Internet of Things Architecture Based Cloud for Healthcare

Iraqi Journal of Information and Communications Technology (IJICT)
Vol. 1, Issue 1, March 2018
Istabraq M. Al-Joboury, Emad H. Al-Hemiary

https://ijict.edu.iq 18
INTERNET OF THINGS ARCHITECTURE BASED CLOUD FOR
HEALTHCARE
Istabraq M. Al-Joboury1
, Emad H. Al-Hemiary2
1,2
Department of Networks Engineering, Al-Nahrain University, Iraq
estabriq_94@coie-nahrain.edu.iq1
, emad@coie-nahrain.edu.iq2
(Received: 16/01/2018; Accepted: 12/03/2018)

Abstract- The Internet of Things (IoT) contains smart devices placed in different environments, connected
with each other across networks and Internet. The integration between Things and Cloud Computing (CC) for
monitoring and permanent storage is required for future IoT applications. Therefore, this paper proposes IoT
architecture based Cloud for healthcare network when patients are remotely monitored by their family and
physicians. This proposed architecture is different from the traditional IoT architecture that consists of Things,
getaways, middleware, and application layers which in turn need connectivity insurance between them. The
proposed architecture is designed and configured using Cisco Packet Tracer version 7.0 over two sites: Site 'A'
located at smart home and site 'B' located at the smart hospital. The results show that the IoT based Cloud
enhances the patient life style by using smart sensors and mobile application, as well as the physicians can
remotely monitor the data in real time.
Keywords- Internet of Things; Cloud Computing; IoT Architecture; Embedded Devices; Packet Tracer;
HTTP; Monitoring.
I. INTRODUCTION
The Internet of Things (IoT) connects all the physical devices such as sensors, actuators, microcontrollers (or so-
called Things) to the Internet, therefore the IoT becomes the source of Information from these Things. The Radio
Frequency Identification (RFID) was the first created IoT concept to unique identify other Things. Then, the Global
Positioning System (GPS) was created to identify the location of humans or Things. However, in the meantime the
IoT Things have been growing rapidly and these Things includes all domains of life such as healthcare, e-learning,
industrial, etc. [1]. The medical Things generates data of the patients to be recorded, managed, monitored, and
remotely controlled in smart hospitals. In addition, physicians and patient's family can observe the status condition of
the patient. Therefore, the Wireless Body Area Network (WBAN) would be a part of IoT concept. The medical sensors
can be placed on the patient's body and connected to Internet using WiFi, Bluetooth, ZigBee, etc. [2].
The IoT concept optimized the healthcare by providing real time monitoring to data from sensors [4]. IoT
architecture has three main layers, namely: Perception layer, consists of two sublayers. The first sublayer is about data
collecting from the medical Things, Patients, nurses, hospital, and so on. Then, these data from sensors are transmit
to the gateways [5]. The network layer includes all routing and switching devices and protocols to forward data from
the perception layer to another network so that for example, patient's family located at different area of hospital could
receive the data of their patient [6]. Finally, application layer which represents the management, monitoring, and
decision-making depends on the data from the perception layer in order to notify the patient [7].
The studies refer that the world will have around 7 trillion IoT Things by 2020 and expected that each user will
have 1000 Things [8]. Therefore, Cloud Computing (CC) becomes a critical need to provide a numerous storage and
facility data sharing [9]. The innovation is to integrate the CC and IoT. It is expected to optimize the healthcare system
by reducing the power, cost, and complexity [10]. CC can be centralized and located at different area or country of
smart hospital. CC has three different types of services, namely: Software as a Service (SaaS), in this type all


