e-ISSN: 2582-5208

International Research Journal of Modernization in Engineering Technology and Science

( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com

DEVELOPMENT OF A CENTRALIZED PATIENT MONITORING SYSTEM

USING ESP32 AND SIM900 FOR REAL-TIME EMERGENCY ALERTS AND
DATA MANAGEMENT
Qusay Jalil Kadhim*1, Nasir Hussen Selman*2
*1,2Department Of Communication Techniques Engineering, Engineering Technical College/Najaf, Al-
Furat Al-Awsat Technical University, Najaf, Iraq.
DOI: https://www.doi.org/10.56726/IRJMETS69357
ABSTRACT
Smart electronics have become a necessity for many daily life facilities. The developments provide time to make
the right decision as soon as possible or to transfer the decision-making issue to the concerned person without
wasting time. The idea of this paper is to seek help from medical professionals when there is no internet
connection.
As known, Internet service is not available in all locations via mobile SIM cards, and not all geographical
locations have access to Wi-Fi. The availability of a mobile device is more convenient and widespread than
internet service. From here, the research aims to provide emergency assistance using text messages by
determining the patient's geolocation and location, where the health side has multiple patients. A chip (ESP32)
is used to connect to the Wi-Fi network and send data to Google spreadsheets (Database), which in turn stores
the data in real-time for review by healthcare and determines the level of severity.
This configuration improves patient care and reaction times by facilitating early recognition of serious medical
problems and ensuring rapid communication of important events. In addition to improving data management,
this approach increases the overall effectiveness and reliability of patient monitoring systems in both urban
and rural areas.
Keywords: Microcontroller, ECG, Google Sheets, Healthcare, Patient Location Tracking.
I. INTRODUCTION
The Internet of Things (IoT) has become an important tool in the industrial and medical fields. It plays a
fundamental role in the development of these fields.
In the healthcare sector, remote patient monitoring is a vital role in saving emergency cases. An example of a
health condition that can be monitored remotely is the ECG, which indicates the patient's level of risk. The ECG
monitoring process requires high-cost devices and is available only in specialized health centers. It also
requires the physical presence of the patient. Providing these devices and human resources from doctors and
intermediate staff in clinics and small hospitals in rural areas is not economically feasible, especially since the
number of patients is expected to be relatively few [1]. Some chronic diseases such as cardiovascular system
and diabetes require continuous monitoring to prevent the condition from worsening. It is important to
monitor the ECG signal to prevent arrhythmias such as bradycardia, supraventricular tachycardia, arterial
fibrillation, ventricular tachycardia, and ventricular fibrillation, which are life-threatening conditions.
Monitoring the heart rate can diagnose some heart diseases before they occur and ensure the stability of the
condition. However, traditional heart monitoring systems often require expensive equipment and an available
Internet, which limits accessibility in these remote or underserved areas [2].
In this paper, real-time health parameters such as ECG signal, heart rate, blood oxygen saturation, and general
condition of the patient are continuously monitored in real-time. The approach integrates Google Sheets for
data analysis and a SIM900 module with a control panel (ESP32) pre-programmed to process signals from the
sensor (AD 8232) for emergency alerts, providing a cost-effective solution. This paper is organized as follows.
The literature review of this IoT application is summarized. After that, the method and components required
for this work are explained. Then the results are discussed. Finally, the conclusion will be presented.

