5.4.3. Entity-Relationship Diagram

The various entities involved in the system’s operation are interrelated with each other in various relationships. The Entity-Relationship diagram, or the ER diagram shows this interrelationship and dependencies among the entities.

Each entity has its own set of attributes corresponding to it. In the figure, the entities are depicted in the rectangular containers and the attributes of those entities are shown in eclipses. The attributes used for each entity can vary in each individual usage of the system.

Unlike the attributes, the relationship between entities are rigid and cannot be changed foreachusage.Therelationshipsareshowninthediamondcontainers.Thelinesjoining the interrelated entities show the multiplicity of the depicted relation. For example; the patient and the doctor are related in many-to-many relationship, i.e. many doctors can treat many patients, and the patient and the health monitoring device are connected by one-to-one relationship, i.e. one patient is supposed to use one device belonging to him/her. The connecting lines show these varying relationships that can be, one-to-one, one-to-many or many-to many relationships.

The ER diagram is useful to understand the direct dependencies among each of the components comprising the designed system.

5.5. Programming Environment

We have used the Django development environment for the development of software for the device. Since Django is written in Python code, the setting up of the environment consisted of installing and setting up Python, Django, and a Database System. Since Django deals with web applications, we also needed a web server setup as well.

The major codes for the system’s software are designed in python language. The use of python programming language has enhanced the code readability of the software. As the language puts emphasis on the use of significant indentation, the code is understandable with its functionality clearly outlined within the codes. The manipulation of the data in the NodeMCU happens with the code provided in this language.

But the major objective of our project is to obtain the fetch data from a web server in realtime. So, only the use of a python based program was not sufficient. The real-time data fetching was achieved by the use of Ajax web development technique. The Asynchronous Javascript and XML, abbreviated as Ajax, is a set of web development techniques that uses various techniques in the client-side to create asynchronous web applications. Since the Ajax technology allows to send or receive data from a server asynchronously (in the background) without interfering with the display or the behavior of the existing page, it is possible to change the contents of the web page dynamically without having to reload the entirepage.Thismakes thewebinterface more user-friendlyand the systemmoreefficient.

The database of the designed system is managed with the help of SQL or Structured Query language. This relational database language allows us to extract a series of records with selection, sporting and computational criteria from the data table. The need to create, update or delete data relating to the system is also performed with this query language.

6. RESULTS

The output of the readings can be observed remotely over the internet in any electronic device by logging on to a specified IP address. The major objective of the project is to allow the caretakers or the health personnel involved with the patient to access the patient’s condition from a remote location. The output interface provides the viewer with information about vital parameters and the presence of a database allows the caretakers to observe the change in those parameters over time and generate useful deductions that can be used for taking decisions to benefit the patient.

6.1. Real Time Output Interface

The real time output interface allows the observer to view three of the patient’s key health parameters; Body Temperature, Heart Beat Rate and Oxygen Level in the blood. The observer who can either be the patient’s caretaker or the patient themselves can use any device to access the web and view the web page.

The readings of the temperature and heart rate is directly achieved from the server as provided by the node mcu whereas the oxygen level is calculated by the software on the basis of the aforementioned parameters. The temperature is presented in the Degree Fahrenheit unit, heart rate in terms of bpm(beats per minute) and the oxygen level in terms of percentage.

The data shown on the output interface is asynchronously accessed from the server and the change in the data is dynamically displayed in the web page. The observer logs on to a predetermined IP address corresponding to a specific health monitoring device where they are asked to provide their login credentials. Once entered and verified, the viewer is able to see the real-time temperature, heartbeat and the blood oxygen level of the patient.

As mentioned earlier, the temperature and the heartbeat reading is directly obtained from the sensors. Unlike these two readings, the blood oxygen level is a derived quantity that is based on the pulse rate and the body temperature of the patient. These vital health signs are interrelated to each other in any person’s body and thus can change simultaneously with change in any one of the parameters. The general values of these parameters are considered and the software is designed in such a way that the value of the blood oxygen level is determined by a series of comparisons between the values of heart rate and body temperature.

