Wireless Personal Communications

https://doi.org/10.1007/s11277-020-07474-0

An Overview of Patient’s Health Status Monitoring System

Based on Internet of Things (IoT)

Kadhim Takleef Kadhim1 · Ali M. Alsahlany1 · Salim Muhsin Wadi1 ·

Hussein T. Kadhum1

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract
The Internet of Things (IoT) is a newly emerging term for the new generation of the Inter-
net which allows understanding between interconnected devices. IoT acts as an assistant
in healthcare and plays an extremely important role in wide scopes of medicinal services
observing applications. Through determining the pattern of parameters that are observed,
the character of the disease can be expected. Health specialists and technicians have devel-
oped a great system with low-cost healthcare monitoring for people suffering from many
diseases using common techniques such as wearable devices, wireless channels, and other
remote devices. Network-related sensors, either worn on the body or in living environ-
ments, collect rich information to assess the physical and mental state of the patient. This
work focuses on scanning the existing e-health (electronic healthcare) monitoring system
using integrated systems. The main goal of the e-health monitoring system is to offer the
patient a prescription automatically according to his or her condition. The doctor can check
patient health continuously without physical interaction. The study aims to explore the uses
of IoT applications in the medical sector, and its role in raising the level of medical care
services in health institutions. Also, the study will address the applications of IoT in the
medical field and the extent of its use to enrich traditional methods in various health fields
and to determine the extent of the ability of IoT to improve the quality of health services
provided. The study relies on a descriptive research approach through an analysis of the
literature published in this field. The results of the study refer to the application of IoT in
the health institutions, it will help to obtain accurate diagnoses for patients, which will
reflect on the quality of service provided to the patient. It will also reduce periodic patient
reviews to the hospital by relying on IoT applications for remote diagnosis. Also, an appli-
cation in health institutions will contribute to providing data correct for the diseases that
patients suffer from, and hence employing them in preparing scientific research to obtain
more accurate results. This paper introduces the review of the Internet-based healthcare
monitoring system (HCMS) and the general outlines on opportunities and challenges of the
patient’s Internet-based patient health monitoring system.

Keywords IoT · e-health · HCMS · Wearable devices · Remote diagnosis

* Kadhim Takleef Kadhim

kadhim_takleef@yahoo.com
Extended author information available on the last page of the article

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Fig. 1  The art framework/architecture for IoT-based smart and ubiquitous healthcare

1 Introduction

IoT can be applied in many different fields such as the most efficient industries [1], smart
home and cities [2–4], intelligent energy [5], vehicular to vehicular communications [6],
intelligent agriculture [7], smart connecting between university buildings [8], health care
[9], logistics [10], among many other areas. IoT enables different physical devices to com-
municate and exchange information with each other through the Internet [11]. Today, peo-
ple live in the age of the Internet where most of the devices around us connected with each
other to share information, so, the world became like a small city. Recently, with rapid
developments of several wireless technologies such as Wi-Fi, Bluetooth, 6LoWPAN, and
ZigBee led to make the process of connecting different devices to the Internet easy, simple
and cheap.
IoT consists of two parts, the first one is the Internet and the second is the Things. The
Internet is a global network of billions of computers and other electronic devices that ena-
ble its users to access any information and anyone else in the world across some standard
protocols. Things refer to any material object that may be concerned with connectivity. IoT
utilizes many technologies such as radio frequency identification (RFID), sensors, actua-
tors, smartphone, and cloud computing support, etc. By utilizing IoT, people can connect
anything to get service and access information about any object from anywhere and at any
time [12].
Inside the context of the healthcare monitoring system (HCMS) guide, the thought
of e-health [13] is a new approach to put in force an HCMS that based on electronic
approaches and communicate through the Internet. There are three elements represent
HCMS and e-health systems which are terminal users, smart sensing units and server
[14]. Figure 1 shows the art framework/architecture for IoT-based smart and ubiquitous
healthcare. Terminal users (client unit) may be technicians, specialists, medical caretakers,
patients and guardians that need access to the HCMS through acceptable authorizations by
using special devices, such as smartphones or special e-health devices [15]. Smart sensing
units (sensor unit) involve different sensitive sensors connected to the patient’s body for