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4000]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com
II. LITERATURE REVIEW
Some previous research related to the work proposed in this paper can be summarized as follows:
Reference [3] gives a cloud-based system that continuously monitors a patient's heart rate using an AD8232
sensor. A NodeMCU ESP 8266 microcontroller processes the transmission and receiving of data. The
microcontroller collects heart rate sensor data and publishes it to the cloud. The used method secures data
transmission and requires high-quality internet, and the target person and doctor are connected to a distinct IP
address.
In reference [4], the HC-05 Bluetooth module and AD8232 sensor are integrated to read the ECG in real-time
and around the clock on the mobile phone screen, and all these details are done by the Arduino (Uno, Mega,
ESP32, ESP 8266) microcontroller.
The author in reference [5], an IoT-based ECG monitoring system is proposed. The patient's heart rate is
determined by this device, which transmits the result (bpm) to a cloud database. Hospital doctors can use this
device to check the vital signs it sends. For patients who are not admitted to the hospital, doctors can also
perform real-time analysis of health-related indicators. Patient health data can be collected and transmitted to
the cloud using this technology, which can be connected to an ambulance. While the patient is still in the
ambulance, the doctor can perform advanced analysis of all these crucial indicators. The main goal of this
system is to use sensors to collect physiological data, which is then uploaded to the cloud.
References [6] have integrated an electrocardiogram sensor into a designed system. The validation process
involves comparing the readings with designs and medical equipment used by physicians and other healthcare
professionals.
In the cited source [7], a pilot concept based on the IoT for implementing a wearable, portable, low-power, real-
time remote vital signs monitoring system is demonstrated. Vital signs have been validated and proven to be
reliable.
In the paper [8], the authors proposed a heart condition monitoring system using two sensors, a single-wire
heart rate sensor AD8232 to extract the ECG signal and a pulse sensor to obtain beats per minute.
The obtained sensor data is transmitted to a cloud server using an ESP32 microcontroller with Wi-Fi capability
for remote monitoring by a health professional. Ubidots and Thingspeak platforms are used as the cloud server.
As a result, any health professional can check the heart condition of the patient anytime, anywhere, and can
take necessary steps.
III. SYSTEM DESCRIPTION
The block diagram of the system is given in Figure 1. The controller ESP32 represents the system's central
component. Three different sensors interact with the human body and convert the signal to a corresponding
electrical signal. For example, the blood pressure sensor converts the blood pressure reading into an electrical
signal and sends it to the control unit. The control unit reads the electrical signal of the sensor and converts it to
values ranging from 0-5 volts, depending on the calibration of each sensor [3, 9].
The controller simultaneously establishes a connection with a pre-prepared Google spreadsheet to save the
data that interested medical personnel can access at any time. By configuring the controller ESP32,
emergencies are detected by reading the data. The controller immediately notifies the interested healthcare
person of an emergency via a text message sent via the SIM900. To determine the correct course of treatment
or basic procedures, interested healthcare practitioners can consult Google spreadsheets for the previously
entered data.
Figure 2 illustrates the schematic representation of the whole proposed system implementation. The patient
side comprises an ESP32 microcontroller, heart rate sensor, ECG sensor, GSM SIM card sensor, and GPRS
sensor. The Wi-Fi technology was integrated inside the ESP32 to access Google Sheets and store data (which
represents patient history). Google Sheets is a reference anytime, anywhere. It is evident that the patient
utilizing the gadget automatically initiates a call (SMS) to request assistance from the healthcare center in real
time. The following subsections illustrate the components employed in the proposed system.

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4001]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com

Figure 1: Block diagram modeling

Figure 2: Block diagram of the system

ESP32 Controller
The ESP32 controller is a type of Arduino controller dedicated to IoT applications and their controllers. It is
equipped to work in industrial environments, with an operating temperature of (from -40 to +125) degrees
Celsius. It is equipped with a high-performance 32-bit dual-core microcontroller with a frequency of 2.4 MHz. It
is characterized by low power consumption of less than 1 mA in some saving modes. In addition to high
encryption capacity, Wi-Fi and Bluetooth features are integrated into the board as shown in Figure 3. It
supports various communication protocols and can be programmed via ESP-IDF or Arduino IDE using
languages such as Arduino, C, C#, C++, Micropython, and JavaScript. It has also been used in the medical field
(precise medical control and case monitoring) [10-13].

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4002]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com

Figure 3: ESP32 configurable pins microcontroller

ECG sensor AD 8232
Figure 4 shows a graphic called an electrocardiogram (ECG), which is used to help diagnose various heart
conditions. The signal sensed by the ECG sensor indicates the electrical activity of the heart. The first ascending
deflection of Figure 5 is point (P) which indicates the contraction of the atrial cavity. Then a group of points
begins with a small descending deflection at point (Q), followed by a larger ascending deflection that forms the
peak at point (R), then a descending point(S), and this combination indicates the polarization and contraction of
the ventricle. Finally, a smaller ascending wave at point (T) represents the repolarization of the ventricle. BPM
can be measured from the chart.

Figure 4: Electrocardiogram of the heart [9]

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4003]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com

Figure 5: The electrical signal of the heart

The AD 8232 sensor in Figure 6 is an integrated circuit board for electrocardiography and other bio-voltage
measurement applications. It can be connected to the ESP32 and monitors the ECG signal using different
methods (graph, database, spreadsheet, and number gate from a specific equation) [14-17]. It is designed to
extract, amplify, and filter small bio-signals in noisy conditions such as those caused by movement or remote
electrode placement. The AD8232 core module uses a nine-wire integrated circuit (IC). The sensor pins
connected to the ESP32 controller are shown in Table 1 [18]. The board is also equipped with RA (right arm),
LA (left arm), and RL (right leg) legs to connect and use the desired sensors in the kit.

