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This document is the original author manuscript of a paper submitted to an IFIP
conference proceedings or other IFIP publication by Springer Nature. As such, there
may be some differences in the official published version of the paper. Such
differences, if any, are usually due to reformatting during preparation for publication or
minor corrections made by the author(s) during final proofreading of the publication
manuscript.
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# SMADE - Smart Medical Assist Device for Elders

Muvva Durga Samhitha*<fnref n="1" />[0000-0001-5964-2612], E Umamaheswari<fnref n="2" />[0000-0002-9542-3000]

Rudra Pratap Singh<fnref n="1" />[0000-0002-9642-7679], Souranil Das<fnref n="1" />[0000-0002-8878-2726]

muvvadurga.samhitha2019@vitstudent.ac.in
umamaheswari.e@vit.ac.in
rudraprataps0110@gmail.com
souranil.das@gmail.com

**Abstract.** This paper presents the implementation and working of a smart medical assist device for the elderly. The Internet of Things (IoT) is attracting attention for applications in various fields. The elderly people of the society are currently facing their inability to understand the proper medication schedule. Pandemic made things harder than usual. Especially during this period, even the caretakers/medical assistants don't tend to travel outside and meet their clients. We looked into no contact medical assistance and chose that as the main objective, along with the intention of providing them with proper medical scheduling for intake and adding the advantage of tracking the amount of medicine. The research paper will handle the medicines' schedule from any place when entered manually. It informs the pharmacy and doctor to see the complete status of medicines with the elderly. The device checks the quantity of medication left and alerts when required.

**Keywords:** Elder Assistance, Arduino UNO, Blynk Application, Pills, Microcontroller.

## 1 Introduction

The Internet of Things (IoT) has been such a powerful paradigm in making the activities of a user easier on a daily basis. The quality of being able to communicate the software with the hardware or usable things is providing the solutions to all kinds of problems. This is progressively becoming the most wanted technology. The numerous research works in this field are making the IoT a more innovative technology nowadays. The extensive work carried out in bringing the sensors more and more close to the software is making it more efficient to work to bring out the best and useful products into the market. One of the major problems that elderly people of the society are facing currently is their inability to understand the proper medicines schedule, even though the doctor prescribes the medicine schedule. As the pandemic hit us hard, we are trying to avoid contact with other people. Statistics say that most of the elders tend to behave as their brain is not ready to adapt to any new changes.

<footnote n="1">¹Vellore Institute of Technology, Chennai - 600127.</footnote>

<footnote n="2">²Center for Cyber physical Systems, Vellore Institute of Technology, Chennai - 600127.</footnote>
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The proposed idea of helping the elderly to find an easier way in knowing their medicines along with their daily schedule by reminding them with a beep alarm makes the task of the people who are taking care of the elderly easier, with the additional quality of reminding the medical assistants when the amount of the medicine is on the edge of completion. The whole prototype is incorporated with all the mentioned qualities, making it a smart assistive medical device.

The project prototype can be implemented in any circumstances. The research paper features no restrictions or rules to implement the features. Since the device performs multiple operations, the features are trained to work one by one. The process flow happens one by one. Initially, the scheduling and choosing the medicines of the respective slots is performed manually. The scheduling is fed into the system. The device, then linked to the Arduino, performs the task. The device gives a beep sound when it's time for the medicines and dispenses out the same. The ultrasonic sensor evaluates the distance of the medicine and alerts when they are on the edge of completion. Sensing and evaluating the medicine amount can further be extended in an error-free manner by using other sensors, though costly to give out the proper output. The prototype, if implemented on iOS and Android, will make usability accessible to various users.

The research paper has various topics, starting with a section describing the background work performed to finalize the problem solution and related work describing the existing problem and the solutions related to the problem. Section 3 has the methodology proposed, and the architecture used to set up the hardware components. Section 4 has the set-up work the paper required to bring out the final solution to the issue found in a detailed manner followed by implementation. The results and outputs are described in the next section, which has the visual proofs of the process performed. The last section has the conclusions and future scope of the project, explaining the outcome of the paper and the future advancements possible.