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tracking health situation, recovering health records, and detectors of sensing data. These
units link to the Internet via any network to transfer recorded data to cloud unit (server). In
the e-healthy system, sensing units prefer to be portable and simple.
The convergence between technologies and the medical field via IoT technology has
a large impact on medicinal services and healthcare applications. IoT includes physical
devices along with embedding devices, sensors, software, and connectivity network to con-
struct such a system for information exchange [2]. The IoT integrates common domains
such as control systems, automation, embedded systems, and wireless sensor networks. The
pre-condition for implementing IoT systems is the Radio Frequency Identification (RFID).
The healthcare services applications have many features that supported by the IoT any-
where, anytime with everyone who uses any network and any service perfectly, produc-
ing smart healthcare services. Embedded or worn over the body networked sensors collect
statistical data about the individuals’ health [16]. Such data can create a positive change
with a high-quality amendment inside the healthcare scene. The recorded data processing
that conjunction with one of the new intelligent processing methods provides (a) accurate
assessment for patient’s situation (b) efficient medical management system, and (c) reduce
healthcare costs with improved results.
This paper presents a general overview of IoT in HCMS. IoT and HCMS comprise four
main elements are IoT medical equipments, information and communication technologies
in HCMS, Internet service, and management and processing medical data. Then discusses
applications of IoT and analysis of medical data in HCMS. Furthermore, the advantages of
IoT in the healthcare sector, IoT-related threats in HCMS, factors determining the future
of IoT in HCMS, IoT and the role of other interdisciplinary fields in boosting smart and
pervasive healthcare, Current IoT trends for 5G networks to revolutionize the patient’s
health witch divide into Ingestible Sensor and Digital Medicine. Furthermore it discusses
Challenges in the IoT Health Care Sector which comprise the following main elements:
Diversity management and device interoperability, Data integration scale, Data volume and
performance of data, The rapid development of applications, Data privacy, and Medical
experience required. Also, discusses Quality of Service (QoS) in IoT networks and Quality
of Experience (QoE) with the impact on the overall system performance. Finally discusses
media transmission which has revolutionized the healthcare sector and comprise five main
elements are Use research, Live online meeting, Faster communication and support, Imme-
diate contact of the patient.
The remainder of the paper is organized as follows: Sect. 2 discusses related works
and paper contribution. Section 3 presents IoT and HCMS that comprises four main
elements: A—IoT medical devices, B—information and communication technologies in
HCMS, C—Internet service, D—management and processing medical data. Section 4
shows the application of IoT in HCMS. The main interesting areas are: A—reduced
standby time in emergency rooms, B—personal health records, C—remote patient
health monitoring, D—doctors communicate with each other. Section 5 discusses IoT
and the analysis of medical data in HCMS. Section 6 explains the benefits of the IoT in
the healthcare sector. The main advantages of the IoT market trends in HCMS organi-
zation and understand its effective use: A—lower costs, B—improve treatment results,
C—enhance patient experience, D—improve disease management and dealing with it,
E—strengthen drug management, F—reduces errors. Section 7 discusses IoT-related
threats in HCMS. Section 8 mentions factors determining the future of IoT in HCMS
which are: A—sensors, B—rely on machine learning, and C—a regulatory environment.
Section 9 discusses IoT and the role of other interdisciplinary fields in boosting smart
and pervasive healthcare. Section 10 presents current IoT trends for 5G networks to

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revolutionize the patient’s health witch divide into Ingestible Sensor and Digital Medi-
cine. Section 11 shows the main challenges in the IoT Health Care Sector. Section 12
discusses Quality of Service (QoS) in IoT networks and Quality of Experience (QoE)
with the impact on the overall system performance. Section 13 discusses media trans-
mission. Finally, Sect. 14 include the conclusion.

2 Related Works and Paper Contribution

The research problem is the emergence of different applications of the web and the
development of multiple information technologies, the most prominent of which is IoT.
The tremendous development in technology has become new features for providing ser-
vices in various fields, including the medical field, as it will affect the level of medical
care provided to patients, the quality of diagnosis and the productivity of work in hos-
pitals. Exposure to this new technology and shedding light on it, in order to familiarize
workers with health institutions with it, and to examine the extent of its potential to
invest in health institutions and the obstacles that prevent their application. The general
objective is to explore the uses of IoT applications in the medical sector and its role in
raising the level of medical care services in health institutions. Sub-goals are to the dis-
closure of applications of IoT in the medical field, Finding out the possibility of using
IoT to enrich the traditional methods of health care, and knowing the extent of the inter-
net’s ability to improve services in health institutions.
A study conducted by Joel et al. [17] on the use of IoT in healthcare, the study exam-
ined many methods and ways to use IoT in the medical field and discussed a method-
ology for applying IoT in the medical field to help and facilitate the decision-making
process. Nipuni et al. in [18] mentioned in there study on healthcare that is dependent
on IoT and the confidentiality of the circulation of health care data in IoT applications.
In [19] the authors highlighted the internet of medical things, applications, benefits and
future difficulties in the field of healthcare. It touched on the great potential that IoT
applications will provide and identify the most prominent challenges in using the inter-
net of medical things applications and highlight some of the applications used in health
institutions. In a study, Shah et al. [20] on the Internet of medical things and big data in
health care, pointed out that IoT is an important aspect of the digital transformation in
health institutions. It also works to enhance health services and improve their quality.
The study also reached results, most notably the need to support and encourage the use
of wearable applications and devices to enable patient health tracking, data collection
and analysis needed remotely and the need for medical personnel to acquire the skills
needed to understand and analyze digital health data. Role of IoT in the healthcare field
and security issues have been discussed in [21]. They pointed out the necessity of inte-
grating IoT in the field of remote health monitoring. The most important finding of the
study mechanism is that there is a need to set standards for operating IoT in healthcare.
These studies came as an indication of the importance of employing applications and
uses of IoT in the health field because of its great role in promoting and developing
health services and the benefits that will be achieved from the application. The intel-
lectual product on the subject of the Internet is considered very scarce by being a mod-
ern topic. The research reached this result after many research operations conducted on
many general and specialized databases.

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An Overview of Patient’s Health Status Monitoring System Based…

1. Theoretical importance This study is not the first in the field of application of IoT in
medical care. But the study derives its theoretical importance by being reviewing the
latest topics in the field of technology, through which the applications of IoT in the
medical field will be identified and its role in improving services in health institutions
and this study expected to enriches intellectual results in the subject of IoT.
2. Medical significance It is hoped that the results of this study will benefit the authori-
ties concerned with the health sector and medical care in health institutions. This study
may contribute to develop techniques used in the medical sector and raise the quality of
services provided in health institutions.

3 IoT and HCMS

The structure of IoT and HCMS is described in this section. An IoT-based HCMS com-
prises four main elements: 1—IoT medical devices, 2—information and communication
technologies in HCMS, 3—Internet service, 4—management and processing medical data.
Figure 2 displays the basic structure of IoT and HCMS. The IoT components for HCMS are
described as follows.