Figure 6: ECG AD8232 Sensor

Table 1: Interfacing pin of AD 8232 sensor to ESP32.
SN. Board Label Pin Function Arduino Connection
1 GND Ground GND
2 3.3v 3.3v Power Supply 3.3v
3 OUTPUT Output Signal 13
4 -LO Leads-Off Detect - 12
5 +LO Leads-Off Detect + 14
6 SND Shutdown Not Used

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4004]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com
From equation 1, a healthy heart can be diagnosed from a heart suffering from temporary disturbances or
diseases [9].

120
𝐻𝑒𝑎𝑟𝑡 𝑅𝑎𝑡𝑒 = (1)
𝑁𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑙𝑎𝑟𝑔𝑒 𝑠𝑞𝑢𝑎𝑟𝑒 𝑏𝑒𝑡𝑤𝑒𝑒𝑛 𝑜𝑛𝑒 𝑅−𝑅 𝑖𝑛𝑡𝑒𝑟𝑣𝑎𝑙

The sensors (dedicated ends) of the sensor are connected to wires before placing them on the body. The
measurement is more accurate and ideal at the point closest to the heart. The cables are distinguished by
specific colors to help determine the appropriate positions. Where: red color: RA (right arm), yellow color: LA
(left arm), and green color: RL (right leg) as shown in Figure 7 [19-21].

Figure 7: ECG electrodes suitable positions

Heart rate sensor
Monitoring heart rate is important for patients because it diagnoses heart health. There are many ways to
measure heart rate. One of the heart rate measurements is the number of beats per minute (bpm), which
measures the number of times the heart muscle contracts and relaxes per minute [21-23].
A heart rate sensor is a blood pressure device that measures blood pressure using light. Figure 8 shows the
heart rate sensor and the photo plethysmograph (PPG) which represents the basis for using the heart rate
sensor. Based on this principle, changes in blood pressure are measured according to changes in the intensity of
the light passing through the heart rate sensor. The receiver is a light detector such as a photodiode, light-
dependent resistor (LDR), or phototransistor. The light source and the receiver are placed opposite each other
where the finger of the person is placed between the transmitter and the receiver [15, 17, 19]. The sensed
signal is transmitted to the microcontroller.

Figure 8: Heart rate sensor

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science
[4005]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com
Global Positioning System (GPS) Sensor
Determining location and position is of great importance in many applications, especially mobile ones (cars,
balloons, ... etc), and this movement is provided to the positioning unit through batteries or a power supply via
a USB cable [24]. Figure 9 shows an image of GEM1205 GPS used in this work and Figure 10 illustrates its
connection with ESP32.

Figure 9: GEM1205 GPS Sensor

Figure 10: GPS Sensor connecting with ESP32

Sim900 GSM GPRS
Figure 11 gives the SIM900 GSM GPRS sensor. It is an electronic card used to send text messages and make
phone calls by connecting it to the microcontroller board. With the help of the GSM module (like the one on the
mobile phone), messages can be sent and calls can be made by programming the microcontroller. The SIM900
module is designed for the 2G network. This means it is mainly designed for the second generation of
communication networks [22]. To make ESP32 work seamlessly with the SIM900, you must choose a SIM card
compatible with 2G networks.

Figure 11: SIM 900A Modeling

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science
[4006]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com
Google Sheets
Using Google service and Google Sheets API provides storage space that acts as a large reference database.
Using the ESP32 controller, access to data in Google Sheets becomes reliable and secure through a WIFI ID. A
Google service account is used by creating a Google account, a unique type of account that features an email
address. The most common way to enable an application to authenticate as a service account is to associate a
service account with the resource that executes the program, such as the Arduino IDE. For example,
applications running on a Compute Engine instance can authenticate as a service account by associating a
service account with the instance. It provides access to Google Cloud resources for both the service account and
the instance applications. Associating a service account is not the only way to enable applications to
authenticate as service accounts [25].
IV. RESULTS AND DISCUSSION
The proposed system given in Figure 3, which has been mentioned previously, was implemented with Wi-Fi
technology built into the ESP32 microcontroller to access Google spreadsheets for storing data as a database
(patient history). The pictorial image of the practical system is given in Figure 12.