## 2 Background and Related Work

### 2.1 Background Work

A typical elderly person expects someone to be there when it comes to notifying and explaining to them about the medication schedule and the respective intake. Even though they get a properly aligned give-out prescription along with a physician/caretaker, the elderly who aren't educated have difficulty with understanding the schedule and medicines allotted. Even if the elderly is educated, studies show that they are facing a hard time in remembering their intake time and the medicine due to their deprived health conditions. Additionally, the pandemic is added to the list of the problems. Though the families are hiring caretakers, they are not willing to travel and take care of their patients during this phase. When the issues are all identified properly, a product prototype with the following features is designed and implemented.
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## 2.2 Related Work

**Medication for Elders.** Elders have been known to have issues with taking regular medication due to either their health issues, or loss of memory power. This, along with being dependent on others just for medication, is a big concern. This has been looked into by a number of papers. [1, 2, 3, 4]

**Technological Acceptability.** This has always been a challenge faced by a lot of people, most important being feasibility [5]. The devices should also have considerations on time [6]. The time taken for setup [7], and the device control has been a significant factor [8]. There is also the factor of acceptance by elders [9]. This can lead to a lot of problems, such that there is no need for a helper for setup. Pharmacies should be able to set up the schedules in the device directly after prescribing their medicines [10, 11].

**Automatic Dispensing.** The automatic dispensing of the medicines is also a significant factor [12]. The correct selection and use of motors, and the containers where the medicines are to be dispensed, is also a significant factor [13]. The control of such a mechanism was explored [14, 15].

**Remote Interface Control.** The control of the system was inspired by baby monitors [16]. The system is similar to such an elder medication system. The connections are done through a smartphone app [17] including an alarm system with dispenser time scheduling and control was also observed, for ease of access. The systems were observed on other similar devices [18,19].

# 3 Proposed Methodology and Architecture

**Medical Dispensing.** Our prototype is designed in such a way that the medicine once loaded into the slot will itself dispense the medicine without guiding it for every single dosage.

**Medicine Alerts.** One of the major difficulties the elderly face is they tend to forget the medicine timing and the respective medicine. So an alert or a reminder will be a cue to them that it's time for medicine. So the prototype also has the feature of alerting the user reminding their medicine time. That's when the device will dispense out the medicine as per the schedule it will be programmed. Additionally, one more alert will be sent to the medical assistant when the box of medicines is on the edge of completion. This is added so that the elderly doesn't have to miss the medicines because of the reason that they missed checking their device. Hence, are programmed into the device.
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**Medicine Scheduling.** Manual work is dominant in this scenario when compared to technical work. The prototype needs a UI interface to feed in the memory of the medicine and the schedule for the user. A UI has to be created in such a way that the caretaker and a medical shop assistant can use it to fill the medicine and set up the reminder alert in the interface, which will be interlinked with the hardware components and setup.

**New Innovation.** It is almost impossible to have the scheduling done by a device. Various sources and research works have been evaluated, and a proper conclusion has been drawn that, in order to have a device schedule the medicines, a new product has to be designed and fed in the memory of the patient's problem and a doctor's appointment. The whole concept extends as a separate problem statement leading to a separate project. If considered, it can be extended and used to design an entirely new prototype for scheduling alone. The existing medical dispenser's working models have been evaluated and concluded that with a touch of new advancements, the prototype can be carried away to the next level. Though various solutions are existing, not even a single solution provides the proper and multiple efficient features. Each of the existing products provides the solution to one or two problems. Additionally, none of the existing products checks the expiry dates of the medicines. All the papers are verified and conclude that there is no such product that dispenses, schedules, alerts, checks the medicine quantity and manufacturing date.

