Proceedings of the 3rd International Conference on E-Health and Bioengineering - EHB 2011,

24th-26th November, 2011, Iai, Romania

___________________________________________________________________________________________________________________

Telemedicine System for Remote Blood Pressure

and Heart Rate Monitoring
Cristian Rotariu1, Alexandru Pasarica1, Hariton Costin1, Felix Adochiei2 and Razvan Ciobotariu3
1

Faculty of Medical Bioengineering, Gr. T. Popa University of Medicine and Pharmacy, Iasi
Faculty of Electronics, Telecommunications and Information Technology, Gh. Asachi Technical University of Iasi
3
Faculty of Electrical Engineering, Gh. Asachi Technical University of Iasi
crotariu74@yahoo.com

Abstract In this paper we present the realization of a remote

blood pressure and heart rate monitoring system, based on
wireless devices, capable to measure and transmit patients
arterial blood pressure and heart rate. The use of the proposed
system is suitable for continuous long-time patient monitoring,
as a part of a diagnostic procedure. The patient can achieve
medical assistance of a chronic condition, or can be supervised
during recovery from an acute event or surgical procedure. We
use commercially available devices, low power microcontrollers
and RF transceivers that perform the measurements and
transmit them to the patient monitoring device. The patient
monitoring device, in form of a PDA that running a personal
heart monitor application, receives the blood pressure systolic
and diastolic values and heart rate, activates the alarms when
these values exceed the preset limits, and communicates
periodically to the central monitoring server by using WiFi or
GSM/GPRS connection. A graphical user interface running on
the central monitoring server for displaying the measurements
was developed. Power consumption by the used devices was also
minimized.
Keywords: telemedicine, remote monitoring, wireless devices,
blood pressure and heart rate.

I.

INTRODUCTION

In the last years, the demographic changes in European

societies became a global phenomenon, resulted from lower
fertility rates and higher life expectancy [1]. All countries in
Europe are experiencing an increasing health care demand
because of an ageing of their population and an increasing
number of people with chronic diseases. Also, chronic
diseases represent the major causes of death all over the
world.
Patient monitoring refers to the continuous observation of
repeating events of physiologic function to guide therapy or
to monitor the effectiveness of interventions. Historically,
these medical instruments are designed to be used by highly
trained personnel, in the intensive care units and operating
rooms of hospitals, and thus such instruments are not
applicable for home monitoring.
Successful trauma management requires accurate
monitoring of several important physiological parameters, so
that proper action can be taken to help maintain critical
functionality.
Telemedicine involves medical assistance from remote
locations, thus merging the latest telecommunication

technologies with medical science. This way, highly

professional medical care can be available to much more
patients.
Doctors can receive information that has a longer time span
than a patient's normal stay in a hospital and this information
has great long-term effects on home health care, including
reduced expenses for health care. Physicians also have more
accessibility to experts, allowing the physician to obtain
information on diseases and provide the best health care
available. Moreover, patients can thus save time, money and
comfort.
Wearable blood pressure monitoring devices allows to
continuous monitor changes in blood pressure and provides
feedback to help maintain an optimal heart status. If
integrated into telemedicine networks, these devices can even
alert medical personnel when parameters are outside the
limits. Long-term blood pressure monitoring devices can
measure the variations in blood pressure signals.
Also known as hypertension, high blood pressure is a
growing concern in our society. According to recent studies
the number of adults with high blood pressure has increased
in the last years. This fact is largely due to an overweight and
aging population and increase the risk of stroke, heart attack,
heart failure and kidney failure.
While the primary cause of hypertension is unknown, high
blood pressure is easy to detect, monitor and control.
Many people with high blood pressure measure their blood
pressure at home, in between visits to their doctor or nurse.
Some people may also be asked by their doctor or nurse to
take measurements at home for a short period of time to find
out whether they have high blood pressure or not.
The computer-assisted measurements involve unwieldy
wires between sensors and monitoring devices that are not
very comfortable for normal activity [2]. In order to avoid
this situation, we use wireless devices, based on low power
microcontrollers, having radio micro-transmitters and
allowing an autonomic movement of the subject.
Healthcare specialists can receive information regarding
patient condition that has a longer time span than a patient's
normal stay in a hospital and this information has great longterm effects on home health care, including reduced expenses
for health care. Physicians also have more accessibility to the

Proceedings of the 3rd International Conference on E-Health and Bioengineering - EHB 2011,
24th-26th November, 2011, Iai, Romania

___________________________________________________________________________________________________________________

healthcare specialists, allowing the physician to obtain

information on diseases and provide the best health care
available.
II.

