Technological Solution to Optimize the Monitoring of CoViD-19

Symptoms in Seniors Patients in Lima

Sara Haro-Hoyo, Edgard Inga-Quillas and Willy Ugarte

Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru

Keywords:

CoViD19, Technological Solution, IoT, Monitoring, Patients.

Abstract:

The aim of the article is to present the implementation of a technological solution based on the use of wearable

that allows optimizing the monitoring process of elderly patients with CoViD19. This is a current big problem

since the pandemic has make a lot of issues emerge for elderly patients. For instance, since elder people are

more vulnerable for CoViD19, they require to avoid social contact or follow more strict rules for lockdowns.

This work addresses and applies aspects from the use of IoT for the monitoring of elderly patients, application

of technological models in real time, and the supervision of symptoms of CoViD19. Our results show the

feasibility of our approach.

1 INTRODUCTION

On January 30, 2020, the World Health Organization

(WHO) reported the existence of a total of 7,818 peo-

ple infected with CoViD19 worldwide, most of them

from China.

According to the Pan American Health Organiza-

tion (PAHO), the WHO declared China as very high

risk and the other countries as high.

Likewise, the WHO published the Strategic Pre-

paredness and Response Plan of the international

community, to help states with poor health systems

to protect themselves from the new virus.

More than 2.9 million people worldwide have died

from the new SARS-CoV-2 coronavirus and about

134.1 million infected.

It is worth mentioning that the country most af-

fected by 2021 is the United States with more than 31

million infections and 560,000 deaths; Brazil follows,

with over 13.2 million diagnosed and with 345,000

deaths; and India exceeds 13 million infected and

167,000 deaths.

According to the latest report from the Ministry

of Health of Peru (MINSA), as of September 2021,

199,727 deaths were registered in our country, where

the most affected province was Metropolitan Lima

with 81,389 deaths, with a 9.23% fatality rate of the

virus.

With these indicators, many countries are in a state

https://orcid.org/0000-0002-7510-618X

of health emergency due to this pandemic, hence the

need to ﬁnd technological solutions based on innova-

tion within the ﬁeld of medicine.

Hence, this article aims to contribute with a pro-

posal for improvement in the process of monitoring

patients with symptoms of this disease, as well as in

the recovery process of the patient infected with this

virus.

A precedent is the study of Remote health mon-

itoring of elderly through wearable sensors (Al-

Khafajiy et al., 2019), which focused on the design

and implementation of an intelligent health monitor-

ing system that can observe the elderly remotely.

The objective of this article is to present a techno-

logical solution based on 2 mobile applications:

• “CoViDSalud Paciente” and

• “CoViDSalud Atenci

on”

Seeking to optimally monitor the symptoms of

CoViD-19 in elderly patients in Metropolitan Lima.

Therefore, the main matrix of the technological

solution is to have a mobile application that can be

linked to a “wearable” device; to obtain constant con-

trol and monitoring of the patient.

This application presents a friendly interface; in

other words, it is easy to use for the target audience,

who are older people, who present speciﬁc and dis-

tinctive needs, as well as signiﬁcant demands regard-

ing the use of ICTs.

The development of this APP contributes as a data

control and monitoring tool that can refer to a possi-

Haro-Hoyo, S., Inga-Quillas, E. and Ugarte, W.

Technological Solution to Optimize the Monitoring of CoViD-19 Symptoms in Seniors Patients in Lima.

DOI: 10.5220/0011034400003188

In Proceedings of the 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2022), pages 17-25

ISBN: 978-989-758-566-1; ISSN: 2184-4984

ble CoViD19 alert; o provide support in the process

of a patient who has already been diagnosed and that

these can serve as an accurate reference for the doc-

tor and thus also contribute to the recovery process of

the patient throughout their process from beginning to

end of the disease.

• We analyze the main technological tools that

allow the development of the solution to opti-

mize the process of monitoring the symptoms of

CoViD19 in elderly patients.

• We validate the solution of the technological

model proposed in elderly patients through the use

of wearable.

• We propose a business continuity plan for the

implementation of the technological solution for

monitoring the symptoms of CoViD19 in elderly

patients.