Figure 12: illustrates the board connection.

When the patient calls for help from the healthcare center in real time for the health crisis, all the technical
capabilities in communications and electronics are employed to build a good environment for saving him. In the
absence of Internet or Wi-Fi service, the health center cannot easily understand the patient's critical medical
information. Therefore, the idea of this work can be implemented by the patient requesting assistance from the
health center automatically and quickly, and informing the specialist doctor by text message if his case is
critical. The health center can infer from the text message the location of the critical medical case by indicating
the location of the medical case. Thus, the health center can follow up the critical medical cases in different
places quickly and in real time. The health center can also treat the medical case through direct attendance by
inquiring about the sent text message and referring to the Google Spreadsheets database to follow up on the
medical case by recording the data. As shown in the graph in Figure 13

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4007]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com

Figure 13: Google Sheets results from implementation for one patient.
As is known at present, there are many medical cases affiliated with one healthcare center within a specific
geographical area, and the health center can follow up all patients' cases using the proposed system as shown in
Figure 14.

Figure 13: Multiple patients in one healthcare center in the same geographical area.
V. CONCLUSION
The advanced idea in this research can be a suitable seed for designing a patient monitoring device that is
connected via the Internet and depends on databases where data can be accessed anytime and anywhere in
addition to text messaging services. By analyzing this data and early warning of this critical condition, it can be
diagnosed and treated with appropriate treatments immediately. The databases are linked to Google
spreadsheets, which in turn store data for more than one patient and more than one case. The SIM900 module
or its variants, depending on the industrial development of this electronic card connects to the ESP32 controller
for emergency text message alerts and real-time multi-patient tracking and data analysis. The data storage
using Google spreadsheets enhances the comprehensive monitoring system. This comprehensive approach

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4008]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com
simplifies data management and greatly enhances the efficiency, and effectiveness of patient monitoring. By
identifying the right treatment at the right time.
VI. REFERENCES
[1] K. R. 1Ansar Sheikh, 3Komal Mahulkar, 4Madhuri Dasariya, 5Avshali Nagpure, "Heart Defect
Monitoring System Using ECG," International Journal of Advanced Innovative Technology in
Engineering (IJAITE),, vol. 6, no. 4, p. 4, JULY 2021 2021.
[2] Z. Ahmad, A. Tabassum, L. Guan, and N. M. Khan, "ECG Heartbeat Classification Using Multimodal
Fusion," IEEE Access, vol. 9, pp. 100615-100626, 2021.
[3] M. A. Al-Sheikh and I. A. Ameen, "Design of Mobile Healthcare Monitoring System Using IoT Technology
and Cloud Computing," IOP Conference Series: Materials Science and Engineering, vol. 881, no. 1, p.
012113, 2020/07/01 2020.
[4] A. Banerjee, C. Chakraborty, A. Kumar, and D. Biswas, "Chapter 5 - Emerging trends in IoT and big data
analytics for biomedical and health care technologies," in Handbook of Data Science Approaches for
Biomedical Engineering, V. E. Balas, V. K. Solanki, R. Kumar, and M. Khari, Eds.: Academic Press, 2020,
pp. 121-152.
[5] C. Bhattarai, S. Yadav, and S. Koirala, "IoT Based ECG Using AD8232 and ESP32," Nepal Journal of
Science and Technology, vol. 21, pp. 115-121, 12/31 2022.
[6] S. Bhattarai, S. Bhujel, S. Adhikari, and S. Maharjan, "Design and Implementation of a Portable ECG
Device," Journal of Innovations in Engineering Education, vol. 3, pp. 147-154, 03/31 2020.
[7] R. Brinda, M. Bhavani, and S. Ramalingam, "IoT Smart Tracking Device for Missing Person Finder
(Women/Child) using ESP32 AI camera and GPS," in 2022 International Conference on Augmented
Intelligence and Sustainable Systems (ICAISS), 2022, pp. 1168-1174.
[8] M. Chhabra and M. Kalsi, "Real Time ECG monitoring system based on Internet of Things (IoT)," vol. 7,
pp. 547-550, 08/01 2017.
[9] S. Das, S. Roy, S. Ghosh, S. Mukherjee, U. Bhattacharya, and B. RoyChowdhury, "Micro-ECG-monitoring
system based on arduino with bluetooth feature," Journal of Physics: Conference Series, vol. 2286, no.
1, p. 012006, 2022/07/01 2022.
[10] B. S. Fjeldsoe, A. L. Marshall, and Y. D. Miller, "Behavior Change Interventions Delivered by Mobile
Telephone Short-Message Service," American Journal of Preventive Medicine, vol. 36, no. 2, pp. 165-
173, 2009/02/01/ 2009.
[11] D. Harianto, H. Bintang, A. Ardiyanto, and V. Widyawan, "Development and Evaluation of an ESP32-
based Temperature and Humidity Control Unit for Textile Storage," International Journal of
Engineering Continuity, vol. 4, pp. 1-19, 11/18 2024.
[12] J. Heaney, J. Buick, M. U. Hadi, and N. Soin, "Internet of Things-Based ECG and Vitals Healthcare
Monitoring System," Micromachines, vol. 13, no. 12. doi: 10.3390/mi13122153
[13] M. J. Joshi, "EMERGING TECHNOLOGIES USING IOT-DRIVEN IN HEALTHCARE: SURVEY, CHALLENGES
AND FUTURE," INTERNATIONAL JOURNAL OF COMPUTER ENGINEERING AND TECHNOLOGY (IJCET),
vol. 15, no. 3, pp. 21-36, 2024.
[14] P. Kumar, T. Naidu, and M. S. Vishnu, "Remote Ecg Monitoring System by using Iot," International
Journal of Engineering and Advanced Technology, vol. 9, pp. 71-73, 12/30 2019.
[15] M. Malathi, A. Muniappan, P. Misra, B. R. Rajagopal, and P. Borah, A smart healthcare monitoring system
for patients using IoT and cloud computing. 2023, p. 030012.
[16] Q.-u.-A. Mastoi et al., "Heart patient health monitoring system using invasive and non-invasive
measurement," Scientific Reports, vol. 14, no. 1, p. 9614, 2024/04/26 2024.
[17] A. Milenković, C. Otto, and E. Jovanov, "Wireless sensor networks for personal health monitoring: Issues
and an implementation," Computer Communications, vol. 29, no. 13, pp. 2521-2533, 2006/08/21/
2006.
[18] M. Naaz, L. Kumari, and Y. Padma Sai, "Classification of ECG beats using optimized decision tree and
adaptive boosted optimized decision tree," Signal, Image and Video Processing, vol. 16, pp. 1-9, 04/01
2022.

