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Indoor Patient Monitoring Through Wi-Fi and

Mobile Computing
Joao M. G. Duarte , Eduardo Cerqueira and Leandro A. Villas
Institute

of Computing, University of Campinas, Brazil


of Computer Science, Federal University of Para, Brazil
Email: j2duarte@lrc.ic.unicamp.br, cerqueira@ufpa.br and leandro@ic.unicamp.br
Dept.

AbstractThe developments in wireless sensor networks, mobile technology and cloud computing have been pushing forward
the concept of intelligent or smart cities, and each day smarter
infrastructures are being developed with the aim of enhancing
the well-being of citizens. These advances in technology can
provide considerable benets for the diverse components of smart
cities including smart health which can be seen as the facet
of smart cities dedicated to healthcare. A considerable defy
that stills requiring appropriate responses is the development
of mechanisms to detect health issues in patients from the
very beginning. In this work, we propose a novel solution for
indoor patient monitoring for medical purposes. The output of
our solution will consist of a report containing the patterns
of room occupation by the patient inside her/his home during
a certain period of time. This report will allow health care
professionals to detect changes on the behavior of the patient
that can be interpreted as early signs of any health related
issue. The proposed solution was implemented in an Android
smartphone and tested in a real scenario. To assess our solution,
400 measurements divided into 10 experiments were performed,
reaching a total of 391 correct detections which corresponds to
an average effectiveness of 97.75%.
keywords: Indoor monitoring; Smart health; Wi-Fi; Mobile
computing; Smartphone; Behavior; Patient

I. I NTRODUCTION
Nowadays, the concept of Intelligent Cities is getting increased importance due to the benets that the projects related
to it can provide for the enhancement of the wellbeing of
citizens. Areas such as transportation, government, health,
education and so one are considered key elds where the
development of smart infrastructures can have a signicant
positive impact. Therefore, a considerable number of projects
related to these elds are being currently developed [1]. In
general, wireless sensor networks play an important role on the
implementation of projects for intelligent cities, in providing
the ability to sense the environment and collect information in
an effective and low cost way. Mobile technology on the other
hand, brings the advantage of ubiquity which enables users
to have permanent access to data and services that were not
reachable on the go in the recent past [2]. In the health sector,
the employment of wireless sensor networks presents numerous advantages. These advantages include data collection and
communication with minimal intervention of patients, the use
of small devices to collect data which increases patients
acceptance, reduction of the amount of visits that patients
are required to perform to medical centers, reduction in costs
when compared with existing wired alternatives and scalability

advantages since the number of sensors may change as medical


needs also change, continuous monitoring of physiological and
environmental data and also providing long term proles of
patients history. Medical systems can then benet from sensor
networks in various areas such as monitoring of patients in
clinical settings, monitoring of chronic and elderly patients in
both home and elderly care centers and also in the collection
of long term databases of clinical data [3]. As the world
population is increasing, it is also aging. Even though this
aging phenomenon itself, is an obviousness that the health
sector is meeting signicant advances, it also carries new
issues to be faced since several health problems are directly
associated with the age of the patients [4] [5]. Due to the
consequences of this demographic distribution, mobile health
applications, with their main characteristic of continuous interaction with users, can potentially minimize the necessity
of face-to-face interactions thereby reducing in this way the
costs and enabling medical specialists to permanently access
patients records. Although mobile health applications already
can offer numerous advantages to patients, mobile health and
more generally smart health can go way beyond. Smart health
can provide extra services such as involving sensors and
wireless sensor networks in monitoring various conditions,
using mobile devices to access a variety of healthcare services,
supporting healthcare professionals to make decisions and
providing emergency care and empowering the elderly to make
suitable healthcare decisions in managing their daily activities
for independent living [6]. Following the previous ideas,
smart health includes tasks such as the monitoring of patients
and remote care, mobile decision making and emergency
interventions, mobile healthcare data access and mobile teleMedicine. Based on this we can say that smart health can
truly extend the reach of healthcare and improve the way that
healthcare services are delivered.
The lifestyle of people also has an increased importance in
their health status. As examples, people that are used to the
practice of sports and that normally have enough amount of
sleep are less likely to face certain health problems including
cardiovascular diseases, obesity, lipid disorders and so on
when compared to sedentary people and those who do not
have enough sleep [7]. Taking into account the stated above,
we believe that effective ways for monitoring patients can have
an important role in the task of providing each day smarter
health care procedures. In this context, this work proposes a