MATHERIALS AND METHODS

The system architecture, represented in Figure 1, consists

of three main components: (1) a wireless blood pressure
monitor, attached on the chronic patient; (2) a Patient
Personal Server in form of a Personal Digital Assistant
(PDA), running a monitoring application which receives the
blood pressure systolic and diastolic values and heart rate,
activates the alarms when these values exceed the preset
limits, and communicates periodically to the central
monitoring server through the Internet by using WiFi or
GSM/GPRS connection; (3) a central medical server for
management of database related to registered patients,
receives and stores the data received from the Personal
Servers and is responsible for broadcasting medical records
and alarms to the users (patients physician, healthcare
specialist, ambulance center or hospital).

Fig. 1. Remote monitoring system network architecture

A. The Wireless Blood Pressure and Heart Rate Device

The wireless blood pressure (BP) and heart rate (HR)
device is realized by using a commercially available A&D
UA-767PC blood pressure monitor [3] (BPM) and a low
power microcontroller board (eZ430-RF2500 Figure 2).
The BPM takes simultaneous blood pressure and pulse rate
measurements and has the following technical specifications:
measurement range for BP: 20 - 280 mmHg, HR: 40 200bpm, accuracy measurement for BP: 3 mmHg or 2%
(whichever is greater) and HR: 5%. It includes a serial port
connection that facilitates bi-directional communication at
9600 kbps.

The method of measurement of the blood pressure used by

the UA-767PC is the oscillometric method. It is often used in
the automatic device for the measurement of the blood
pressure because of its excellent reliability. On the other
hand, it is less precise than the auscultatory (Korotkoff)
method, but many automatic devices measuring the blood
pressure during 24/48 hours use this measurement method.
The pulsations induced by the artery are different: when the
artery is compressed, no pulsation is received by the BPM,
then when the pressure decreases in the cuff, the artery starts
to emit pulsations: the pressure then measured on the device
defines the maximal blood pressure or systolic blood
pressure. During the pressure decrease in the cuff, the
oscillations will become increasingly significant, until
maximum amplitude of these oscillations defines the average
blood pressure.
The eZ430-RF2500 uses the MSP430F2274 [4] 16 bit
microcontroller, providing all the hardware and software for
the MSP430F2274 microcontroller, and Chipcon CC2500
2.4GHz wireless transceiver [5], designed for low-power
wireless applications. Operating on the 2.4 GHz unlicensed
industrial, scientific and medical (ISM) bands, the CC2500
provides extensive hardware support for packet handling, data
buffering, burst transmissions, authentication, clear channel
assessment and link quality. The radio transceiver is also
interfaced to the MSP430F2274 microcontroller by using the
serial peripheral interface and has 5m/10m range
indoors/outdoors.
The eZ430-RF2500 communicates with the BPM on this
serial link through a RS232 to serial transceiver to start the
reading process and receive the patients blood pressure and
heart rate readings. Once the readings are received, the
eZ430-RF2500 (configured as End Device) communicates
with the receiver (another eZ430-RF2500 configured as
Access Point) and transmits them to the patient personal
server. The eZ430-RF2500 is powered from BPM by four AA
alkaline batteries.
The UA-767PC blood pressure monitor and the ez430RF2500 (experimental device) are presented in the Figure 3.

Fig. 3. The UA-767PC blood pressure monitor and the ez430-RF2500

(prototype)
Fig. 2. The UA-767PC blood pressure monitor and the ez430-RF2500

Low power consumption is an important characteristic of

wireless devices. Low power consumption contributes not

Proceedings of the 3rd International Conference on E-Health and Bioengineering - EHB 2011,
24th-26th November, 2011, Iai, Romania

___________________________________________________________________________________________________________________

only to prolonged lifetime, but also to system miniaturization.

It is well known that the most power consumer component in
a wireless sensor is the wireless transceiver. Therefore, we
carefully chose a very low power transceiver that consumes
less than 21.2 mA in transmission mode (0 dBm output
power) and 17.0 mA in receiving mode (500 kBaud, input
above sensitivity limit).
In the Figure 4 it is represented the flowchart of software
working on MSP430F2274 microcontroller from the eZ430RF2500 module.
In this instance, eZ430-RF2500, after a START command,
wakes up to read data from the BPM and battery voltage and
communicates the data to PDA. Energy consumption by the
eZ430-RF2500 was minimized by sending it into a low power
sleep mode when it is not in use.