3.1 IoT Medical Devices

Internet of medical things consists of a network of physical devices and embedded systems
that interact with electronics, software, sensors, and dynamic actuators that require wireless
connectivity. A wireless connection enables these objects to communicate and exchange
data. When the IoT is enhanced by dynamic sensors and actuators, technology will become
an integral part of physical electronic systems connected to the Internet. Figure 3 shows
the IoT model for HCMS architecture. The ability to connect embedded devices with CPU,

Fig. 2  Illustration of IoT and healthcare monitoring system

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Fig. 3  The IoT model for HCMS

architecture

memory and limited energy resources. These systems rely entirely on the inclusion of a
built-in system that should be noted that these embedded systems must have a mini-com-
puter or what it is called Microcontroller. Microcontroller works as the heart of IoT system.
Many accessories can be connected to these controllers depending on the function per-
formed by the system via general-purpose input/output (GPIO). IoT medical devices will
have the biggest part in IoT systems. These sensors are very important devices that plays
a role in providing life to the patient by sensing various parameters such as temperature,
pulse/heart rate, muscle, fingerprint, image, pressure, infrared, flow, strength, humidity,
thermistor and position [22–28]. Networked medical devices, healthcare devices, and their
applications are already creating an Internet of Medical things aimed to improve health
monitoring and preventive care. The main benefits that make IoT medical devices appropri-
ate for HCMS purposes are as follows. 1—memory, 2—power efficiency, 3—portability,
4—computational efficiency, 5—coverage, 6—durability, 7—cost, and 8—reliability [29].

3.2 Information and Communication Technologies in HCMS

The Information and communication technologies in HCMS plays an important role in the
successful of IoT systems in healthcare. Current Information and communication technolo-
gies in HCMS are categorized based on heterogeneous frequencies, communication stand-
ards, and transmission rates. The communication standards are divided into a long-range
and short-range communication standard. The communication heterogeneous frequencies
are divided into licensed and unlicensed frequencies. The transmission rates for transfer-
ring data for IoT devices depend on networking, sensor devices, and distribution topologies
[30].

3.2.1 Frequencies

The licensed frequencies that dedicated to the cellular network can provide more effi-
cient traffic management, a high level of security, high-quality service guarantees over
large areas, better reliability, lower infrastructure cost trousers, and operators are not at
the risk of interference and can control usage levels. As a result, licensed cellular IoT is
the only option for services that require significant levels of warranty. Licensed frequen-
cies promote sustainable long-range investment in networks where access and quality

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are ensured. The disadvantage of using licensed frequencies are subscription costs for
transfer data and the amount of power consumed in IoT devices [31]. On the contrary,
unlicensed frequencies take advantage of the industry science and medical frequency
band known as the Industrial scientific medical (ISM) band. Therefore, Unlicensed fre-
quencies are substantially less suitable for broadband IoT applications, especially those
requiring a higher quality of service levels. The disadvantages of using the unlicensed
frequencies are security problems, infrastructure cost and interference [29]. Table 1
shows the famous license and unlicensed frequency bands.

3.2.2 Communication Standards

There are many networking standards to support the physical infrastructure of the
IoT-based HCMS. Some of which have been listed in Table 1. It is classified into two
groups, short-range (which includes devices supporting near-field communication,
Z-Wave, Bluetooth and ZigBee systems, passive and active (RFID) systems), and long-
range communication standard (such as Sigfox, LoRa, and NB-IoT). The maximum
coverage distance for short-range communication technologies up to 100 m, while for
long-range communications technologies coverage extends to a distance of 10’s of kilo-
meters. Long-range communication technologies use low energy and can cover a large
area [32–35].

3.2.3 Transmission Rates for Transferring Data

The selection of communication technology is depended on IoT device applications. The

communication technology can represent nodes or networks that can use to IoT devices.
The distance covered by the nodes is very short with minimum data rate and power con-
sumption. Backhaul network can be used for very long distances, and also supports high
data rates. The bi-directional link is supported by some communication technologies.
This link permits the handshaking process to ensure data reliability, forward error cor-
rection, over-the-air firmware updates, encryption of data and allows devices to commu-
nicate with each other. In [36], the difference between Narrowband-IoT (NB-IoT) and
Long Range (LoRa) has advantages as well as disadvantages, so, the most appropriate
technology is highly dependent on application. Therefore, the topology type that will be
used to distribution IoT devices will determine the required communication technology
type. There are many kinds of topology as mesh topology, peer-to-peer or line topology,
star topology, tree topology, ring topology, and bus topology. The topology type will
specify the functions and roles for each IoT device. The role may be as an end device or
a personal area coordinator (PAN). Functions may be a reduced function device (RFD)
or a full function device (FFD). Different topologies types and type of roles played by
IoT device is shown in Fig. 4. End IoT devices may work either FFD or RFD while in
P2P type, PAN works like FFD and initiates communication. End devices who work like
FFD may have various associations while end devices who work an RFD may just inter-
face with one FFD and cannot go together with another RFD. Stars topology consists of
PAN which initiates and accepts communication from other devices. End devices only
allowed to establish communication with the PAN coordinator [37].