This paper is organized as follows. In section 2, we

will describe the differences and comparisons with

other works about the evaluation of the level of de-

pression; in section 3 we will address the key con-

cept for the core of our approach in the evaluation

of depression level with facial and voice analysis and

the aggregated value of the our work according to the

evaluation of the level of depression. Subsequently, in

section 4 we will present the validation of the techno-

logical model functionalities in a simulated scenario.

Finally, in section 5 we will specify our main con-

clusions and results of the ﬁnished application.

2 RELATED

WORKS/DISCUSSION

For the development of the proposed technological

solution, 2 mobile applications were implemented

that are linked to a “wearable” device to obtain

constant control and monitoring of the patient with

CoViD19.

For this, an analysis of the state of the art was car-

ried out, selecting its most relevant scientiﬁc articles:

In the paper (Mohammadzadeh et al., 2020), the

author achieved the optimization in the informa-

tion reporting processes of the main symptoms of

CoViD19, so that it serves as part of the process of

studies considered in possible diagnoses.

What differs from our paper is that we will con-

sider four measurement indicators, temperature, heart

rate, sleep status and blood saturation.

In the same way, in the paper (de Morais Bar-

roca Filho et al., 2021), the authors manage to demon-

strate the need for an intelligent diagnosis and mon-

itoring of infected patients to reduce hospital care,

since they are the most vulnerable people, and this

could have great consequences.

The objective of this research is to present a plat-

form designed for constant monitoring of patients in

critical condition, using portable sensors to monitor

patients infected with coronavirus.

What sets us apart from this paper is that we not

only rely on monitoring, but we also provide virtual

medical assistance to those who use our application.

Another study that follows the same line of re-

search is the paper (Rathee et al., 2021), which delves

into the 2 studies already mentioned, since it explains

the importance of the use of AI in the health sector,

mainly, in medical systems, which can be very use-

ful to automate and remotely quantify CoViD19 pa-

tients and improve recognition of infected patients in

the early stages of contagion.

What differentiates us from this paper is that they

are based on the ﬁrst stages of contagion, however, we

already work with patients infected with CoViD-19,

providing them with continuous monitoring, medical

and laboratory assistance from day one.

Hence, when we are faced with the inexplicable

situation of a pandemic that has not yet been over-

come, the motivation of the researchers of the pa-

per (He et al., 2021) is observed, to propose exten-

sive analyzes and evaluations on the technological so-

lutions that can help in the ﬁght against the expan-

sion of CoViD-19, and thus continue to inspire other

researchers to continue making their contributions to

mitigate the damages of the pandemic.

What differentiates us from this paper is that we

already apply a solution to CoViD-19 patients mon-

itoring the main symptoms and there will also be a

caregiver who will also follow the steps of a respec-

tive patient.

However, one of the most vulnerable groups and

that suffered high mortality rates were the elderly,

therefore, in paper (Gordon et al., 2020), it refers to

the importance of constant monitoring with the el-

derly, since they are more vulnerable due to the pos-

sible congenital diseases, or those already developed

by age.

Therefore, and according to the positions, it is vi-

tally important to interconnect with the integrated sys-

tems developed to combat CoViD19.

Compared to this paper, our solution implements

an alert system to our elderly patients that is sent both

to the patient, caregiver, and GP.

ICT4AWE 2022 - 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health

Figure 1: Remote Monitoring Validation Engineering System (ReMoVES) Architecture (Trombini et al., 2021).

3 TECHNOLOGICAL SOLUTION

3.1 Preliminary Concepts

In this section, the main concepts involved in our re-

search will be developed.

We propose that, for each concept, there is a def-

inition and a respective example based on a review

of the literature on depressive disorder and facial and

voice recognition.

Deﬁnition 1 (Use of IoT technologies (Blas et al.,

2021; Trombini et al., 2021; de Morais Barroca Filho

et al., 2021; Rathee et al., 2021; Vedaei et al., 2020)).

The concept of IoT refers to a digital interconnection

of everyday objects with the internet. It is the internet

connection more with objects than with people.

According to Forbes, with the appearance of

CoViD19, at the beginning of 2020, thermometers be-

gan to be used, which were connected by a 5G net-

work, such as smart rings and / or bracelets that had

the function of collecting data from patients such as

the blood oxygen level and heart rate (Milenkovic,

2020).