**Bedridden Patients.** Majority of the elderly are bedridden and even find it difficult to understand technology and the idea of the SMADE is to make the medicine intake easier for them. The setup however is designed in such a way that the caretaker or sons/daughters sets up the medicine slot and time for dispensing in the application. Once the setup is made, the major part left is dispensing the medicine at the right time by alerting the elderly. The SMADE has to be placed in the reach of bedridden elders so that they just take the medicine whenever it comes out without any help required. The SMADE will pop out the medicine container and the elderly should be educated whenever the container pops out, they take the medicine in that particular container. There is no fixed distance to maintain between the device and the elderly people. They can keep the device at any distance depending on their ease.

**Setup.** The set-up mentioned in this paper has two parts, the hardware, and the software.

**Hardware System.** The hardware system consists of Items as mentioned (Table 1).

1. The hardware system performs three functions:

2. Dispensing Medicines according to set time

3. Alerting while dispensing

4. Getting information about Medicine quantities
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<table><caption>**Table 1. Hardware System**</caption><thead><tr><td>Hardware</td><td>Description</td></tr></thead><tbody><tr><td>Arduino UNO</td><td>Main microcontroller</td></tr><tr><td>DS3231 RTC Module</td><td>Clock synchronization module</td></tr><tr><td>Piezo Electronic Buzzer</td><td>Alert buzzer</td></tr><tr><td>LED Lights</td><td>Alert lights</td></tr><tr><td>LCD1602</td><td>16x2 Display</td></tr><tr><td>SG90 Servo Motor(s)</td><td>Rotary actuator for dispensing</td></tr><tr><td>HC-SR04 Ultrasonic Sensor</td><td>Distance sensor for quantity check</td></tr></tbody></table>

<table><caption>**Table 2. Software System**</caption><thead><tr><td>Hardware</td><td>Description</td></tr></thead><tbody><tr><td>Blynk</td><td>Library and Application for wireless control</td></tr><tr><td>Android / iOS</td><td>Mobile OS</td></tr></tbody></table>

**Software System.** The software system consists of Items as mentioned (Table 2). The Software System performs two functions:

1. Display Dispense Events Log

2. Setup time for each medication

3. Turn on or off each medication

4. Alert when the Quantity of medication is low and needs refilling.

**Workflow.** The system communicates according to the Flow Chart defined above.

1. For Setup, the timing for each of the medicines available is set.

2. The required buttons for each medicine in the app are turned on.

3. The Hardware requires being on and connected to the Blynk server.

4. When it is time for dispensing medicine(s), The Arduino dispenses the required medicine, provides visual and auditory alerts, and checks for the quantity of medicine left in the dispensed container.

5. The quantity is checked against a certain value, depending on the size of the container, and if it is below a certain level, the information is sent to the application as alerts.

The setup mentioned in this research paper used many components as per the requirements. The setup used I2C LCD to display the output and RTC for real-time clocks, which will be saving time. The Buzzer and Led are used to alert the user, and a detailed description of the alert will be shown on the LCD used.
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The servo motor is used to dispense the medicine, this will be connected in such a way that whenever scheduled medicine time has reached then the servo will open the container where medicine will be stored, and it will dispense the medicine. The ultrasonic sensor is just used to detect the distance between the sensor and medicine, and this will alert the user when the medicine level is down.

<figure><img src="image_2.png" /><figcaption>Fig. 1. Flow Diagram of the System</figcaption></figure>

<figure><img src="image_3.png" /><figcaption>Fig. 2. The Framework of the System</figcaption></figure>
<figure><img src="image_4.png" /><figcaption>Fig. 3. Schematic Diagram</figcaption></figure>

<figure><img src="image_5.png" /><figcaption>Fig. 4. Circuit Diagram</figcaption></figure>

**Setup.** In this schematic as presented in Fig. 3 and circuit diagram as presented in Fig. 4, the connections of the component are as follows:

**For Ultrasonic Sensor 1.**

Echo Pin is Connected to Pin 8 of Arduino

Trig Pin is Connected to Pin 9 of Arduino

**For Ultrasonic Sensor 2.**

Echo Pin is Connected to Pin 10 of Arduino

Trig Pin is Connected to Pin 11 of Arduino

**For Servo Motor 1.**

Signal Pin is Connected to Pin 3 of Arduino
### For Servo Motor 2.