MSP430 Application UART. It also contains a low dropout

voltage regulator (TPS77301 from Texas Instruments) to
provide 3.3V to the eZ430-RF2500.
Wireless data transmission between the devices and PDA
may be performed by using Bluetooth or WiFi standard, but
they are more expensive, consume more power and are useful
for applications that require high bandwidth. The wireless
protocol used to transfer data from device to PDA was
SimpliciTi (from Texas Instruments). SimpliciTi is an opensource protocol for networks that typically contain battery
operated devices which require long battery life and low data
rate.
When an anomaly is detected in the measured blood
pressure and/or heart rate, the software application sends an
alarm to the central medical server.

Fig. 5. The Patient Personal Server (PDA)

C. The Central Medical Server and User Application

Fig. 4. The flowchart of software working on MSP430F2274 microcontroller

The communication with the BPM is in ASCII format and

it is described in [6].

The central medical server application was developed by

using the Microsoft Visual Studio 2008. The database is
based on SQL Server 2008 and contains relational tables.
In order to process the blood pressure and heart rate
measurements it was developed an interactive viewing and
analysis software for monitoring the patients blood pressure
and heart rate running on users computers (Figure 6).

B. The Patient Personal Server

The Patient Personal Server was implemented by means of
a PDA (HTC X7500) running Windows Mobile 5 as
operating system. The software working on PDA was written
by using C# from Microsoft Visual Studio 2008. The
software displays temporal waveform of received blood
pressure systolic and diastolic values and heart rate and the
status of the device (the battery voltage and distance of the
device from the PDA Figure 5). The distance is represented
in percent of 100 computed based on RSSI (received signal
strength indication measured on the power present in a
received radio signal).
The USB interface is realized by using a serial to USB
transceiver (FT232BL from Future Technology Devices
International) [7] and enables the eZ430-RF2500 to remotely
send and receive data through USB connection using the

Fig. 6. The User Application

The User Application, including the communication with

the central medical server, was developed to run on windows
based systems and was written by using the
LABWindowsCVI, National Instruments.

Proceedings of the 3rd International Conference on E-Health and Bioengineering - EHB 2011,
24th-26th November, 2011, Iai, Romania

___________________________________________________________________________________________________________________

While the server is running, the user can start a session

from anywhere in the Internet.
The main interface consists of a drawing area for
displaying the patients blood pressure and heart rate
(systolic, diastolic and pulse), a control area consisting of
various buttons and a displaying area for user-specific
information.
III.

RESULTS

A prototype system containing all described above has

been implemented and tested. Using patients connected to the
BPM we have successfully making measurements of blood
pressure and heart rate, forward the values to central medical
server through PDA. The measurements were performed with
the PDA connected to Internet by WiFi and GSM. In both
situations, the user connected to central server displays the
values correctly (equaled to the values displayed on the BPM
LCD display). The alerts sent to the user were also correctly
generated.
In order to analyze the current profile of the BPM
transmitter module, the hardware used is represented in the
Figure 7.

IV.

CONCLUSIONS

In this paper a prototype of a system for remote monitoring

of blood pressure and heart rate is presented. The system tried
to meet the diverse needs of users, minimizing cost and
maximizing extensibility and reliability.
Although blood pressure and heart rate monitors are used
only to collect data, it still remains the most used device. Data
processing and analysis are performed offline, making the
device impractical for continual monitoring and early
detection of medical disorders. Such devices had unwieldy
wires between the sensors and the monitoring device which
may limit the patient's activity and their comfort. For the
proposed system data recording and processing are performed
in real time.
The proposed system use devices with low power
consumption suitable for battery operation and high peak
performance.
The integrated system provides continuous medical care for
patients, through Internet network infrastructure.
Continuous and pervasive medical monitoring is now
available with the present of wireless healthcare systems and
telemedicine services.
ACKNOWLEDGMENT
This work was supported by a grant from the Romanian
Ministry of Education and Research, within PN_II
programme (www.cnmp.ro/Parteneriate), contract No. 11067/2007.

Fig. 7. BPM power supply test hardware

The largest contributor to current consumption is the

BPM. To calculate the average current consumption by the
BPM, we used the MATLAB to take the integral of the
voltage curve resulted an area under the curve of 12418mAs
(Figure 8). In this way, we obtain average_current =
(12418mAs / 1800s = 6.89mA). The time between
consecutive measurements was set at half hour.
To calculate the battery life expectancy of the BPM and
assuming that the four alkaline batteries still maintain a
2000mA*hr rating under the hypothetical condition in which
the batteries hold their voltage ideally and until their capacity
is exhausted (Figure 8), we obtain: hours_of_operation =
current_rating / average_current = 2000[mA*hrs] / 6.89[mA]
= 290[hrs] / 24[hrs/day] = 12[days].

Fig. 8. The current profile of BPM

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