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Automated Hospital Ward Management System Interacting with Mobile Robot

Platform WDBOT

Conference Paper · August 2018

DOI: 10.1109/ICMA.2018.8484356

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 Proceedings of 2018 IEEE
International Conference on Mechatronics and Automation
August 5 - 8, Changchun, China

Automated Hospital Ward Management System

Interacting with Mobile Robot Platform WDBOT
D.M.H.T Dasanayake, P.S Gunasekara, H.D
A.L. Kulasekera
Wickramasinghe, Shehan Fernando
Department Mechanical Engineering Department Mechanical Engineering
General Sir John Kotelawala Defence University University of Moratuwa
Ratmalana, Sri Lanka Moratuwa, Sri Lanka
hasithict@gmail.com asitha@uom.lk

Abstract - This paper presents a novel intelligent Automated technology and lack of specialized education, quality of
Hospital Ward Management System (AHWMS) based on a mobile delivered patient care is reduced by the nurses [3]. Also,
robotic platform named WDBOT for a hospital ward. The need documentation process of the hospital ward system has many
of an automated system including an assisting robot for draw backs due to inefficient method of data entering and
performing activities in the hospital system is great importance for retrieving. Less reliability and accuracy can occur due to
doctors, nurses, patients and other healthcare assistants due to overcrowded patients, stressed out workers and bottlenecks at
demanding work load and limited number of personnel. The aim single data entry points. Medicine management and distribution
of this research is to provide an automated mobile robot based within the present hospital ward systems has its own cons due to
solution to improve the effectiveness of ward management and
poor documentation system and excess number of patients.
medicine management and distribution processes. AHWMS
Medical negligence can occur due to these reasons [4]. Also, in
interacts with WDBOT via wireless network to achieve the above-
mentioned tasks with the help of controlling, image analysis,
terms of medicine distribution, two nurses spend nearly one to
processing and communication. Verification of the system was one and half hours per shift for delivering medicine to patients.
done with the help of simulation and physical modeling of some Therefore, nurses limit the patient caring time and interaction
units. This system shows it’s use can improve the effectiveness of time. In Sri Lanka, generally, 75-85 patients are available in a
the present hospital ward management system. ward but only 5 or 6 nurses are assigned in a day shift [3].
Keywords— automation, robot control, mobile robots, image To find solutions for the above-mentioned drawbacks and
analysis, simulation. increase the efficiency in the hospital ward, the concept of an
“Automated Hospital Ward Management System” (AHWMS)
I. INTRODUCTION along with a mobile robotic platform (WDBOT) was
A hospital ward is a complex co-domain within the hospital implemented.
system. Doctors, nurses, other healthcare assistants must
seamlessly interact to meet the requirements of patients in a II. LITERATURE SURVEY
hospital ward. From the above personnel, nurses play a key role
Development of the mobile robotics, researches have shown
in any hospital ward. Their role can be summarized as a
its success in the hospital environment. In 1985, Koren et al. [5]
caretaker, client advocator, collaborator, communicator and
first described a mobile platform for use as a nursing robot. Then
researcher. Mainly the role of the nurse is to support the other
some feasibility studies and designs were done in order to
health care professionals to identify the critical needs of the
implement teleoperated healthcare service systems during the
patient [1].
period of 1990 to 2010 (Ex: HSR-I, WebROBOT etc.) [6-7].
Several documents with legal value must be maintained by HSR-I concept is bit similar to our design because it was
the nurses as part of their duty such as the admission documents, controlled via TCP/IP [6]. Care-o-bot [8] and Skillgent [9] are
documents related to medicine management, Bed Head Ticket servicing robots which can be used for home and hospital
(BHT) etc. Therefore, it’s necessary to maintain these within a environment. These robots are not capable of interchanging their
hospital ward system. Admission is a process in which an service units like, patient monitoring, cleaning units etc. Those
individual is entered a health care agency for medical or surgical units are manufactured as onboard features of the robot. Also,
treatment and nursing care. Whether it is inpatient or outpatient those robots can’t communicate in a ward communication
the main purposes of patient admission is for treatment, network or connect to a ward server. iWARD is a nursing robot
investigation, illness prevention and health promotion [2]. presented more recently in 2014. It is an intelligent system for
Medicine management and distribution is one of the key patient monitoring, cleaning and delivering within a mobile
responsibilities of a ward nurse. Nurses are legally responsible platform. These robots have interchangeable service units for
for the safe and accurate administration of medication, having those tasks, but those units are separately controlled. These
sufficient drug knowledge to recognize and answer the patient’s methods are not suitable for hospitals which allocates a separate
question. time for each separate task. This method is not cost effective in
developing countries because each unit needs a separate control
A Sri Lankan health-care delivery review revealed that due system and power supply. Also, in that system, they used sensor
to poor working conditions like lack of hospital resources, busy belts for every patient in vital sign monitoring purpose. That is
work environment, inadequate salary, lower exposure to