Example 1. In (Trombini et al., 2021), the research,

presents a system based on IoT that provides us with

a program where the patient can perform his totally

personalized rehabilitation and is reviewed by a pro-

fessional to monitor the performance and efﬁciency

of workouts from any device. This work used a Re-

MoVES architecture which has 4 layers as shown in

Fig. 1:

3.1.1 Wearable Sensors

Advanced technology to ”carry”, mobility is its main

characteristic and the IoT the basis of its approach,

since sensors allow data to be constantly collected and

transmitted to different devices, accessories, and gar-

ments.

While it might seem like most wearables are worn

on the wrist, there are devices designed to be worn

almost anywhere on the body.

For this reason, in addition to bracelets, wearables

can be found in rings, necklaces, headbands and even

shoe inserts with advanced functions (Motti, 2020).

According to Filho (de Morais Barroca Filho

et al., 2021), an analysis of the various previous stud-

ies for the spread of CoViD19 based on IoT technolo-

gies, cloud computing and mobile applications can be

carried out.

Which are already being used to process patient

data regarding health monitoring and obtain an im-

mediate response as soon as the patient needs it. See

Fig. 2.

According to the Pan American Health Organi-

zation (2021), the epidemiological update caused by

SARS-CoV 2 has had different variants that affect

public health.

Technological Solution to Optimize the Monitoring of CoViD-19 Symptoms in Seniors Patients in Lima

Figure 2: Methodology to develop PAR (de Morais Bar-

roca Filho et al., 2021).

In October 2020, a new variant was detected in

India called B.1.617, which is under investigation.

Also, other variants of great interest for public health

have emerged, such as variant P.1, lineage B.1.1.28

on January 9, 2021, in Japan, which was detected in

travelers coming from Brazil.

According to the virologist Kamil, one of the mu-

tations of this new variant is like those identiﬁed in

the countries of Brazil and South Africa and he con-

siders it to be less infectious compared to the variant

in the United Kingdom

According to (Rathee et al., 2021), the authors

propose the use of monitoring of 15 symptoms of in-

fected patients in an-ANN-based system to manage

patient data, to improve the classiﬁcation of CoViD19

infected patients.

The model used in this research is the multilayer

perceptron network (MLP) which is considered a type

of ANN those researchers often use frequently, see

Fig. 3.

Figure 3: Multilayer perceptron architecture net-

work (Rathee et al., 2021).

3.2 Method

Prior to the development and proposal, a benchmark-

ing analysis was carried out as the methodology to ex-

Epidemiological Update - PAHO

tract the data, using Gartner

, which has a wide ﬁeld

regarding the evaluation of tools from different areas.

On this occasion, this methodology was adapted

to generate a quantitative report that serves to qualify

the tools in question.

3.2.1 Phases

The project development approach was based on ﬁve

phases, which are detailed below:

• In the ﬁrst phase, the scope of the project was de-

ﬁned together with the Product Owner. Likewise,

an in-depth investigation was generated regard-

ing the initially agreed requirements. With these

premises, the Project Charter documentation be-

gins.

• For the second phase, an analysis was carried out

regarding the technologies that would be involved

for the proposed solution.

• In the third phase, the technological model was

designed, validated by the Product Owner.

• During the fourth phase, the development of the

proposed solution (product) that was delivered to

the Product Owner was carried out. Addition-

ally, the corresponding validations were generated

based on the initial requirements.

• Finally, in the ﬁfth phase, the results of the project

(ﬁnal product) were presented.

3.2.2 Execution

Two mobile applications will be developed for the

Android operating system as part of the technologi-

cal solution, which will bear the name of ”CoViD-

Salud Paciente” whose main purpose will be to op-

timize the monitoring of main symptoms of elderly

patients to rule out or accompany the CoViD19, using

a wearable device via Bluetooth connection.

And it will work together with another application

called ”CoViDSalud Atenci

on”, whose main purpose

will be to contribute to the management of doctors,

caregivers and laboratories, to be able to provide med-

ical assistance to patients, by appointment in an efﬁ-

cient manner.

This technological solution will contribute with

the monitoring of the main symptoms to prevent the

patient from getting worse his state of health, as well

as keep a record in the reports of symptoms that keep

the patient stable and collaborate with the tranquility

of this (see Fig. 4).