Signal Pin is Connected to Pin 4 of Arduino

### For LCD Display.

SDA is Connected to Pin A4 of Arduino

SCL is Connected to Pin A5 of Arduino

### For RTC Module.

SDA is Connected to the default SDA pin of Arduino

SCL is Connected to the default SCL pin of Arduino

### For Buzzer and LED.

Power pin of buzzer and Led is connected to Pin 2 of Arduino

The rest of the pins are connected to the VCC or GND as per their requirements.

<figure><img src="image_6.png" /><figcaption>Fig. 5. PCB Design</figcaption></figure>

## 4 Experimental Setup and Implementation

For hardware, everything has been designed on a breadboard and connected to two Ultrasonic Sensors - Servo Motor Systems for 2 Medical Containers support and presented in Fig. 6. For software, the Blynk application is used, where the setup of Time Input and an Enable/Disable button is used for each medication as presented in Fig. 7. Arduino UNO has been used as the microcontroller to configure the device, and this can be replaced by any board depending upon the need of the user and industry requirements. As SMADE is a modular device, it can be configured with any number of medicine slots, and replaced with any microcontroller in place of the Arduino UNO.
<figure><img src="image_7.png" /><figcaption>Fig. 6. Hardware Implementation</figcaption></figure>

<figure><img src="image_8.png" /><figcaption>Fig. 7. Software Application Implementation</figcaption></figure>

## 4.1 Default Time Display

When alerts, or no dispense or quantity check options are triggered, the default display mode of the device is set to a time display mode. This shows the time and the date, and changes when there is a medicine to dispense as presented in Fig.8.
<figure><img src="image_9.png" /><figcaption>Fig. 8. Time for Medicine 1</figcaption></figure>

## 4.2 Application Setup

The android app is set up to initiate once every x day's a week, and the time can also be set. The expiry option is also present, which checks for the expiry month of medicine and alerts when it has expired as presented in Fig. 9.

<figure><img src="image_10.png" /><figcaption>Fig. 9. Application Setup</figcaption></figure>

## 4.3 Medicine Time Alert

When it is time for dispensing medicines, the timer runs, and alerts. This is done by checking the configurations provided in the Android app as presented in Fig. 10.

<figure><img src="image_11.png" /><figcaption>Fig. 10. Time for Medicine 1</figcaption></figure>
4.4 Medicine Level Alert

Medicine levels are checked after every dispense and alerts are scheduled accordingly
When the quantity is below 20%, a "Refill" alert is initiated as presented in Fig.11.
When the quantity is below 10%, a "Mandatory refill alert" is initiated.

<figure><img src="image_12.png" /><figcaption>Fig. 11. Medicine 1 Quantity alert</figcaption></figure>

The following picture Fig. 12 shows the average medical delivery services as per the
sources and most of them are internet and mobile-based, making this paper more
visual proof of a better outreach.

<figure><img src="image_13.png" /><figcaption>Fig. 12. Medical Delivery Services</figcaption></figure>

By allowing the user to choose the dosage of the medicine and the time of the dosage, the device relieves the user from constantly forgetting their medicine cycle and intake. By dispensing the medicine as per the schedule the software is fed into, the device is completely taking up the task of the scheduler/medical assistant going to the elder to give the medicine.