978-1-4799-8784-9/15/$31.00 2015 IEEE

Wi-Fi signal strength based mechanism for monitoring the patterns of room occupation by patients inside their home using
smartphone. This approach presents as advantage the fact that
no extra infrastructure is required for its implementation since
existing Wi-Fi infrastructure and patients smartphones are to
be used.
The output of this application is a report containing the
dates and time when the patient entered each of the rooms of
his home or went outside. This report is intended to be used
by health specialists to track possible changes in the behavior
of the patient that can potentiate the immediate uncovering of
health issues. For example, a patient that is staying more time
than the usual in the bedroom or that is staying inside at the
time when she/he was used to go outside for a walk may have
started experiencing any health problem even though disease
symptoms are not yet being perceived.
The remaining of this work is organized in the following
manner. Section 2 presents an analysis of related works, section 3 presents a background overview, section 4 describes our
proposed solution section 5 presents a performance analysis of
our solution, section 6 presents an overview of the applicability
of this proposal and nally section 7 presents the concluding
remarks including some insights on future works that can be
performed to enhance this proposal.
II. R ELATED W ORK
Most of the research on Wi-Fi-based indoor localization has
shown its feasibility and proved its range of efciency [8].
In [9] the BeWell application for Android smartphones is
presented. This application uses an architecture based on the
interaction between cloud computing servers and smartphones
to track activities that impact physical, social, and mental wellbeing namely, sleep, physical activity, and social interactions
to provide feedback to users about their health state. In [10],
the WiMoCA, a wireless body area network that uses nodes
mounted on different parts of the human body is presented. Accelerometers which are nowadays standard sensors embedded
in mobile phones are used for monitoring human movement. In
[11] a Mobile Presence Control Information System model for
iOS and Android devices is presented. This model relies on the
geolocation capabilities of personal mobile devices and Mobile
Web technology to obtain location information of employees in
a business infrastructure. This work also proposes a technique
for determining the exactness of the received location data. In
[12] a multimodal system for seamless surveillance of elderly
people in their living environment is presented. The system
combines information from visual ow-based image analysis,
collected from premise-embedded sensors specic for each
environment and accelerometer-based information collected
from a wearable sensor network for each individual. This
system relies on a polar histogram-based method of visual
pose recognition and on an algorithm for danger detection.
The work proposed in [13] analyzes Wi-Fi signal intensities
from access points to determine whether or not it is possible
to locate and determine the orientation of old-aged people
in an elderly home, based on the use of these type of