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 Table 1  The famous license and unlicensed frequency bands
Type Frequency bands Transmission distance Data rate Type of network Bi-direc-
tional

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link

License spectrum
802.11p 5.9 GHz <1 km WLAN Yes
802.11af 54–790 MHz 1 km 26.7–568.9 mbit/s
SigFox 868 or 902 MHz Rural: 30–50 km 100 bps (UL), 600 bps (DL) LPWA
Urban: 3–10 km
LoRaWAN Various, sub-GHz < 20 km 0.3–37.5 kbps
3GPP NB-IoT (cellular) 450 MHz–3.5 GHz < 35 km 250 kbps
Telensa 60 MHz, 200 MHz, 433 MHz, 1 km (Urban) 62.5 bps (UL), 500 bps (DL)
470 MHz, 868 MHz, 915 MHz
Ingenu/OnRamp 2.4 GHz 15 78 kbps (UL), 19.5 kbps (DL) No
3GPPLTE-MTC (Cat-M1) 1.4 MHz < 5 km 200 kbps WWLAN Yes
EC-GPRS GSM licensed bands < 5 km 240 kbps
WiMAX 2–11 GHz, 10–66 GHz Up to 50–80 km 70 Mbps
Unlicensed spectrum
802.11a/b/g/n/ac 2.4/5 GHz 6–50 m 2 Mbps–7 Gbps WLAN Yes
802.11ah Various sub-1 GHz 1000 m 78 Mbps
Bluetooth 2.4 GHz < 100 m 2–26 Mbps WPAN
ANT+ 2.4 GHz < 30 m
MiWi Sub – GHz, 2.4 GHz < 50 m 256
ZigBee 2.4 GHz < 1 km 250 kbps WHAN
Z-Wave 900 MHz < 100 m 100 kbps
Thread (6LoWPAN) 868/915/2450 MHz < 30 m 250 kbps
Enocean/(ISO/IEC14543-3-10) 900 MHz < 30 m 125kbps WHAN
WirelessHART​ 2.4 GHz < 228 m 250 kbps WFAN
WiMAX 2–11 GHz, 10–66 GHz Up to 50–80 km 70 Mbps WWAN
K. T. Kadhim et al.
 Table 1  (continued)
Type Frequency bands Transmission distance Data rate Type of network Bi-direc-
tional
link

NFC 13.56 MHz < 20 cm 424 kbit/s P2P No

An Overview of Patient’s Health Status Monitoring System Based…

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Fig. 4  a Peer-to-peer topology. b Star topology

3.3 Internet Service

Developments in wireless communications, mobile units, and provided services every-

where have smooth the way for Internet connectivity. Billions of connected devices make
up parts of the IoT, using embedded physical and software components to receive and
transmit data through using many communication protocols and IoT middleware. Examples
of IoT middleware are structured services architecture (SOA) [38, 39]. Users’ smartphones
may be used as a gateway to connect with the internet, connect via physical hardware in
the home that acts as a router or connects directly to the internet service provider at home.
The Internet is the core network layer where information is regularly sent to distributed
computing servers where is aggregated and analyzed together [40]. As a rule, we can get
to the outcomes with applications or programs on mobile phones or home PCs, and some
may be installed to refresh your cases on different social networks. IoT connectivity allows
data to be available anywhere and anytime. It is very important to perform a rigorous secu-
rity testing and examination, as well as, regular updating of software. Adopting industry
standards for producers and devices helps reduce security problems. Industrial businesses
support the integrity of internal information technology and establish authorization author-
ities to access aggregated data. SOA for the IoT consists of a multi-layered structure. Some
proposed IoT structure consists of the following layers: sensor, method access to network,
intermediate, and application layers.

3.4 Management and Processing Data

IoT medical devices need processing and storage capabilities to achieve basic processes,
analysis, and conversion of measuring data. IoT medical devices may process medical data
directly or transfer medical data to other devices such as gateways, servers, and cloud appli-
cations to collect and analyze. The terminal analysis involves analyzing data on the edge of
the network rather than the central location. The amount of medical data is big, rather than
transferring that data to the cloud server or data center for analysis. Medical data analysis
is almost real-time on the same devices or on a close gateway device (such as a router)
which connected with IoT medical devices directly. Edge-on medical data processing pro-
vides a chance to collect and filter medical data as it is collected, identifying medical data
that is the most important to send to the top [41, 42]. Eventually, edge analysis reduces

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initial processing and storage capacity requirements as well as reducing the burden on the
network [43]. More recently, fuzzy or blur computing is supported, as IoT devices and
gateways perform calculations and analytical operations to reduce access time for critical
applications, reduce cost, and enhance the quality of service (QoS) [44, 45]. The process-
ing and storage power employed by IoT application depends on the amount of processing
that is performed on the device itself versus the amount of processing by services or appli-
cations that use the data.

4 Application of IoT in HCMS

The applications of IoT in HCMS refer to the use of digital information and communica-
tion technologies, such as computers and mobile devices to manage people’s health. An
application of IoT in HCMS is also called e-health system or mobile HCMS and includes
various healthcare services. Figure 5 shows flow graph to illustrate possibilities offered by
IoT in HCMS. There are many applications of IoT in the medical field [46] such as smart
sensor control, transfer of patient data from away point to clinic or hospital [47], integra-
tion of medical devices and possibilities of data exchange among them [48], improve pro-
cedures doctors in provide care [49], promote interaction between patients and doctors
[50], manage and control different connected devices [23], the possibility of converting
IoT data into procedures by doctors, more accurate diagnosis of health problems and mon-
itoring patterns of (heart rate, temperature, blood pressure, sugar level in the body, and

Fig. 5  Flow graph to illustrate possibilities offered by IoT in HCMS

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digestive system) [51, 52], the possibility of transmit recorded data to the doctor for pro-
cessing and take suitable medical action, connected devices take vital data throughout the
day and transmitted wirelessly to doctor’s devices such as computers and smartphones, and
reduce medical expenses. There is tremendous potential for the Internet-connected HCMS
and intelligent medical devices for the well-being of people in general. HCMS use IoT in
several cases such as: A—reduced standby time in emergency rooms [53], B—personal
health records [54], C—remote patient health monitoring [55], D—doctors communicate
with each other [56].

