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| 1 | +# Patient Monitoring Hub – Reference Implementation |
| 2 | + |
| 3 | +## Table of Contents |
| 4 | +- [Overview](#overview) |
| 5 | +- [Demo](#demo) |
| 6 | +- [Architecture](#architecture) |
| 7 | + - [High-Level Components](#high-level-components) |
| 8 | + - [Proxmox Host](#proxmox-host) |
| 9 | + - [OpenWRT VM](#openwrt-vm) |
| 10 | + - [Monitoring Hub](#monitoring-hub) |
| 11 | + - [Patient Monitoring Devices](#patient-monitoring-devices) |
| 12 | + - [Wired Devices](#wired-devices) |
| 13 | + - [Wireless Devices](#wireless-devices) |
| 14 | + - [Central Monitoring System Server](#central-monitoring-system-server) |
| 15 | +- [Data Flow](#data-flow) |
| 16 | + - [Downstream (Patient Monitoring Devices → Monitoring Hub)](#downstream-patient-monitoring-devices--monitoring-hub) |
| 17 | + - [Upstream (Monitoring Hub → Central Monitoring System Server)](#upstream-monitoring-hub--central-monitoring-system-server) |
| 18 | +- [Validated Hardware and Benchmark Results](#validated-hardware-and-benchmark-results) |
| 19 | + - [Validated System Components](#validated-system-components) |
| 20 | + - [Network Components](#network-components) |
| 21 | + - [Latency Benchmark Summary](#latency-benchmark-summary) |
| 22 | +- [Get Started](#get-started) |
| 23 | +- [Known Limitations](#known-limitations) |
| 24 | + |
| 25 | +--- |
| 26 | + |
| 27 | +## Overview |
| 28 | + |
| 29 | +> **Ready to deploy?** Jump directly to [Get Started](#get-started) |
| 30 | +
|
| 31 | +The Patient Monitoring Hub is a **virtualized edge solution** designed to collect, process, and forward patient vital signs from monitoring devices to backend systems and nurses station dashboards. |
| 32 | + |
| 33 | +This solution demonstrates: |
| 34 | +- Real-time patient data ingestion from connected devices |
| 35 | +- Edge-based processing and aggregation |
| 36 | +- Upstream data forwarding to central systems |
| 37 | +- Support for both wired and wireless device connectivity |
| 38 | +- Support for touchless sensor connectivity |
| 39 | + |
| 40 | +The entire stack runs on a **Proxmox virtualized environment**, leveraging: |
| 41 | +- **OpenWRT Virtual Machine (VM)** for network routing and DHCP service |
| 42 | +- **Ubuntu LXC container** as the monitoring hub |
| 43 | +- **MQTT** messaging protocol for lightweight and fault-tolerant data streaming |
| 44 | +- **InfluxDB** database designed to handle huge volumes of continuous data stream |
| 45 | + |
| 46 | +--- |
| 47 | + |
| 48 | +## Demo |
| 49 | + |
| 50 | + |
| 51 | + |
| 52 | +--- |
| 53 | + |
| 54 | +## Architecture |
| 55 | + |
| 56 | +<p align="center"> <img src="./assets/Architecture_diagram.png" alt="Architecture diagram" /> <br /> <em>Architecture diagram</em> </p> |
| 57 | + |
| 58 | +The system is deployed within a **single-node virtualized edge environment**. |
| 59 | + |
| 60 | +### High-Level Components |
| 61 | +- **OpenWRT VM** – Network routing and DHCP services |
| 62 | +- **Monitoring Hub (Ubuntu LXC container)** – Data ingestion, processing, and forwarding |