signal. Despite that Wi-Fi based indoor location mechanisms


have been catching the attention of a signicant number of
researchers, as far as we know, this is the rst proposal that
uses this technique to create a long term prole of the patients
behavior in terms of room occupation inside their home, for
posterior analysis by health specialists. On the other hand,
this proposal is also economically viable since it relies only
on existing resources.
III. BACKGROUND OVERVIEW
A. Wi-Fi
Usually, the main Wi-Fi components of Wi-Fi networks
include a router, the host devices and an access point. After
connecting to the access point, trafc from the client reaches
de Internet through the access point [14]. When a client wants
to connect to the Internet through Wi-Fi, it scans for available
Service Set Identiers (SSIDs) which are the names of the
networks. After getting the information, the client chooses
the network to connect and authenticate itself with the access
point. When the authentication is done, the user will get access
to the network. Wi-Fi networks can operate on either 2.4 GHz
frequencies or 5GHz frequencies and each channel occupies
a bandwidth of 20 MHz [14]. In indoor environments WiFi can be used to determine devices position based on the
assumption that each position has a unique interval of WiFi signal intensities expressed in dBm, and that those values
of intensity can be stored among with the description of the
specic positions, creating a prole of positions versus Wi-Fi
signal intensities [13]. The values of Wi-Fi intensity read at
each moment are then compared with the values stored and by
nding the closest match the actual position is then returned.
B. Mobile Computing
Mobile Computing enables users to access data and services through the use of wireless enabled devices, without
having to be connected to a xed physical link and it can
be characterized according to three main dimensions. The
mobile communication dimension refers to the protocols,
services, bandwidth and other aspects required to deal with
establishing and maintaining communications. The mobile
hardware dimension refers to the devices such as smartphones,
tablets, smartwatches and others that are able to access the
services of mobility. Mobile devices normally possess the fullduplex mode conguration which enables them to send and
receive signals permanently. The third dimension is mobile
software which refers to the operating systems that run in
mobile devices. These operating systems must incorporate
all aspects of wireless communications to ensure portability
[15]. The main advantage of mobile computing resides on its
location exibility since it allows users to access data and
services without being at specic locations. Current mobile
technologies include 3G networks, 4G networks (LTE), Global
Positioning System (GPS), WiMax and Near Field Communication (NFC) [16]. Despite that mobile computing presents
several advantages, when compared with its static counterparts
it presents some major limitations. Focusing on resources, the

limitations in weight, power and size penalize mobile devices


in terms of processor speed, memory size and storage capacity.
On the other hand mobile connectivity stills highly variable
in terms of performance and reliability in dependence of the
location. Mobile devices also still have to deal with concerns
of power consumption [15]. In order to mitigate the resources
constraints of mobile devices the concept of Mobile Cloud
Computing is recently gaining ground. Mobile Cloud Computing provides a way to efciently execute resource-intensive
components of mobile applications outside of the device in
a cloud-based computing, richer in terms of computational
resources [17].
IV. P ROPOSED S OLUTION
In this work we propose a mechanism for monitoring the
location of a patient inside her/his home during a certain
period of time. This mechanism will automatically generate
an occupation prole which will indicate each time that
the patient visited each room or went out of her/his house.
This occupation prole is intended to be used for medical
purposes by specialists. This proposal assumes that the sensor
used to detect Wi-Fi intensity is permanently carried by the
patient. Examples of possible alternatives could be a sensor
embedded in a smartwatch or a smartphone. In this work the
smartphone approach is used. Figure 1 shows the execution
workow of the proposed mechanism implemented as an
Android application.
While running, the application will use the values of SSID
and password previously stored to authenticate and get connected to the appropriated Wi-Fi network. After the connection
process, it will continuously sense the Wi-Fi signal intensities
every second and compare the value read with the ranges of
Wi-Fi intensity of each room of the patients house. If the
current read value ts in one of the known ranges, the patient
will be considered to be at the room with that specic range
of Wi-Fi signal intensities. On the other hand if the read Wi-Fi
signal intensity does not t into any of the known ranges, the
patient is considered to be outside of his home. Whenever the
patient moves from one room to a different one or to outside
of the house, a new entry is added to the prole output report.
This entry is formed by the identication of the place, the date
and the time at that specic instant. A new entry will only be
added to the prole output le when the location of the patient
in terms of rooms changes.
Algorithm 1 shows the main steps of the implementation of
the proposed mechanism.
V. P ERFORMANCE A NALYSIS
A. Methodology
The mechanism proposed in this work was implemented
in an Android smartphone running Android 4.1.2 operating
system and a small apartment was used for testing purposes.
This testing environment consisted of a bedroom, a bathroom,
a kitchen-living room and the outside room which represents
any location outside of the apartment. Using an application
based on the proposed algorithm, the range of Wi-Fi signal

Fig. 1. Execution workow of the proposed mechanism.