4.1 Reduced Standby Time in Emergency Rooms

An electronic visit (e-visit) is electronic system gives patient ability to determine an

appointment with a doctor online without the need to present to a medical institution,
where you compose your inquiries or issue, generally as a piece of progressive inquiries.
The message will send to a medicinal services provider who will review it and replay an
answer. You may get a solution for a medication or a recommendation for a subsequent
visit, or any other counsel. All messages send are very secure, which means no person can
see or read them. Visits can take place directly through video chat. e-visits may save you
and your doctor time compared to visit at the clinic. It may be particularly useful for people
in rural areas or those who do not have easy transportation.

4.2 Personal Health Records

A personal health record (PHR) is a collection of information about people’s health that
specialists manage and maintain. If people have a vaccine record or a medical paper file,
people already have a basic personal health record. Personal health records electronic sys-
tems, known as PHR systems, can access to PHR at any time via a device that supports
Internet connectivity, for example, a computer, mobile phone or tablet. PHR can save per-
sonal life in an emergency, may quickly provide important information for paramedics,
such as the illness is being treated, medications are taking, allergies and how to communi-
cate with the family doctor.

4.3 Remote Patient Health Monitoring

Devices such as heartbeat monitors can link to the Internet or visual gadget that enables
up close and personal communication with medicinal services suppliers. Health tracking
at home can be especially useful for human beings with chronic illnesses, such as heart
disease, People those living in rural or isolated regions [57]. Also, an additional advan-
tage that is easy dealing with patients, few visits to the medical institution and easy get
the care and medical advice. The appearance of wearable monitors devices that are con-
nected via clinic networks or control center. It allows doctors to monitor sounds, images,
body movement and vital signs such as blood pressure, body temperature, heart rate, pulse,
body weight, and oxidized blood. Furthermore, they can monitor sleep patterns and physi-
cal activity.

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4.4 Doctors Communicate with Each Other

Doctors can depend on technology to reduce patients suffering and provide them
a much better take care. An example of this is often virtual counsel that enables medi-
cal care doctors to get a consultation from different specialists once they have questions
about a selected diagnosis or treatment. The specialist will answer the letter electroni-
cally or request to make a video conference with the doctor to discuss satiation face to
face if necessary. Sometimes, the specialist needs to see the patient’s case through visual
communication.

5 IoT and Data Analytics in HCMS

Important body functions are measured using the Internet of medical things. IoT medical
devices record body temperature, pulse rate (heart rate), blood pressure, respiratory rate,
and ECG and may include other measurements depending on diagnostic requirements and
expected disease. These continuous measurements produce big data. Big data benefits soci-
ety and makes this world a better place, here are its contributions and trends in HCMS [58].
IoT makes people able to predict and prevent disease for treating [59] and to provide
appropriate treatment for every person with the help of a huge amount of information col-
lected by their smartphone [60]. Data from various sources that collected through mobile
devices, such as smartphones [61], wearable technologies [62], low-cost diagnostic tools,
and wirelessly connected standards, that provide a more accurate picture of the health sta-
tus of people, and the treatments they receive. The overeating firm evidence of doctors and
healthcare providers were able to make better decisions.
Improvements in smartphone sensors and portable diagnostic tools will help health-
care providers intervene early. Knowing more information about health makes treatments
more specialized. Most medical experts agree that the digitization and sharing of medi-
cal records among general practitioners, hospitals and other sources can lead to significant
improvements in how health services are managed and disease management. At the same
time, data collection faces a major challenge amid concerns about people’s privacy. The
analysis of these data helps to discover correlations that were not very clear before, which
can refine the way of practicing medicine. Hospitals can also allocate resources more effi-
ciently and target smaller groups with tailored treatments. Analyzing data will allow for
the identification of any treatment that would be better, as live statistics would support the
wisdom and traditional experience of doctors. In general, many hospitals around the world
benefit from big data to reduce waiting time in emergency departments, track patient move-
ment, and increase the efficiency of medical management.

6 Benefits of the IoT in the Healthcare Sector

Today, the IoT is revolutionizing various industries as well as professional sectors. Nowa-
days with the efficiency of the IoT, new tools are provided to develop an integrated HCMS
that ensures patients are treated in the best possible way with a strong focus on improv-
ing treatment outcomes [63]. Consequently, the accumulation of multiple opportunities
that can be used by promoters and hospitals to optimize resources more effectiveness [64].

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Currently, the majority of hospitals benefit from IoT in medical examinations management
as well as temperature and humidity control within operating theaters. The main advan-
tages of the IoT market trends in HCMS organization and understand its effective use.

6.1 Lower Costs

Healthcare providers can benefit from the communication process associated with health-
care solutions [65]. This will help to monitor the patient directly all the time (in real-time),
and this will help reduce the number of unnecessary visits to the doctor [66]. In the hospi-
tal thus reducing expenses.

6.2 Improve Treatment Results

Healthcare solutions with the help of cloud computing or any other form of virtual infra-
structure give specialists in the medical field the ability to use real-time information to
make precise decisions. Also, it ensures that healthcare is provided in a timely and appro-
priate manner so that is accordingly updated treatment results [67].

6.3 Enhance Patient Experience

Linking the HCMS to IoT will make the delivery of services better for patients [68, 69].
This connection provides accuracy in terms of diagnosis, treatment outcomes improved
and timely intervention by the physicians, leading to responsible healthcare delivery that is
highly appreciated by patients.

6.4 Improve Disease Management and Dealing with It

It is important to note that when patients are monitored on a regular basis with real-time
data available, the treatment of diseases can be managed before the problem becomes more
serious [70].

6.5 Strengthen Pharmaceutical Management

According to statistics and analysis of the IoT industry. The development, management,
and improvement of medicines is seen as a major expense for the healthcare industry. With
the help of IoT processes and equipment, these costs can be better handled. By identifying
essential medicines, Prediction and quantification of medicines, develop a system to pur-
chase medicines, storage of essential medicines and distribution of medicines [71].