networking, computing, and storage, are controlled by the third party such as Gmail. Platform as a Services (PaaS), in
this type only the data and application controlled by the user such as Amazon Cloud. Finally, (Infrastructure as a
Service-IaaS), in this type the storage is controlled by the third party, and all other services are controlled by the user
[11].
It can be seen that the IoT layers are different from the Cloud layer and therefore it is essential to provide assurance
connectivity [12]. We propose IoT architecture based on Cloud for storage, control, and monitoring the patient. The
proposed architecture is designed and configured using Cisco Packet Tracer version 7.0 [13] over three sites: Site A
located at smart home, site B located at smart hospital, while site C located at different area of smart hospital. The
Cisco Packet Tracer is chosen because it includes the IoT, Cloud, and OSI layers, as well as supports several
programming languages of sensors such as python, Java Script, and visual Scripting. Other IoT simulators like IoT
Simulator [14], and SimpleIoTSimulator [15] which include only the Things and Cloud layers can be used as
alternatives to Cisco packet tracer.
The rest of this paper is organized as follows: Section II covers related works. Section III, proposes IoT architecture
based on Cloud. Section IV, shows the results of this proposed architecture. Section VI, discusses the proposed
architecture. Finally, section VII concludes this paper.
II. LITERATURE REVIEW
This section presents the literature review related to this paper. There are a few papers uses the Cisco packet tracer
to simulate the IoT application. In [16], the authors verify the proposed architecture for asthma patients based Cloud
using Cisco packet tracer. In this proposed architecture, temperature sensor is used to sense the temperature values
from the patient and sent to Cloud through wireless router. In addition, the authors implement this proposed
architecture practically. However, the architecture does not consider multiple sensors running simultaneously, as well
as monitoring the system in real time in Cisco packet tracer. In [17] the authors use IoT concept in educational filed.
That paper proposes architecture with Raspberry Pi microcontroller instead of using the traditional Personal
Computers (PCs) in order to reduce cost. This work is implemented using Cisco packet tracer, as well as practically.
Finally, in [18] the authors introduce the Cisco packet tracer simulation tool to simulate the IoT environment with the
help of Microcontrollers (MCUs) such as Raspberry pi and Arduino with sensors and actuators.
III. IOT BASED CLOUD ARCHITECTURE
The integration between Things and Cloud for monitoring and permanent storage is required for future IoT
applications. Therefore, IoT based Cloud architecture is presented for healthcare network when patients are remotely
monitored by their family and physicians. This proposed architecture is different from the traditional IoT architecture
which requires connectivity insurance between layers. The traditional IoT has five layers: Things, gateway,
middleware, application, and business layers. These layers have limited capabilities in storage and energy. Things are
a low cost and light-weight devices which can store few bytes of messages locally.
The proposed architecture uses several different medical Things integrated with each other to provide a valuable
information and connected to the Internet through network gateway. To enhance the traditional IoT in terms of


processing and storage, this proposed architecture integrates Cloud layer with traditional IoT architecture. Cloud can
provide real time and realistic services when integrated with IoT. In this proposed architecture, Cloud layer provides
a permanent storage and makes messages accessible everywhere over the Internet. CC has different layers than IoT,
thus connectivity between IoT and Cloud layers are required by using API, frameworks, protocols, or software. Several
tools are provided to monitor normal and abnormal messages in real time globally from Cloud or locally from Things.
This proposed architecture not only provides storage and monitoring, but also humans can contact with each other
using smart devices or emails.
The proposed architecture is configured and run using Cisco Packet Tracer version 7.0 over two sites: Site 'A'
located at smart home, and site 'B' located at smart hospital. The layers of proposed architecture are as follows (Fig.
1):
A. Things Layer
This layer consists of sensors that are placed on patient's body, and in smart home located at site 'A' to provide
continuous messaging. The transmitted messages can be monitored using smart devices such as phones and tablets
and stored in Cloud servers. This layer consists of three medical and two home sensors (sensors called IoE in the Cisco
Packet Tracer). The three medical sensors, namely: Patient's Implanted Glucose Meter, fitness (which includes
respiration rate and exercise level), and temperature sensors are used to collect messages from the patient's body. In
addition, the two home sensors, namely: Electronic door and video camera provide patient monitoring. These sensors
are programmed using Java Script language in Cisco Packet Tracer, and the main functions used to program the sensors
are as shown in Table I. The IP addressing for sensors is obtained through DHCP service configured inside APs which
takes the network identity 192.168.0.0/24.
TABLE I
MAIN FUNCTIONS USED IN THINGS LAYER
Function Meaning
Get
Gets messages with units of sensors from the simulation Cisco Packet Tracer, for instance the
messages of glucose meter sensor maps between (40 to 500) in Milligrams per Deciliter (mg/dl)
API
Connects the Things layer to the Cloud layer so that Cloud layer receives the messages and
provides a remote control
Callback Processes the response from Cloud layer to Things layer
States
Reports the states of Things layer to the Cloud layer, for instance sends the states of electronic
door sensor: close, open, locked or unlocked. In addition, if the sensor does not work properly, it
sends the problem to Cloud layer
B. Gateway Layer
For smart monitoring, the Things layer needs Internet access so that the physicians and patients` family can receive
messages from sensors. Things layer is connected to two APs, namely: Digital Life Controllers (two DLC-100) located
at site 'A'. DLC-100 is a modern device and supports automation packages. AP transfers these messages from Things
layer using WiFi (IEEE802.11n) technology to Cloud layer. Cisco switch (2960-24TT) is included in this proposed
architecture to connect both APs to modem PT by Fast Ethernet cable. Then, the modem PT is connected to the