978-1-5386-6075-1/18/$31.00 ©2018 IEEE 557

an impractical concept for patients who has serious injuries and III. AUTOMATED HOSPITAL WARD MANAGEMENT
problems. [10]. Cao et al. [11] categorized different architectures SYSTEM
in the cooperative, multi-robot domain. Attempts have also been
AHWMS comprises a database management system and a
taken to analytically determine the minimum information
smart mobile application that can be run over a wireless network.
required for solving a task [12] and for automatic generation of
Requirement of database defers from person to person who
robot teams [13]. However most of these attempts have not
works in a hospital. As an example, receptionist of the hospital
succeeded the issues of distributed collaborative behaviour and
system needs to take information of the patient. Therefore,
distribution of resources across robots. Presently, self-
requirements of the receptionist can be considered as: login to
navigating mobile robots have been used in many hospital
database, register patient, view patient record, search for past
systems [14 - 18]. This has major drawbacks due to the need of
records and edit patient records. After getting registered, a nurse
costly sensors, high performance controllers and high power
will take care of the patient. Nurse also needs to access the
requirements. Also, the self-navigating feature is not essential
database for several activities: login to database, view patient’s
due to properly mapped locations. Therefore, mechanism to
records, search for records, assign patient to ward and assign a
detect and avoid dynamic obstacles by stopping is sufficient for
bed to patient and upload daily readings of patient’s health. After
these applications. As an example, if we consider that beds are
these, the doctor checks the patient and needs to: login to
stable, and patients are static. Therefore, track guiding
database, view patient’s record, upload patient diagnosis
algorithms are more reliable and effective comparing with self-
summery, search for history records of patient and upload
navigation algorithms.
prescription. To fulfill above requirements, a MySQL database
Due to excess no. of patients, hospital ward management was designed in a particular manner where all the patients’
system is an essential computer-based system for a hospital ward records are kept in an organized, easily updatable searchable and
system. Database management, wireless networking are the key secure manner. In that several types of tables are made for
features of this system. Hospital Information management gathering admission information, drug charts, treatment
system (as an integrated information system) which helps to information, different health parameters and lab test reports. The
improve the patient care by uplifting the user’s knowledge and interconnection among tables is made through Patient’s ID
uncertainty allowing rational decisions to be made for the which is given by the system.
information provided [19]. With the help of different software
To communicate with database, a web-based interface is
that are integrated to capture data in specific sections, helps to
designed and that includes every form that the hospital needs to
handle the work flow of the daily routine of medical staff and it
keep records of. To access the database by using HTTP protocol,
also helps to keep administrative and clinical data up to date
tablet devices can be given to each nurse and doctor in the ward
[20]. Mostly doctors and nurses do not have easy access to
with a login ID.
patients’ records when they work "bedside” and the information
is mostly recorded on paper and subsequently transliterated on According to the Fig. 1, privilege level is given to the system
paper for further processing [21]. Paper recording has been an based on profession. As an example, prescription only can be
issue when it comes to sharing information, retrieving updated by doctor and automatically updated drug chart can be
information and storing information. Manual paper viewed only by nurse. Tablet devices are supplied to staff of the
documentation takes a lot of space and time for data processing. wards and to communicate with the server there is a local area
Therefore, importance of computer-based database management network in the ward which allows communication among tablet
system is highlighted. The hospital information system is the devices, with the database server and with WDBOT.
complete information processing and information storage
subsystem of a hospital, whereby it is not just about computer There are wireless access points fixed in the ward to give
systems and networks and the computer-based application wireless connectivity to the devices to login to the server. Access
systems that are installed on them. But it encompasses all the points are connected to a switch which will enable the
information of the hospital [22]. connection between server and the access points as shown in Fig.
2. In order to increase the user-friendliness, specific domain
Medicine distribution is an essential process in a hospital name is given to access the web-based interface through enabled
ward. Several researches have been carried out in the areas of DNS service in the server.
drug dispensing and drug distribution. Karat and Jackrit [23]
proposed a system for medicine distribution among hospital
wards via automated guided vehicles but their proposed system
didn’t touch the area of medicine distribution among patients or
nurses. Similar automatic drug dispensing systems were done by
Fritzpatrick et al [24] and Chapuis et al [25] but that system was
compatible with specific drug types. Sakine et al [26] described
a system but that was based on voice commands of the nurse.
Drawbacks can occur in that system due to busy and noisy
situations. Therefore, accuracy of voice command control
cannot be guaranteed. Fig. 1 Login page of the AHWMS