6.6 Reduces Errors

The presence of IoT in the healthcare sector provides an accurate set of data as well as
automated workflows [72]. Furthermore, it also maintains an examination of data-based
decisions to reduce errors, and reduce system costs. This is one of the bright benefits of IoT
enjoyed by this sector.

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7 IoT‑Related Threats in HCMS

The IoT is an effective part of the healthcare sector, but it also suffers from a number of
challenges due to the sensitive nature of health data. For example, when health data are
shared incorrectly, this health information has the potential to destroy the reputation of
the facility or even destroy the medical profession to some extent.

• When the patient is continuously monitored using devices that can be used at home,
the doctors responsible for monitoring these cases increase the demand for the data
center and increase the pressure on it along with the infrastructure of the facility as
well [73].
• The inability of medical services to share data with each other requires the availabil-
ity of a standard language as a solution to encourage the exchange and use informa-
tion as much as possible.
• Data security is another form of risk that is likely rising as the amount of data is
shared. The volume of data will also increase dramatically, thus increasing the need
to protect healthcare information from attackers [74].

8 Factors Determining the Future of IoT in HCMS

All things around us will have access to the Internet, including the human body. So
there are many factors that determine the future of IoT in HCMS [75]. The most impor-
tant factors are shown below.

8.1 Sensors

It is one of the most important factors that prove that the future of the IoT in HCMS is
full of achievements in the near future, sensors are one of the most important compo-
nents of the IoT. There are many companies that are now using millions of those devices
to collect data that help them in their work from different countries around the world.

8.2 Rely on Machine Learning

Machine learning is a subset of artificial intelligence (AI) that focuses on building

systems or improving its’ performance based on the data you consume [76]. Artifi-
cial intelligence is a comprehensive term that refers to systems or devices that mimic
human intelligence. For example, Microsoft and Google World spend a lot of money on
research and development of artificial intelligence and machine learning for large rea-
sons. These companies are looking at controlling the best data analytics.

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 K. T. Kadhim et al.

8.3 A Regulatory Environment

To attract many consumers, companies around the world must develop their infrastruc-
ture to secure technology and information. People must be convinced that their privacy
will be protected.

9 IoT and the Role of Other Interdisciplinary Fields in Boosting Smart

and Pervasive Healthcare

Every day, the healthcare sector is increasingly dependent on the IoT and another tech-
nology that supports the analysis of big data such as the cloud [77] to available quickly
access to services provided in healthcare, increase quality of service that provides to
patients and reducing time to obtain medical care. IoT and other supporting technolo-
gies are making high-quality healthcare provide to everyone in a timely manner. Sus-
tainable health care is the ability to detect early diseases, ensure prevention and the
provision of home care instead of the expensive clinical system. Satisfactory results and
increased patient satisfaction with the services provided by IoT technologies. Use IoT,
Cloud computing, and techniques of massive data analysis for the design and develop-
ment of intelligent health care systems with increased momentum on IoT [78] (Fig. 6
shows role of IoT, cloud and bid data analytics in smart health care).
In 2019, many companies had clear trends in the internet of medical things.

1. The wearable devices are on the market with wish main mobile phone technology pro-
viders to improve the wearable devices and added more health tracking features.
2. Surgical robots have become a common reality. The surgical prosthetics that are sup-
ported with artificial intelligence are considered more accurate than the doctor on many
occasions. There are many risks and restrictions on their use, but technology is in the
light of continuous development and look forward to becoming more prevalent in the
near future.

Fig. 6  Role of IoT, cloud and bid data analytics in smart health care

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An Overview of Patient’s Health Status Monitoring System Based…

3. The integration of other technologies such as artificial intelligence, machine learning,

augmented reality, blockchain, big data, and smart contracts with IoT. All this broadens
and increases the capabilities of the internet of medical things.

10 The Future Trends for 5G Networks and IoT Toward Revolutionizing

in the Health Care Systems

This section discusses the future uses of IoT to revolutionize patient health.

10.1 Ingestible Sensor

Ingestible sensor technology is provided as pills [79]. The pill consists of components
found in normal food, the sensor is activated only upon ingestion. This pill follows the time
set for taking the pills in order to track compliance with the drugs [80, 81]. The sensor is
operated by fluids in the patient’s body and battery or antenna is not required in the pill.
After a pill swallowed, the liquid chemical in the stomach operates the sensor and available
the power needed for the operation of the sensor. The sensor in the patient’s stomach avail-
able real-time data about the patient’s response to medications [82]. Hence pills are useful
to patients that take pills to chronic diseases [83, 84]. After activating the pill, the pill cre-
ates a unique number then sends it in a message. Besides the unique number, the consum-
able sensor transmits various parameters of the body to the user’s mobile device. This data
is sent from the mobile phone to a central portal where it is sent to a secure data server.
Any person who monitors the patient’s condition accessing the data sent to the server at
any time through the mobile phone and from anywhere. Figure 7 shows architecture of
ingestible sensor.

10.2 Digital Medicine

The medicine in digital medicine becomes itself digitally. Digital medicines are the same
as medicine currently present with only additional elements. A small sensor provides
parameters about the behavior of the medicine and the body’s response to the medicine

Fig. 7  Architecture of ingestible sensor

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 K. T. Kadhim et al.

while tracking many vital signs of the body [85–87]. The sensors activated only when the
acid in the stomach comes into contact. These medicines revolutionize the health care sec-
tor as a result of the ability to track vital signs of the body and report them throughout the
days of the week around the clock. Digital medicines not received food and drug adminis-
tration approval yet.

11 Challenges in the IoT Health Care Sector

A lot of challenges facing integrating IoT in health care [88]. Some of the challenges will
discuss in this section.