| 63 | +- **Patient Monitoring Devices** – Wired and wireless endpoints publishing data |
| 64 | +- **Central Monitoring System Server** – Centralized database server |
| 65 | + |
| 66 | +--- |
| 67 | + |
| 68 | +### Proxmox Host |
| 69 | + |
| 70 | +The Proxmox host provides the virtualization layer and network isolation for the Patient Monitoring Hub. |
| 71 | + |
| 72 | +**Network Configuration:** |
| 73 | +- `vmbr0` – WAN / NAT bridge |
| 74 | + - Subnet: `192.168.100.0/24` |
| 75 | + - Used as OpenWRT WAN interface |
| 76 | + |
| 77 | +- `vmbr1` – LAN bridge |
| 78 | + - Virtual switch for local external devices (patient monitoring devices) |
| 79 | + - Subnet: `10.0.0.0/24` |
| 80 | + |
| 81 | +- **USB Wireless Adapter** |
| 82 | + - Passed through to OpenWRT |
| 83 | + - Acts as a Wireless Access Point |
| 84 | + |
| 85 | +- **Physical NIC (`nic0`)** |
| 86 | + - Attached to `vmbr1` |
| 87 | + - Enables external wired devices to join LAN |
| 88 | + |
| 89 | +--- |
| 90 | + |
| 91 | +### OpenWRT VM |
| 92 | + |
| 93 | +The OpenWRT virtual machine on Proxmox Host acts as the **network gateway** within the Patient Monitoring Hub. |
| 94 | + |
| 95 | +**Interfaces:** |
| 96 | +- `eth0` → `vmbr0` (WAN) |
| 97 | + - Static IP: `192.168.100.50` |
| 98 | + - Provides upstream network access |
| 99 | + |
| 100 | +- `eth1` → `vmbr1` (LAN) |
| 101 | + - IP: `10.0.0.1` |
| 102 | + - Default gateway for LAN devices |
| 103 | + |
| 104 | +- `br-lan` |
| 105 | + - Includes USB Wi-Fi adapter |
| 106 | + - Provides Wireless Access Point functionality |
| 107 | + |
| 108 | +**Key Functions:** |
| 109 | +- DHCP server for LAN (`10.0.0.0/24`) |
| 110 | +- NAT and routing to upstream network |
| 111 | +- Connectivity between isolated LAN and external network |
| 112 | + |
| 113 | +--- |
| 114 | + |
| 115 | +### Monitoring Hub |
| 116 | + |
| 117 | +The Monitoring Hub on Proxmox Host (Patient Monitoring Hub) is deployed as a **lightweight Ubuntu LXC container**. |
| 118 | + |
| 119 | +**Core Services:** |
| 120 | +- MQTT broker (device message ingestion) |
| 121 | +- InfluxDB (time-series database) |
| 122 | +- Python processing service: |
| 123 | + - Consumes MQTT messages |
| 124 | + - Writes to local InfluxDB database |
| 125 | + - Forwards data to upstream server |
| 126 | + |
| 127 | +**Network:** |
| 128 | +- IP assigned via DHCP (10.0.0.x) |
| 129 | +- Default gateway: OpenWRT (10.0.0.1) |
| 130 | + |
| 131 | +--- |
| 132 | + |
| 133 | +### Patient Monitoring Devices |
| 134 | + |
| 135 | +Patient Monitoring Devices are external Patient Monitors that publish vital-sign telemetry to the Monitoring Hub over MQTT. Devices connect to the local LAN either via wired Ethernet or wirelessly through the OpenWRT Access Point. |
| 136 | + |
| 137 | +#### Wired Devices |
| 138 | +- Connected via physical NIC to Proxmox host |
| 139 | +- Join LAN (`10.0.0.0/24`) via `vmbr1` |
| 140 | +- Publish data directly to Monitoring Hub via MQTT |
| 141 | + |
| 142 | +#### Wireless Devices |
| 143 | +- Connected via Wi-Fi AP (OpenWRT) |
| 144 | +- Join LAN (`10.0.0.0/24`) |
| 145 | +- Publish MQTT data to Monitoring Hub |
| 146 | + |
| 147 | +--- |