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 After the processing, SBC sends relevant commands to the
motor controllers via CAN-bus protocol. Four “Mecanum”
wheels are used to drive the unit and to bear up the weight and
for the ease of handling in connecting the main unit to the
subordinate units. “Mecanum” drive needs angle, magnitude and
rotation for voltage multiplier for each wheel.
Four DC brushless geared motors were used with two motor
controllers. These two dual channel controllers are
communicated to use CAN-bus protocol to operate it as a single
four-channel drive. One driver is served as a master and other
Fig. 2 Network architecture as slave. Then the master is controlled via SBC. A scanning
rangefinder (Hokuyo UST-05LN) is used for the object
The end user tablet devices communicate with server detection and holding purpose of the mobile robot as shown in
through web application which got a back end written from PHP. Fig. 4.
To communicate with robot, Python program with PHP plugins
were used. The ward server is connected to the Hospital
webserver. Therefore, Doctors get remote-access capability to
patient records as well. To control the mobile robotic platform,
nurses need to be signed in. then he/she can access the
WDBOT’s controls such as medicine distribution etc. As an
example, when a nurse is logged in to WDBOT he/she will get
options to select the task. Then he/she needs to click on medicine
distribution, the search form will appear (which can be used to
select the patient). It shows the patient’s medicine that has been Fig. 4 Scanning rangefinder
prescribed by the doctor. Finally, the nurse should give
command to fetch the medicine. Power for the mobile robot unit is given by a valve regulated
lead-acid battery pack. Valve regulated lead acid batteries are
IV. MOBILE ROBOT: WDBOT ideal for hospital environments where cleanliness is important,
WDBOT comprises of multiple control units. The main and gassing is not permitted. There is no watering or special
robotic unit consists of a main control unit and a 6 d.o.f robotic equalized charging needed for the life of the battery under
arm and it is controlled by an industrial computer. Along with normal conditions. Automatic battery swap out charging method
is used due to the busy hospital environment. This method
it, a secondary processing unit of single board computer (SBC)
allows the mobile robot to operate for about 12 hours and up to
(Raspberry pi 3 model B), is attached to do the processing for
5 to 10 minutes of down time for the battery replacement
magnetic track guiding, obstacle detecting and avoiding for procedure [27].
navigation. Subordinate robot units for other applications can
be connected automatically with the nurses’ command (Ex: B. Robotic manipulator: Six D.o.F Robotic Arm
Medicine distribution unit).
A custom designed robotic arm driven by six separate servo
A. Main Mobile Robot Unit: Mobile platform motors with harmonic drives is used as the robotic manipulator.
Main mobile robot unit is the heart of the WDBOT. An adaptive gripper was designed, including a camera and
According to the Fig. 3, magnetic track guiding method is used vacuum head as an end effector.
as the navigation method of the robot. In the design, we used “LINUX(Debian)” based software called “Linux CNC” is
adhesive magnetic tape for the floor-level track which can be used as the controlling application of the manipulator.
followed by the robot. Advanced signal processing accurately According to the Fig. 5, robotic manipulator was configured by
measures lateral distance from the track’s centre, from a height referring to the INI and HAL files of “PUMA 560” [28].
up to 60mm. Mechanical design is matched with that value. The Kinematics and inverse kinematics implementation is provided
magnetic guide sensor provides appropriate position resolution in Linux CNC.
compared to optical track guiding method, magnetic track
guiding method is very reliable because track can be buried
under the top layer of floor therefore track is protected from
external interferences.

Fig. 3 Magnetic sensor connected to SBC Fig. 5 Industrial robot arm controlling via Linux CNC

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C. Subordinate Mobile Robot Unit: Medicine Distribution
According to the Fig. 6, subordinate units are used in this system
to connect various service units to the main mobile robot unit.
Medicine distribution is one major task in the hospital ward
system. In this research, an effective and secure method was
implemented for that.

Fig. 6 Design of main unit with medicine distribution unit

When a nurse wants to provide medicine for patients in a

ward, she uses the given tablet device to command the robot to
do the task as in the Fig. 7. If the main unit in the robot is
available for use, it sends a signal back to the tablet device
informing that it is getting ready for operation. After that,
medicine distribution unit connects up with the main unit and
the combined unit goes from patient to patient with the nurse in
order of a patient list. This motion is managed via track guidance
and obstacle detection and avoidance schemes.