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4009]
 e-ISSN: 2582-5208
International Research Journal of Modernization in Engineering Technology and Science
( Peer-Reviewed, Open Access, Fully Refereed International Journal )
Volume:07/Issue:03/March-2025 Impact Factor- 8.187 www.irjmets.com
[19] P. S. Pandian et al., "Smart Vest: Wearable multi-parameter remote physiological monitoring system,"
Medical Engineering & Physics, vol. 30, no. 4, pp. 466-477, 2008/05/01/ 2008.
[20] L. Pillalamarri and I. Reddy, "IoT-Based Air Quality Monitoring System Using SIM900," 2022, pp. 291-
299.
[21] T. A. Prasath, M. M. Arif, S. Srinivasan, A. Muthumanojkumar, M. Sushmitha, and S. Sankaran, "IoT Based
Heart attack Detection and Heart Rate Monitoring System," in 2023 Advanced Computing and
Communication Technologies for High Performance Applications (ACCTHPA), 2023, pp. 1-4.
[22] A. Qtaish and A. Al-Shrouf, "A Portable IoT-cloud ECG Monitoring System for Healthcare," vol. 22, p.
269, 01/01 2022.
[23] M. A. Rahman, Y. Li, T. Nabeed, and M. T. Rahman, "Remote monitoring of heart rate and ECG signal
using ESP32," in 2021 4th International Conference on Advanced Electronic Materials, Computers and
Software Engineering (AEMCSE), 2021, pp. 604-610.
[24] K. Raj, K. Kumar, M. Agrawal, D. Prasad, and P. Kadam, "IoT based Patient Health Monitoring Using
ESP8266 Module & Arduino," 06/08 2023.
[25] K. Ravisankar, K. Dinesh, M. Satish, B. Ram Vara Prasad, and K. Vedaprakash, "GSM Based Heart Rhythm
Monitoring System Using ECG," Journal of Digital Integrated Circuits in Electrical Devices, vol. 8, pp. 26-
32, 08/05 2023.

www.irjmets.com @International Research Journal of Modernization in Engineering, Technology and Science

[4010]