| 148 | + |
| 149 | +### Central Monitoring System Server |
| 150 | + |
| 151 | +The Central Monitoring System Server is a dedicated server that serves as the central data ingest and storage endpoint for patient telemetry forwarded from the Monitoring Hub. |
| 152 | + |
| 153 | +**Core Services:** |
| 154 | +- InfluxDB (time-series database, running in Docker) |
| 155 | +- Receives upstream patient telemetry from the Monitoring Hub |
| 156 | + |
| 157 | +**Network:** |
| 158 | +- Must be network-reachable from the Monitoring Hub |
| 159 | +- Should use the same subnet as the Proxmox host during initial setup |
| 160 | + |
| 161 | +--- |
| 162 | + |
| 163 | +## Data Flow |
| 164 | + |
| 165 | +### Downstream (Patient Monitoring Devices → Monitoring Hub) |
| 166 | +1. Devices publish data via MQTT |
| 167 | +2. Monitoring Hub receives messages |
| 168 | +3. Python service processes and stores data in InfluxDB |
| 169 | +4. Data available locally for analysis |
| 170 | + |
| 171 | +### Upstream (Monitoring Hub → Central Monitoring System Server) |
| 172 | +1. Monitoring Hub sends processed data upstream |
| 173 | +2. Traffic routed via OpenWRT gateway |
| 174 | +3. OpenWRT forwards traffic to hospital network (e.g. Medical Device Network) |
| 175 | +4. Data reaches centralized database server |
| 176 | + |
| 177 | +--- |
| 178 | + |
| 179 | +## Validated Hardware and Benchmark Results |
| 180 | + |
| 181 | +### Validated System Components |
| 182 | + |
| 183 | +| Component | Model | Processor | Memory | OS | |
| 184 | +|----------|------|----------|--------|----| |
| 185 | +| Patient Monitoring Hub | ASUS IoT PE2300U | Intel® Core™ Ultra 7 265U | 32GB | Debian 13 + Proxmox VE 9.1.0 | |
| 186 | +| Wired Device | ASRock iEP-7020E | Intel® Core™ i7-1370PRE | 32GB | Ubuntu 24.04 | |
| 187 | +| Wireless Device | Intel® NUC11PAHi7 | Intel® Core™ i7-1165G7 | 32GB | Ubuntu 24.04 | |
| 188 | +| Central Monitoring System Server | Intel® NUC11PAHi7 | Intel® Core™ i7-1165G7 | 64GB | Ubuntu 24.04 | |
| 189 | +| Nurses Station | Intel® NUC13RNGi9 | Intel® Core™ i9-13900K | 32GB | Ubuntu 24.04 | |
| 190 | + |
| 191 | +> ASUS IoT PE2300U Ethernet driver setup: [Download Link](https://www.asus.com/networking-iot-servers/aiot-industrial-solutions/embedded-computers-edge-ai-systems/pe2300u/helpdesk_download?model2Name=PE2300U) |
| 192 | +
|
| 193 | +--- |
| 194 | + |
| 195 | +### Network Components |
| 196 | + |
| 197 | +| Component | Model | Interface | Notes | |
| 198 | +|----------|------|-----------|------| |
| 199 | +| Router | Asus RT-AX86U | 1Gbps | Upstream gateway | |
| 200 | +| USB Wi-Fi Adapter | MediaTek MT7612U | USB 2.0 | AP mode supported | |
| 201 | + |
| 202 | +--- |
| 203 | + |
| 204 | +### Latency Benchmark Summary |
| 205 | + |
| 206 | +Benchmark configuration: |
| 207 | +- Duration: 120 seconds |
| 208 | +- Channel count: 1, 10, 20, 30 |
| 209 | +- Default MQTT settings |
| 210 | + |
| 211 | + |
| 212 | +| Channel Count | Wired Patient Monitoring Device<br> to Server Latency (s) | Wireless Patient Monitoring Device<br> to Server Latency (s) | |