Fig. 8 Flow chart process of syrup selection

Fig. 7 Web interface example
According to the Fig. 9, to identify the correct, medicine a
By the patient ID, the PC of main unit accesses the ward label with the QR code is attached to the top of the lid. The QR
database and retrieves data related to that particular patient. code is appropriate for this application since it is able to store
Then the medicine which has been prescribed by the doctor is large amount of information about the medicine (quality
indicated in the relevant dispensers for the particular patient. attributes, dosage form, dosage strength) with compared to
Then nurse confirms the medicine with the information given by barcodes. And another significant advantage is that it is capable
the database using the tablet device. When the confirmed signal of reading in 360 degrees. If the QR code gets dirt or damaged,
is received by the unit, it dispenses the capsules. According to the information can still be retrieved with a suitable error
the nurses’ responsibilities, nurses should follow “three checks” correction algorithm at some predefined level. After recognition
in medicine distribution. According to these regulations this of the correct syrup, the robotic arm will be directed to pick the
system was designed along with single nurse (in manual respective bottle.
systems, two nurses are assigned for medicine distribution).
Therefore, in this system the 1st check is covered in medicine
uploading (to containers). Then 2nd check is covered before
pouring the medication. Finally, 3rd check is covered before
giving the medication to the patient. In every “check”
confirmation must be done by the nurse in the web application.
If syrups are prescribed, safety lock of the syrup rack will be
deactivated by the system, then camera will be focused, and the
correct syrup will be picked according to the flow chart in Fig 8. Fig. 9 QR code identification

560
Finally, overall system can be summarized according to the Fig User interface was tested with the help of 30 users (10
10. doctors, 10 nurses and 10 other healthcare assistance) and their
feedback was recorded as, 83.3% for the user friendliness and
73% for the efficiency.
Robot Arm Motor Drive x 6 Servo Motors x 6
B. Mobile Robot: WDBOT
The main unit and subordinate units were separately tested
Sensor Module I/O Mesa Card Vacuumed head through software simulation tools and physical models. Some
models of the mechanical structures were created and tested (Ex:
Touch Display
Mecanum wheel structure and robot arm).
Module
Robot PC Wi-Fi Module
Controlling of the mechanical units were simulated in V-Rep
Camera Module Pro Edu [29] based on “Kuka youBot” and animated in
Main Unit Solidworks. See Fig. 12 and Fig. 13.
R-Pi
Sensor Module The controllability of the robotic arm was simulated in V-
Rep Pro Edu [29]. Therefore, the required DOFs, DH
DC Motor DC Motor
parameters, max. reach and payload, position repeatability and
(Left, Front) Master Motor Drive
(Right, Front) workspace of robotic arm were analysed with respect to the
application of medicine distribution and future research of
patient monitoring system.
DC Motor DC Motor
Slave (1) Motor Drive
(Left, Rear) (Right, Rear)

DC Motor DC Motor
Slave (2) Motor Drive
(Left, Rear) (Right,

Actuators Drug Distribution

Display Module
Unit

Fig. 10 Flow diagram of system overview Fig. 12 V-Rep simulation

V . RESULTS AND DISSCUSSION

The testing and effectiveness of the AHWMS and WDBOT
were mainly analysed using simulation software.

A. Automated Hospital Ward Management System

Initially wireless network was tested with the help of user
interfaces of the system. Referring to Fig 11., network
simulation software called Cisco Packet Tracer was used to
check the accuracy of the network configuration. Collisions
were not monitored therefore simulation became successful. Fig. 13 Corresponding Solidworks simulations
Finally, network was built with the help of actual components
and tested its’ reliability and accuracy during the run time. User Finally, time consumption for the total application was taken
Interface of the mobile application was tested with the help of a from simulation results.
tablet device (Samsung Galaxy Tab S2).
According to the Table I, each shift has a medicine
distribution process; consumed time for medicine distribution is
90 minutes per shift. No. of patients in the ward is considered as
58 [3]. Medicine delivering time for patients in present system
is 5400 seconds and in automated system is 3771 seconds.
Finally, saved time can be taken as 1629sec (27 minutes) from
our automated solution.
There are two nurses assigned for that duty. Therefore, time
consumed for medicine distribution for two nurses is 10,800
seconds and time consumed for automated system for one nurse
is 3,771 seconds. Therefore, after implementing automated
system, duty of one of the nurse can be cancelled. Also 27
Fig. 11 Packet Tracer simulation and web App testing minutes of the other nurse can be saved.

561
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