This research is aimed at elderly patients, that is,

60 years and older, since according to WHO research

Benchmark Analytics

ICT4AWE 2022 - 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health

Figure 4: Physical Architecture Diagram.

statistics (2020), they are the society with the greatest

vulnerability and/or risk against CoViD19.

This part of the population has a weaker immune

system and, in most cases, they have one or more

chronic diseases, such as diabetes, hypertension, car-

diovascular and pulmonary conditions (COPD), so

their ability to respond to infections is less.

The objective of this architecture, see Fig. 5, is

to be able to identify the requirements that have an

impact on the software structure and reduce the risks

associated with its construction.

The architecture must support future changes in

software, hardware and functionality demanded by

customers (which occur very often).

Similarly, it is the responsibility of the software

architect to analyze the impact of his design deci-

sions and establish a compromise between the differ-

ent quality requirements, as well as between the com-

promises necessary to satisfy the users, the software,

and the business objectives, and which are functional

and quality requirements, hence it is vital to determine

the type of software to be developed.

Presentation Layer. It is the part of the system

with which the user interacts. Your screens, forms are

all user interfaces (UI) that are part of the presentation

layer User interfaces can make use of components or

user process controllers (UIC) to communicate with

the back end and navigate or process the user inter-

face.

Service Layer. The services layer in the archi-

tecture allows the functionality of the system to be

exposed to client and external applications. It is also

the key to achieving cross-platform and interopera-

ble solutions. Service components expose the func-

tionality of the components through contracts, which

are the interfaces where service providers and service

consumers agree and must be immutable.

Business Logic Layer. It contains all the pro-

cessing logic to make the application possible. The

Component is where you put this processing logic

where each one can be coded in independent meth-

ods.

Technological Solution to Optimize the Monitoring of CoViD-19 Symptoms in Seniors Patients in Lima

Figure 5: Integrated Architecture Diagram.

Table 1: Modules and responsibilities.

Module Responsibility

User interface (UI) Forms are all user interfaces (UI) that are part of the pre-

sentation layer.

Presentation logic components Process a request, generating response content, and for-

matting the page for the client

Contracts (Service interfaces) Allows data transfer, it applies speciﬁc actions (POST,

GET, PUT and DELETE) on resources.

Services Provide additional services that the application requires.

App Expose the business logic.

Workﬂows Organize the ﬂow that carries out the execution of the

business process

Components (edit) Component that performs business tasks

Entities Component that represents custom business classes.

Data access components to Data Components that deal with the database tables

ICT4AWE 2022 - 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health

Table 2: Scenarios.

Patient 1 2 3 4 5

Preexisting

Morbidity

Alzheimer’s

Irritable colon,

Gastritis

Type 2

diabetes

Low back

pain

Migraine

Age 89 89 67 65 61

Heartrate (bpm)

CONTEC-CMS50D 91 90 90 88 89

AFK-YK009 89 88 89 86 87

HUAWEI BAND 6 92 91 92 90 90

SpO2 (%)

CONTEC-CMS50D 97 98 97 99 98

AFK-YK009 95 96 95 97 96

HUAWEI BAND 6 98 99 98 99 99

Temperature(

◦

Thermometer Mercury 36.3 36.5 36.5 36.5 36.8

Thermometer Digital 36.2 36.4 36.4 36.5 36.7

DreamState

Galaxy Wacth (h/d) 7:15 6:15 7:46 8:20 7:00

HUAWEI BAND 6 8:15 7:15 8:10 8:40 8:15

Data Layer. The data layer is where we save our

components as CRUD operations, which handle the

insertion (Create), the selection (Read), the modiﬁ-

cation (Update) and the elimination (Delete) of data,

see Table 1. In this presentation we show the different

modules with their respective responsibilities.

4 EXPERIMENTS

In this section we are going to treat an experimental

study to show the feasibility of our project, in each of

the following paragraphs the experimental protocol,

the results measuring the efﬁciency of the proposal

and a short discussion will be detailed.

4.1 Experimental Protocol

For the development of our solution, an IDE called

Android Studio 3.6 was used, where the Java and

Kotlin language were used for the entire Front-end

part.

Firebase cloud-based platform for the back end,

HMS Core (Huawei Mobile Services) for wearable

and mobile device connectivity.