Internet. The IP addressing for getaways layer is obtained through DHCP service configuration from hospital router
which takes the network identity 209.165.200.224/27.
Figure 1. Simulated IoT healthcare network showing the integration of Cloud layer with traditional IoT architecture
C. Cloud Layer
This layer connects two sites ('A', and 'B') together through the router 2911 series (named in the architecture hospital
router). DHCP is configured in the hospital router to distribute IP addresses from the pools to the connected networks.
CELL and WAN pools are assigned to the cell tower layer and the gateway layer respectively. From the other end,
the hospital router is connected to a switch (named in architecture hospital switch) located at site 'B'. Then, hospital
switch is connected to another switch (named in architecture core switch) and followed by four switches for four
medical departments which are: physicians, emergency room, pharmacy, and radiology. The type of all switches of
this proposed architecture is Cisco catalyst 2960-24TT.
This layer consists of two servers (PaaS) located at site 'B'. The IoEH server has three services, namely IoE, email,
and HTTP. Where, IoE feature is used to remote control Things layer so that sensors can be controlled by physicians
as shown in Fig. 2. Each sensor can register itself on IoEH server using username and password authentication. As an
example, the electronic lock of the door can be remotely opened or closed when the paramedics arrived at urgent need


(this type is called M2M interaction). The smart hospital allows the patient to take the right decisions by sending the
right instructions based on messages coming from sensors (this type is called Machine to Human (M2H)). However,
patient may regularly visit or contact his physician to ensure that the treatment fits his condition (this type called
Human to Human (H2H)). Finally, all messages from the sensors are stored in Cloud servers. The HTTP protocol is
used for communication and to browse messages.
The email service is used for exchanging mail messages between physicians and patient. The email service uses
SMTP for sending and processing outgoing mails and uses POP3 for receiving and handling incoming mails. Thus,
each patient has an email identity in the hospital database. The simulation includes another service named DNS which
is used to map domain names into IP, for example "coie-nahrain.edu.iq" is mapped to 5.10.230.122. The network
identity of this layer is 10.0.0.0/24.
Figure 2. Smart monitoring and control of sensors from Things layer using Packet Tracer.
D. Application Layer
The smart hospital is connected to the central office server and cell tower for making local and long distance calls
using the Third Generation (3G). The IP addressing for cell tower layer is obtained through DHCP service
configuration from hospital router which takes the network identity 209.165.201.224/27.
The patient’s family and physician can monitor messages from sensors using smart devices. However, if there is an
abnormal condition, notification is sent to the smart devices. In addition, an ambulance is sent to the patient's home
when the patient’s condition does not improve. The video camera sensor assists the paramedics to find the patient's
location in site 'A'. The monitoring tools are installed and configured on phones and tablets using Cisco Packet Tracer
as shown in the next section. Finally, Cisco Packet Tracer can show messages from sensors through graphs.
Flow of packets in the proposed IoT based Cloud architecture is discussed in steps below:
1) Things are connected to the nearer AP in home, then packets from these things are sent to AP that Things
connected to it.
2) Smart devices like mobile receive messages from Things to monitoring packets locally at home.
3) Packets from AP are reached to switch in home, and its turn sends packets to modem PT to enable Internet.
4) Hospital router receives packets from Things layer through modem PT, then forwards these packets to several
medical departments. In addition, two servers in hospital receive packets to provide different services like email.