5 **Result Analysis**

The proposed application tested with 5 elder volunteers, and it was found that most of them were able to handle the device without any difficulty. The medicines were dispensed, and the average data among volunteers for certain age groups.
The details for the analysis as given in Table 3 show the average delay for three main aspects of operation: Scheduled time, dispensed delay, and intake delay. The data is also shown as a plot in Fig. 12. The time is plotted on the X-axis and the blue line describes the scheduled time whereas the orange line represents the delay caused in dispensing medicine. The gray line shows the delay caused by the patient in taking the medicine. As per the data, the device was able to dispense the medicines on time, with 99% accuracy, and the confirmation notifications were being sent to the caretakers and doctors via the Blynk application. The dispensed delay is close to 2 seconds which is an accurate delay as it can be considered as the time taken by device to pull out the slot.

<table><caption>**Table 3.** Average Testing Delays</caption><thead><tr><td></td><td>Dispensed Delay (s)</td><td>Intake Delay (s)</td></tr></thead><tbody><tr><td>Elder 01</td><td>2.51</td><td>5.6</td></tr><tr><td>Elder 02</td><td>2.44</td><td>8.45</td></tr><tr><td>Elder 03</td><td>2.12</td><td>10.42</td></tr><tr><td>Elder 04</td><td>2.32</td><td>9.45</td></tr><tr><td>Elder 05</td><td>2.95</td><td>6.67</td></tr><tr><td>Elder 06</td><td>2.68</td><td>7.9</td></tr><tr><td>Elder 07</td><td>2.91</td><td>5.32</td></tr><tr><td>Elder 08</td><td>2.29</td><td>6.29</td></tr><tr><td>Elder 09</td><td>2.43</td><td>6.98</td></tr><tr><td>Elder 10</td><td>2.92</td><td>9.89</td></tr></tbody></table>

<figure><img src="image_14.png" /><figcaption>**Fig. 13.** Average Operational Delays</figcaption></figure>

The quantity of medicines is dependent on the size of container used, and can be customized based on use cases and requirements, and whenever the quantity was below preset levels, the notification was sent to the caretakers and pharmacies for a refill, based on the doctor's confirmation the medicine slots can be refilled by the pharmacies.
# 6 Conclusion and Future work

The proposed software implementation is minimal, and the UI design is extremely easy for the user to choose and work on. The prototype itself performs multiple tasks including scheduling, alerting, and dispensing the medications. Every feature implemented in the prototype reduces the burden of the user in one or another way. Blynk made the software interface easier to program than the authors analyzed.

The background work evaluated gave birth to the new idea of designing a proper prototype for feeding the medicine schedules too. The above designed product needs manual work to feed the medicine dosage and time. If analyzed properly by identifying the loopholes and numerous ways of implementing a smart scheduler, the project can be extended further. With the introduction of smart scheduling algorithms along with proper medical treatment strategy, the same project can be extended further to develop a Smart Medicine Input Scheduler.

**Technical Upgrades:**

1. PCB Model Printing and Implementation

2. 3D-Printed Case for the PCB Designed.

3. Identifying Expiry dates from medicine Strips visually.

An additional feature is where the device visually scans the medical strip and evaluates the expiry date based on the time allotted. To proceed with the further coding, proper scanning algorithms have to be incorporated into the hardware setup.

1. Full-Scale Android/iOS Application.

2. An additional feature where alerts can be incorporated as currently, we are working on the medicine dispensing part only so we have included all the possible features related to medication dispensing.

The proposed work currently uses the Blynk application to create a user interface that takes the user timings and medicine slots. Instead of using Blynk, a proper android or iOS application can be designed for better and easier access to the hardware device.

# Acknowledgement

This work is supported by the management of Vellore Institute of Technology, Chennai under the guidance of Dr. E. Umamaheswari. The authors wish to thank the management for all the encouragement we received in taking our ideas further.
References

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3. Coughlin, S.P.: Medicament Dispensing Cell. U. States. US, Scriptpro, LLC, Mission, KS. pp. 202-209, (2002).

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