The table presented below is used as the reference by the software while calculating the oxygen level from pulse rate and temperature:

6.2. Database

The use of the database allows for a broad assessment of the readings that are taken by the device over a long period of time. A database is maintained to keep record of the readings of parameters and make use of them in future context if required.

The observer is able to access the database of the parameters for any specific patient in a tabular form. Data for each instant is available with its timestamp which allows to observe the trend of change in the health parameters being checked. Also, the system provides a functionality to allow the observers to print the data from the database. The print functionality is essential to allow the doctors or health professionals to obtain health readings of certain significant time spans in hard-copy form and take decisions in benefit of the patient.

A properly maintained database is vital for this system because the device is meant for the use of people with chronic medical illnesses. For such patients, the health parameters of one time instant is not enough to generate a complete assessment of the patient’s health condition. Thus a database is required to determine the trend in which the parameters are changing over a specified period of time.

The analysis of the data in the database is most important to examine the effects of medications provided to the patients and thus to determine if the medical actions taken for the patients are providing expected results or not. Database allows the doctors to understand the patient’s condition more thoroughly and take proper decisions regarding medications and other medical procedures if required. A properly arranged database containing large data from different patients can also be raw data that can be used for broader research purposes.

6.3. Exceptions to be Considered

There are certain exceptions to be considered when the patients or the health workers make use of the system that has been developed. It should be understood that the device focuses mainly on the examination of the health of differently-abled people with chronic conditions. So the usage of the device for other people might generate outputs that may not be consistent with the real values of the vital signs of such users.

The device does not use a separate sensor to measure the oxygen level in the patient’s blood. It has been mentioned that the Oxygen Level is calculated from the temperature and heart rate. So, the reading obtained for the blood oxygen level will be correct in most of the general conditions but may be incorrect for certain specific patients. If any person is a patient of some form of medical condition that affects the blood oxygen level without causing substantial disturbance in the body temperature or heart rate, then the device may show the oxygen level that will be different from the real value. It will not be wise to use this device for such patients as the readings might lead to false assessment of their health and cause unfortunate consequences.

Also the use of this device to measure the vital signs of athletes, heavy load workers or other similar people is not advisable. For such people the values of temperature and heart rate might depend on several other factors that cannot be evaluated under the scope of the prepared device.

Other several exceptions might arise that can be specific to individual patients. Such exceptions should be assessed and reasonably considered by the doctors and caretakers for the patients.

7. CONCLUSION AND FURTHER WORKS

The device designed to fulfill the specified objectives was able to carry out the intended functionality with appreciable accuracy. We were able to obtain the readings of heart beat and temperature and observe the data over the internet in real time. The major objective of making the use of the internet to view the data was successfully conducted.

7.1. Conclusion

The device that has been designed and prepared for this project has great potential to help the differently-abled people and their caretakers by allowing the basic health check-up facilities in their home with greatest of ease. The use of the Internet has opened the possibilities for involvement of any number of relatives, caretakers or health professionals at any given time. Patients will have higher chances of getting medical attention at the earliest hours whenever it is required. It should also be noted that the device is simple to use and is designed with a minimum number of components such that patients with severe limitations in physical movements may be able to operate with little to no support from others

7.2. Further Works

Even after successfully carrying out aforementioned functionalities, this device is not itself a complete product. There are numerous possibilities that can be explored to increase the scopeofuseforthedevicethathasbeen prepared.Increasingthe functionalityof thedevice by adding more sensors and increasing the accuracy of the system by using better sensors are the most basic activities that can be carried out to make the product better. Also, different functionalities can be added in the program itself to make better sense of the obtained data of health parameters.

It is also necessary to improve the security of the software and the internet channel, to make sure that the patients using the services will not lose the integrity of their private information. The database management can be improved to make it more readable and easy-to-follow. Over the long term, it can be essential to add features that can analyze data from various devices corresponding to different patients and determine if anyone requires the attention of the healthcare professionals and allocate the required resources with minimal human intervention.