| 213 | +|---------------|-------------------------------|----------------------------------| |
| 214 | +| 1 | Average : 0.181 s<br> Typical (p50): 0.161 s<br> 95% of msgs ≤ : 0.354 s<br> 99% of msgs ≤ : 0.467 s | Average : 0.109 s<br> Typical (p50): 0.088 s<br> 95% of msgs ≤ : 0.184 s<br> 99% of msgs ≤ : 0.382 s | |
| 215 | +| 10 | Average : 0.128 s<br> Typical (p50): 0.123 s<br> 95% of msgs ≤ : 0.193 s<br> 99% of msgs ≤ : 0.220 s | Average : 0.113 s<br> Typical (p50): 0.079 s<br> 95% of msgs ≤ : 0.301 s<br>99% of msgs ≤ : 0.369 s | |
| 216 | +| 20 | Average : 0.215 s<br> Typical (p50): 0.205 s<br> 95% of msgs ≤ : 0.390 s<br> 99% of msgs ≤ : 0.479 s | Average : 0.211 s<br> Typical (p50): 0.107 s<br> 95% of msgs ≤ : 0.749 s<br> 99% of msgs ≤ : 1.186 s | |
| 217 | +| 30 | Average : 0.209 s<br> Typical (p50): 0.205 s<br> 95% of msgs ≤ : 0.334 s<br> 99% of msgs ≤ : 0.397 s | Average : 0.836 s<br> Typical (p50): 0.758 s<br> 95% of msgs ≤ : 1.929 s<br> 99% of msgs ≤ : 2.167 s | |
| 218 | + |
| 219 | +**Key Observations:** |
| 220 | +- Stable latency under moderate load (≤20 channels) |
| 221 | +- Wireless latency increases significantly at high channel count (30) |
| 222 | +- Multi-channel testing simulates concurrent patient vital data streams |
| 223 | + |
| 224 | +Latency metrics: |
| 225 | +- **Average:** Mean latency |
| 226 | +- **p50:** Median latency |
| 227 | +- **p95:** 95th percentile |
| 228 | +- **p99:** Worst-case latency |
| 229 | + |
| 230 | +--- |
| 231 | + |
| 232 | +## Get Started |
| 233 | + |
| 234 | +Follow the setup steps in sequence: |
| 235 | + |
| 236 | +1) [Setup Proxmox Host](./docs/proxmox_setup.md) |
| 237 | +2) [Setup OpenWRT VM](./docs/openwrt_setup.md) |
| 238 | +3) [Setup Central Monitoring System Server](./docs/server_setup.md) |
| 239 | +4) [Setup Monitoring Hub (Ubuntu LXC)](./docs/monitoring_hub_setup.md) |
| 240 | +5) [Connect and Configure Patient Monitoring Device](./docs/patient_device.md) |
| 241 | +6) [Setup Nurses Station Dashboard](./docs/nurse_dashboard.md) |
| 242 | +7) [Run End-to-End Workflow](./docs/end_to_end_workflow.md) |
| 243 | + |
| 244 | +--- |
| 245 | + |
| 246 | +## Known Limitations |
| 247 | + |
| 248 | +This reference implementation is intended for demonstration, evaluation and benchmarking purposes. Current limitations include: |
| 249 | + |
| 250 | +- **No disconnection alerts** |
| 251 | + Loss of connectivity from patient monitoring devices or hub is not detected or notified |
| 252 | + |
| 253 | +- **No transport security (MQTT)** |
| 254 | + MQTT messages are transmitted in plaintext |
| 255 | + - No TLS encryption |
| 256 | + - No device authentication (mTLS) |
| 257 | + |
| 258 | +- **No strict message guarantees** |
| 259 | + - Duplicate or out-of-order messages may occur |
| 260 | + - No correction or deduplication mechanisms |
| 261 | + |
| 262 | +--- |
| 263 | + |
| 264 | +## Disclaimer |
| 265 | + |
| 266 | +This solution is a **reference implementation** and is not intended for direct clinical deployment without appropriate validation, security hardening, and regulatory compliance. |
| 267 | + |
| 268 | +--- |
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