intensities at each room were previously measured and stored,


enabling the used android device to perform the comparisons
required by this mechanism. To assess the efciency of our
solution, a set of 10 experiments were carried out at different
time and dates. In order to perform the experiments, a set of
random points were selected inside each one of the rooms belonging to the used apartment. In this way, for each experiment
fteen points each were chosen from the bedroom and from
the kitchen and ve points were chosen from the bathroom.
Five outside points located near to the kitchen door were also
chosen to represent the exterior of the apartment.
B. Results
In general this proposed mechanism performed well with
some exceptions occurring on few points located at the boundaries between the bedroom and the bathroom and between the
bedroom and the kitchen room. In overall 400 measurements
were performed and the proposed mechanism was able to
correctly detect the location of the device 391 times which
corresponds to 97.75% of effectivity. Table 1 shows the results
of the experiments carried out.
Upon the completion of the experiments stated above, it was
possible to generate proles of occupation of each room by

Algorithm 1: Implementation of the proposed mechanism


1
2
3
4
5
6
7
8
9

Implementation():
path establishment for the output le
Wi- network authentication and connection
Timer conguration
Get Wi- Intensity
if roomChanged then
if intensity is in range 1 then
handle message 1
else
if intensity is in range 2 then
handle message 2

10
11
12

else
if intensity is in range 3 then
handle message 3

13
14
15

else
handle message 4

16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33

Handler(message):
Get System Date and Time
Create the output le if necessary
switch message do
case 1
Open output le
Append Room ID
Append System Date and Time
Close the le
.
.
.
case 4
Open output le
Append Room ID
Append System Date and Time
Close the le

TABLE I
R ESULTS OF THE E XPERIMENTS
Total of Saples
400

Saples per Room / Correct Result


Bedroom
Bathroom Kitchen
Outside
150 145 50 49
150 147 50 50
Overall Efciency=97.75%

the patient. Figure 2 shows an example of a prole generated


by monitoring a person using this mechanism during one hour
from the 06:09 pm to the 07:09 pm on March 6, 2015.

VI. A PPLICABILITY
The output prole generated by the implementation of this
mechanism allows medical specialists to determine the amount
of time spent at each room by the patient and also to gure
out at what time the patient visited each room. Correlating
this data with more information provided by the patient about
the kind of activities that she/he is used to perform at each
room, the heath care professional in charge, can infer the
activities that were performed by the patient during the time
of monitoring. According to the activities that were performed
during each day by the patient, the health care professional
can therefore, conclude about changes in the behavior of the
patient inside home.
VII. C ONCLUSION AND F UTURE W ORK
In this paper we proposed, implemented and analyzed the
performance and applicability of a Wi-Fi based mechanism
for indoor monitoring of patients for medical purposes. This
mechanism relies on a real-time continuous sensing algorithm
that uses the ranges of Wi-Fi signal intensities to determine the
location of a patient inside its home at each moment. Based
on the values read, a prole of room occupation is then build
providing information about each time that the patient visited
each room of his/her house or went outside. The information in
the generated prole will allow medical specialists to monitor
the day to day of patients and detect changes on the behavior
of the patient that could be interpreted as early signs of any
disease. Such a mechanism is very welcome since it presents
a preventive way of health service provision and yet does
not require extra infrastructure. After performing several tests
at different times and with different durations at the selected
place, we concluded that this mechanism was able to detect the
changes of rooms by the patient and generating the intended
prole of room occupation.
As future work, we plan to extend this mechanism with
the employment of other types of sensors such as accelerometers, gyroscope and magnetometer in order to provide more
information such as the orientation of the patient inside a room
and activities being performed, besides also including building
plans to provide visual feedback of the location of the patient.
We are also planning the implementation of this mechanism
in other types of devices such as smartwatches to allow the
assessment of its feasibility in different kinds of devices.
ACKNOWLEDGMENT
The authors would like to thank CAPES / CNPq Brazil for
the nancial support.
R EFERENCES

Fig. 2. Prole of room occupation by the patient

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