However, for those users who do not have mobiles

with an Android operating system, an emulator called

Blue Stacks 5 with an instance in Android 9.0 was

used to run the tests of our application.

In the same way, to run the programs used, a com-

puter with 10th generation Core i7, 16GB of RAM

and a 10GB reserved storage for the application was

used.

Likewise, to carry out the respective tests, a Sam-

sung Galaxy Note 20 Ultra cell phone with Android

11.0 operating system was used, accompanied by a

Huawei Band 6 Smart Band with Bluetooth connec-

tion.

Then install the Huawei Health Kit and create an

account that will be associated with the wearable.

When opening the app, it will ask to connect with

Huawei services, for this Huawei HMS Core will be

downloaded.

Immediately after downloading it, you will enter

the application and you will be prompted to enter your

Huawei account email and password.

Finally, it will ask for the permissions to read your

data, it should be noted that all the data it reads is

saved in Firebase.

Our code and our data are publicly available at the

following links:

For the main apk: https://github.com/retto710/

CoViDSaludAppAndroid and for the patient apk:

https://github.com/retto710/CoViDSaludPaciente.

Technological Solution to Optimize the Monitoring of CoViD-19 Symptoms in Seniors Patients in Lima

(a) Morbidity vs Heart Rate. (b) Morbidity vs SpO2.

Figure 6: Comparison of results.

4.2 Results

This section will show the solution developed from

the proposed architecture.

In addition, to validate the developed solution, the

test to which it was subjected, and the results obtained

from it in different elderly patients with different mor-

bidities are shown.

Our ﬁnal IoT-enabled prototype is designed with a

Huawei Band 6 wearable and a mobile device where

the measurements of the main symptoms will be dis-

played.

The accuracy of heart rate and oxygen saturation

measurement are compared using two handheld de-

vices: CONTEC-CMS50D and AFK-YK009.

As shown in scenario 1, see Table 2, measure-

ments with the Band 6 device are more effective, see

also Fig. 6 for variations.

On the other hand, the temperature measured by

the device is compared with the Thermometer mer-

cury thermometer.

It can be seen in Table 2 that the results shown for

5 patients with different ages by the proposed IOT-

enabled wearable device are almost close to the values

obtained by the smart band and the thermometer.

Finally, for the sleep state, a comparison was made

between two wearable devices: Galaxy Watch and

Huawei Band 6, in which the following results are

shown.

ICT4AWE 2022 - 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health

4.3 Discussion

We describe the implementation and impact of a

CoViD-19 senior monitoring solution, in which we

found that the RPM program was associated with sig-

niﬁcantly lower risk from our endpoint and the per-

centage of hospitalized or readmission patients hos-

pitable has decreased.

In addition, among patients who have used our

app, 67% did not produce alerts for symptoms that re-

quire manual monitoring, suggesting that PROM for

CoViD-19 patients can provide extensive monitoring

without the need to directly contact a physician. for

your review.

5 CONCLUSIONS AND

PERSPECTIVES

The main objective of this research was to analyze the

main technological tools regarding the different types

of follow-ups to patients with CoViD-19, during the

ﬁrst stage of contagion.

The paper determines the management of scien-

tiﬁc information, as well as the capture of data in

terms of health monitoring and analysis of results

with the laboratory approach.

As a second conclusion, the solution of the pro-

posed technological model was validated, since IOT

technology was used using a wearable to capture data

on oxygenation in the blood, heart rate and sleep

status, and thus see the progress and monitoring of

the main symptoms of CoViD-19 patients in a timely

manner.

The experimental results of the proposed solution

show higher precision and shorter response time in

various functions of our application using Huawei’s

smart band 6 device.

Therefore, this project represents a preliminary

study, a precedent to continue developing improve-

ments in the Peruvian health system with the use of

technologies and encourage the involvement of pri-

vate companies for the creation of I+D+I, Research,

development, and innovation.

Evenmore, using Genetic information to seek for

historical data about a patients (Arroyo-Mari

nos et al.,

2021) or monitoring symptoms with a similar tech-

nological solution for other diseases (Jorge-L

evano

et al., 2021).

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Technological Solution to Optimize the Monitoring of CoViD-19 Symptoms in Seniors Patients in Lima