11.1 Diversity Management and Device Interoperability [89]

Using IoT in the field of medical care, measurement data are collected from different
devices, sensors, and instruments and send to the server linked on the Internet that contains
databases through the use of gateways. There are specific communication standards in the
network interface that exist between devices and gateways. The interface among gateways
and databases will also govern some of the regulations that impose the use of approved
certain standards and certifications. The main problem is the products of many vendors do
not meet these standards and certificates. This will lead to problems with interoperability
and an increase in system cost.

11.2 Data Integration

To build smart health applications generate an alert, it is sent to the doctor or person inter-
ested in the patient’s status if there is a defect in reading the vital signs of the patient. To
do this, data must be integrated from several sources [90, 91], as these sources include
many devices such as weighing scales, electrocardiography (ECG) monitors, blood pres-
sure monitors, glucose meters, heart rate monitors, fitness equipment, blood oxygen moni-
tor, social networks, imaging systems, and many another web resources. Collection data
from various sources is not yielding valid and meaningful results unless understood syntax,
structure, and meaning of the sentence in a way correct. A correct understanding can build
smart applications or a mixing process.

11.3 Scale, Data Volume, and Performance of Data [77]

Many devices are integrated with each other in the IoT system, and these devices provide
large amounts of data that will be absorbed, stored, and analyzed to extract meaningful
conclusions. The nature of the data that will be created will differ from one device to
another, for example, medical devices create image data while other devices create video
data, etc. This leads to classic problems of big data that make the infrastructure and plat-
forms not sufficient to deal with them. The performance requirements for applications and
devices will vary, which increases the data-processing mechanisms in the healthcare eco-
system for IoT.

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An Overview of Patient’s Health Status Monitoring System Based…

11.4 The Rapid Development of Applications [92]

With the emergence of new cases of use and business models, the construction of
advanced medical devices will begin. This leads to the fact that all applications and
components of programs require an ongoing upgrade by specialists with special tech-
nologies and features of the medical field. Many applications are developed using the
collection source model, and this is used by end-users in the application market (such
as a play store). Therefore, it is necessary to create platforms and technologies that can
maintain the collective pattern of consumption and application development.

11.5 Data Privacy [18]

Must protect the data collected from the medical devices from unauthorized access. Use
this medical data must be available only for the purposes that the patient gave permis-
sion. Must follow policies and processes ensure can access the patient’s medical data
are persons and applications authorized.

11.6 Medical Experience Required

It is important to ensure that data collected by medical equipment is interpreted cor-

rectly and that patients cannot diagnose themselves. Data diagnosis must be made using
an automatic decision support system, where qualified doctors must provide standards
for each patient’s condition.

12 Quality of Service (QoS) in IoT Networks and Quality of Experience

(QoE) with the Impact on the Overall System Performance [93–96]

Quality of Service (QoS) Communications networks require interconnection on a

local, regional and global scale to support the end-to-end transmission of information
and facilitate global telecommunications information and communication technology
services. Therefore, the quality of service applied in one network (or in one country)
affects the quality of service from end to end. This means that quality cannot be seen
only at the national or regional level, but must be taken into consideration from a global
perspective. Today, citizens around the world rely on telecommunications information
and communication technology to carry out daily activities in personal life or in the
business sector. This requires the implementation of some quality of service parameters.
Meeting quality of service standards is especially important for critical services, such
as direct automation, remote control, or intelligent transport systems. Generally, QoS
is directly related to planning and network design, in addition to monitoring and imple-
mentation, which is something especially important in a mobile network environment.
Thus, the basic skills required in the field of quality of service include the following:

1. Understanding quality of service (QoS), quality of experience (QoE) and network per-
formance in different fixed and mobile networks and for different types of services

13
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(real-time, non-real, critical and non-critical), and choosing the appropriate set of key
performance indicators.
2. Planning and design skills for fixed and mobile networks with service quality constraints,
Because it is always better to prevent degradation rather than facing the imposition of
QoS implementation by governments or regulatory bodies.
3. Skills to regulate the quality of service in relation to the telecom/ICT market and the
requirements for different groups of end-users, including pain will work from humans
as well as machines as peripherals.
4. Understanding network neutrality and implementing it in practice.
5. Skills to analyze and develop business models appropriate to services that require spe-
cific service quality guarantees, as well as traffic management techniques that telecom
operators apply to different types of traffic (such as voice, video, and various data).

13 Media Transmission has Revolutionized the Healthcare Sector

Social media has become one of the main technologies that help modern medical services
[97]. Today, hospitals and doctors are popular on social media. The proliferation of online
media in recent years has made healthcare providers more flexible than ever, allowing
them to better understand strategies, expand coverage, and help patients. Medical services,
especially hospitals, establish coordination through online channels, communicate with
patients, answer practice questions, conduct public outreach [98]. Let’s discuss five innova-
tive ways that will revolutionize the social media medical industry.

13.1 Use Research

Many health and medical care providers use social media platforms to learn about medical
devices, biotechnology, and medicines. For the same information, can search on the social
media sites of device manufacturers and pharmaceutical companies. Physicians can even
use online internet channels as a means of communicating with other professionals in the
field. Can read online journals in various disciplines to learn about their practices. Thanks
to the footprints of social media in various fields, this huge amount of information can ben-
efit humanity on a global scale [99]. Therefore, physicians, pharmaceutical organizations,
and emergency clinics use these platforms for the following reasons:

1. Share the results of the latest research.

2. Publication of work data, photos and results (with permission).
3. Educate consumers of medical services.
4. Marketing of new medical equipment.
5. Give patients updates that are relevant to the practice itself.
6. Distribute patient recommendations and inquiries

13.2 Source of Medical Awareness

In addition, because of the large amount of data available about various diseases and other
general health problems, there is great potential for using online web platforms as a source
of information. For example, if health professionals are aware of a future epidemic, they

13
An Overview of Patient’s Health Status Monitoring System Based…

may take preventative measures and pass it on to professionals. They can also provide rel-
evant training information to prevent the effects of misinformation and guidance. Sharing
news about health risks or epidemics is an effective way for WHO (World Health Organi-
zation) to use data in minutes. The healthcare industry also recognizes that this platform is
a tool for disseminating knowledge through a variety of techniques, such as sharing general
influenza information and tips on how to avoid the flu.