5) Also, Hospital router forwards packets from Things to central office server to enable smart monitoring through
Internet and 3G.
IV. RESULTS
The results of the IoT based Cloud architecture show for healthcare network using mobile application installed on
smartphone and configured to monitor the patient status. First of all, Ping program is used to test reachability between
different layers in the simulated IoT network. Fig. 3 shows an example where the command line of Ping is used from
the PC at home to test connectivity to the IoEH server.
Figure 3. Pinging connectivity between PC at home to IoEH server located at Cloud layer
Messages from three sensors (glucose meter, respiratory in Breaths per Minute (BPM), and exercise levels) are shown
in Fig. 4. For clarification, there are three levels of the exercise sensor (low, medium, and high). These messages can
be monitored by the patient himself, patient's family, and physicians in real time at home, hospital, or anywhere using
smartphone or tablet. It can be seen from Fig. 4 that all messages of sensors are within the normal levels for the patient
status. If the messages are out of the normal ranges, a warning message appears in this mobile application to notify
the recipient in order to take action immediately as shown in Fig. 5. Fig. 6 shows sensors reading averaged per five
hours to help the intended recipient in making decisions. The five-hour period can be adjusted in the simulation
environment and can be set according to the patient’s condition. The respiratory rate and exercise level can be
monitored in the patient's smart watch so that the patient can observe his levels in real time from anywhere. Fig. 7 (a)
presents the messages within normal range. The smart watch is connected to the glucose sensor. If the sugar level gets
very high or very low, a warning message is sent to the intended recipients as shown in Fig. 7 (b). Furthermore, if the
patient status is not getting well, the paramedics are sent to the patient location.
Figure 4. Mobile application in smart phones and tablets using
Packet Tracer
Figure 5. Warring message appearing in mobile to monitor abnormal
messages using Packet Tracer


Finally, the simulation can demonstrate sensor readings per day. This result is programmed in Packet Tracer to
enable record archiving and per day statistics. The physician can look at the per day readings to decide if the patient
needs more attention. Fig. 8 shows a sample result of respiration sensor where the x-axis is an hour time scale and the
y-axis is the breathing rate in BPM. The simulation assumes that this rate changes during the day to highlight graph
significance.so that the patient can observe his levels in real time from anywhere. Fig. 7 (a) presents the messages
within normal range. The smart watch is connected to the glucose sensor. If the sugar level gets very high or very low,
a warning message is sent to the intended recipients as shown in Fig. 7 (b). Furthermore, if the patient status is not
getting well, the paramedics are sent to the patient location.
Figure 6. Mobile application provides the average messages of sensors per five hours using Packet Tracer
(a) (b)
Figure 7. Patient's smartwatch for monitoring sensors using Packet Tracer:
(a) Messages of sensors within normal range (b) A warning message appearing for out of normal range messages
Figure 8. History of values of respiratory sensor using Packet Tracer
IV. DISCUSSION
IoT Based Cloud architecture for the healthcare network is simulated using Cisco Packet Tracer. Although the
simulation is intended for healthcare networks, it can be adopted for any field such as transportation, smart home, etc.
by changing the type of the sensor in the Things layer. Cisco Packet Tracer simulates the IoT technology and provides


smart monitoring without the complexity of hardware. The simulation provides a dashboard environment to control
messages from sensor such as a glucose meter sensor. This dashboard provides multiple situations like the induce
Hypoglycemia, induce Hyperglycemia, or normal levels as shown in Fig. 9. The architecture is tested under different
situations and prove validity of simulation with IoT based Cloud architecture. The previous works implemented IoT
architecture based on two layers: Things and gateway and remote control was not included, while the contribution of
this paper is to design and implement IoT architecture based on four layers: Things, gateway, Cloud, and application
as well as remote control, notification, monitoring, and decisions-making are included. In addition, programming
functions in this proposed to automate IoT sensors and several protocols to configure networking layers in order to
connect to Internet and Cloud with its services, in contrast the previous works are just to monitor data from Things
layer locally.
Figure 9. Condition controller dashboard of messages on sensors using Packet Tracer
V. CONCLUSION
This paper proposes an IoT architecture for healthcare network over three different sites, namely: Smart home,
smart hospital, and different area of smart hospital. The data from Things are needed to be stored for processing and
monitoring the patients. The result show that integration between the IoT and Cloud enhances the real-time
monitoring. The sensors that are placed on patient's body or at smart home can be remotely monitored. The proposed
IoT architecture based Cloud is designed and simulated using Cisco Packet Tracer. The assurance connectivity
between IoT and Cloud layers is provided. Monitoring tools, mobile and smartwatch application are provided in order
to observe the values of sensors. Notify is sent to the patient and the paramedics when there is an abnormal value.
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