, indicating its accuracy in
vital sign reading. Averaging a mean difference of 2.43 percent to the four parameters measured, PaglauM achieved an overall
accuracy of 97.57 percent. While further refinement to the design may have been necessary to acquire much more precise
measurements, the researchers’ findings suggested that PaglauM’s performance was promising in the pre- diagnosis of vital signs,
making it a valuable tool for early detection of health-related issues. The results on the electrical characteristics of PaglauM
demonstrated that the device operated efficiently, with minimal fluctuations in voltage, current, power, and shunt voltage.
Additionally, the charging and discharging of the device exhibited promising performance, indicating that the device could be
used for extended periods without the need of frequent recharging. This suggested that the device was well-designed and capable
of providing reliable and long- lasting functionality for its intended purposes.
The telemedicine-ready application of PaglauM, while functional, was not yet fully developed and has room for improvement.
The current features met the basic requirements, such as appearance of real-time vital sign reading and facilitating
teleconsultations. However, enhancements were needed to support additional functionalities, such as sending information via
email and text, conducting teleconsultation on the telemedicine application itself, and control of the PaglauM device during vital
sign reading. Overall, the application showed promise in fulfilling the essential needs of telemedicine services, but further
refinement and feature expansion will be necessary to optimize its effectiveness and user experience.
Lastly, the researchers proposed recommendations including enhancing the functionality of PaglauM by integrating additional
parameters that can be detected, measured, or analyzed by the vital sensors, providing more comprehensive vital sign checking,
considering replacement of the Raspberry Pi Pico W with a more advanced and capable board to optimize the functionality of the
device, allowing integration of a more robust system that can stimulate multiple vital sign monitoring of the PaglauM, enhancing
the system’s functionality by adding periodical reading mode, enabling automatic and scheduled vital sign checking for
individuals, and evaluating the ECG tracing results to medical device with equal number of leads.
The researchers also suggest using higher-grade wires, while also considering the cost-effectivity of the device, to minimize
grounding issues and inaccuracies in ECG results. The recommendation includes enhancing the functionality of application,
enhancing the design by developing a more compact, ergonomic, and streamlined housing and chassis to enhance portability and
accuracy of the measurements of vital parameters, making it a wearable wrist or arm device where the sensors are readily
positioned at the optimal places where vital signs are to be measured, and increasing the sample size to conduct beta testing.
Acknowledgement
Special thanks to Our Lady of Fatima University Antipolo, Dean Evangeline M. Teruel, Ms. Lara Marjorie Narinay Dellosa, Sir
Ruzhel M. Del Valle, Ms. Micah Loraine V. Arceo, Ms. Rian Paula D. Badilles and Sir Francis John O. Clavillas for the use of
their facilities, equipment, and assistance to the prototype testing and evaluation. The researchers also give special thanks to their
esteemed thesis advisor, Engr. Kristian Carlo Victorio, for his unwavering support, invaluable mentorship, and insightful
feedback. Lastly, the researchers also give special thanks to the research panelists, Engr. Clark Jhune Marmeto, Engr. Daniel P.
Durias, and Engr. Faustino Rural for their thoughtful guidance, constructive criticism, and support throughout the research
process.
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MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)
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www.ijltemas.in Page 224
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