13.3 Live Online Meeting [100]

Twitter is following the online medical conference. The meeting coordinator creates tweets
and hashtags, and even patients need to link to these topics. The less the disease, the more
attention patients get. On the whole. This system disseminates knowledge over the network
and the symptoms currently being discussed directly and safely.

13.4 Faster Communication and Support [101]

Everyone knows how important regular checkups are for health. However, people also
neglect dating. With the help of this social media platform, healthcare organizations can
now use this channel to send messages and plan easily for individuals. It can also pro-
vide personalized reports tailored to individual needs. With the help of this information on
the Internet, the number of calls to the doctor’s appointment by patients is reduced, which
helps them to spend more time on important care. The online web platform aims to give
patients the opportunity to receive information and interact with others in real time.

13.5 Immediate Contact of the Patient [102]

In order to gather feedback and improve quality, health care providers use medical tools to
help the patient understand the overall effects of the drug and reach a common agreement
on new procedures in this area. Fast and real-time feedback, accessible through online
portals, allows healthcare professionals to check and adjust and modify patient responses.
Using the comments on this platform, WHO can assess the capabilities of other manag-
ers in this field. Using the comments on this platform, WHO can assess the capabilities
of other managers in this field. One of these models is: artificial intelligence, which helps
physicians classify patient care.
For example, AI-based solutions can facilitate large-scale operations by reading radio-
graphic images in rural areas, while radiologists are placing images in remote locations.
To diagnose the disease, can manage resources that include diagnosing and treating the
patient and planning the patient’s treatment. Artificial intelligence will eventually increase
the level of care and improve the relationship between doctors and patients.

14 Conclusion

Many health institutions are working to improve the level of services and raise the rate of
people’s satisfaction. The application of IoT represents one of the best steps that increase
the quality of the services provided by that institution. The successful health institution
will benefit from IoT applied in different areas such as raising the level of services through

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obtaining diagnoses and more accurate analysis. Also, saving time and money by reducing
periodic patient reviews of the hospital by relying on IoT applications in remote diagnosis.
The other aspects are to facilitate the practical research of doctors because some doctors
working in health institutions find difficult to carry out scientific research. IoT will provide
data to researchers in a manner structured and ready. IoT will encourage doctors to prepare
studies and research in the field of their specialties.

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Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and
institutional affiliations.

Kadhim Takleef Kadhim was born in Najaf, Iraq, in 1993. He received

the B.Sc. degree in the communication techniques engineering from
Al-Furat Al-Awsat Technical University, Iraq, in 2015, and Now a
master’s student in the communication techniques engineering in Al-
Furat Al-Awsat Technical University, Iraq. He is working as an exter-
nal lecturer in Communication Techniques Engineering Department,
Engineering Technical College/Najaf, Al-Furat Al-Awsat Technical
University. His research interests include wireless communication,
optical communication, data communications and Wi-Fi network
security.

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An Overview of Patient’s Health Status Monitoring System Based…

Ali M. Alsahlany was born in Najaf, Iraq, in 1984. He received the

B.Sc. degree in the communication techniques engineering from Al-
Furat Al-Awsat Technical University, Iraq, in 2006, and received mas-
ter’s degree in electrical engineering from Basrah University, Iraq, in
2012. He is working as a lecturer for information theory and advance
communication systems in Communication Techniques Engineering
Department, Engineering Technical College/Najaf, Al-Furat Al-Awsat
Technical University. He has many publications and a reviewer for
some refereed journals. His research interests include wireless commu-
nication, optical communication, data communications and Wi-Fi net-
work security.

Salim Muhsin Wadi was born in Najaf, Iraq, on April 26, 1980. He
received the B.Sc. degree in Communication Techniques Engineering
from Technical College, Najaf, Iraq, in 2002. He received the M.Sc.
degree in Communication Engineering from University of Technology,
Baghdad, Iraq, in 2005. He completed his Ph.D. from Electrical Elec-
tronic & System Engineering, Faculty of Engineering and Built Envi-
ronment, National University of Malaysia UKM. His main research
interests are Image processing, Encryption and Steganography, Image
Enhancement and IoT.

Hussein T. Kadhum Received the B.Sc. degree from the University of

Kufa, Al Najaf, Iraq, in 2010, the M.Sc. from University of Baghadad,
Baghdad, Iraq, in 2012, both in electrical engineering (Power and
Electrical Machine). Currently, he is Director of Technical Training
Division in IT and Computer center of AL Furat AL Awsat Technical
University. His main area of research interests are analysis and mode-
ling of power systems and distribution networks, power electronic and
motor drives, smart electrical network, PLC and SCADA system.

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 K. T. Kadhim et al.

Affiliations

Kadhim Takleef Kadhim1 · Ali M. Alsahlany1 · Salim Muhsin Wadi1 ·

Hussein T. Kadhum1
Ali M. Alsahlany
alialsahlany@atu.edu.iq
Salim Muhsin Wadi
coj.sal@atu.edu.iq
Hussein T. Kadhum
hutakleef@atu.edu.iq
1
Department of Communication Engineering, Engineering Technical College/Najaf, Al-Furat Al-
Awsat Technical University, Najaf, Iraq

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