Beyond the Gateway: A Secure P2MP Lora-Based Architecture for Rural Health via Iterative Key Derivation

Öz

Aging is characterized by a progressive decline in functional capacity resulting from biological and environmental factors, and is shaped by genetics, lifestyle, chronic diseases, and socioeconomic conditions. As individuals grow older, decreases in musculoskeletal strength, cognitive performance, and overall physical activity become more evident, posing significant challenges for elderly individuals living in rural regions with limited access to continuous healthcare. The increasing share of older adults in the global population underscores the need for innovative technological solutions that can enhance quality of life. Advances in the Internet of Things (IoT) have enabled remote health monitoring systems capable of collecting and processing patient data through sensor-integrated devices. Among communication protocols such as Wi-Fi, Bluetooth, and ZigBee, LoRa and LoRaWAN stand out for their low power consumption and long-range communication capabilities. LoRa employs CSS modulation to securely transmit data over several kilometers, while LoRaWAN operates through a star topology using frequency bands such as 433 MHz, 868 MHz, and 915 MHz. As the volume of health data increases, secure storage and advanced analytics have become essential, with cloud platforms such as Microsoft Azure, AWS, and Google Cloud providing scalable infrastructures; Azure is particularly notable for its integrated AI tools and compliance with HIPAA, GDPR, and ISO 27001 standards. Ensuring data privacy in LoRa-based healthcare applications is critical, and LoRaWAN addresses this through multi-layer AES-128 encryption for network, application, and device authentication, supported by additional algorithms such as RSA, ECC, SHA-256, and Vigenère. However, the high cost of LoRaWAN gateways and the energy demands of conventional encryption methods limit adoption in rural areas. To overcome these constraints, this study introduces HealthGuard, a LoRa-enabled, gateway-independent, and high-security health monitoring platform designed for elderly individuals in rural settings. The system employs a cost-effective P2MP communication architecture and transmits pulse and body-temperature data to Microsoft Azure IoT Hub. Data security is ensured through the IGATA, a lightweight dynamic key-generation method optimized for low-power devices. Field tests demonstrated reliable communication up to 5 km, medical-grade measurement accuracy (Temperature MAE ±0.4°C; Pulse correlation 96%), and low latency (1.1 s). Overall, HealthGuard provides an energy-efficient, low-cost, and privacy-preserving solution that enables continuous remote monitoring and supports improved quality of life for older adults.

Anahtar Kelimeler

• LoRa technology
• Elderly individuals
• Patient tracking
• Health services

Kaynakça

1. Abdulmalek, S., Nasir, A., Jabbar, W. A. (2024). LoRaWAN-based hybrid internet of wearable things system implementation for smart healthcare. Internet of Things, 25, 101124. https://doi.org/10.1016/j.iot.2024.101124
2. Adi, P. D. P., Wahyu, Y. (2023). The error rate analyze and parameter measurement on LoRa communication for health monitoring. Microprocessors and Microsystems, 98, 104820. https://doi.org/10.1016/j.micpro.2023.104820
3. Ali, M. M., Haxha, S., Alam, M. M., Nwibor, C., Sakel, M. (2020). Design of internet of things (IoT) and android based low cost health monitoring embedded system wearable sensor for measuring SpO2, heart rate and body temperature simultaneously. Wireless Personal Communications, 111(4), 2449–2463. https://doi.org/10.1007/s11277-019-06995-7
4. Andrade, R. O., Yoo, S. G. (2019). A Comprehensive study of the use of LoRa in the development of smart cities. Applied Sciences, 9(22), 4753. https://doi.org/10.3390/app9224753
5. Buchman, A. S., Bennett, D. A. (2011). Loss of motor function in preclinical Alzheimer’s disease. Expert Review of Neurotherapeutics, 11(5), 665–676. https://doi.org/10.1586/ern.11.57
6. Chen, M., Ma, Y., Song, J., Lai, C.-F., Hu, B. (2016). Smart clothing: Connecting human with clouds and big data for sustainable health monitoring. Mobile Networks and Applications, 21(5), 825–845. https://doi.org/10.1007/s11036-016-0745-1
7. Dammak, B., Turki, M., Cheikhrouhou, S., Baklouti, M., Mars, R., Dhahbi, A. (2022). LoRaChainCare: An IoT architecture integrating blockchain and LoRa network for personal health care data monitoring. Sensors, 22(4), 1497. https://doi.org/10.3390/s22041497
8. Dimitrievski, A., Filiposka, S., Melero, F. J., Zdravevski, E., Lameski, P., Pires, I. M., Garcia, N. M., Lousado, J. P., Trajkovik, V. (2021). Rural healthcare IoT architecture based on low-energy LoRa. International Journal of Environmental Research and Public Health, 18(14), 7660. https://doi.org/10.3390/ijerph18147660

9. Drăgulinescu, A. M. C., Manea, A. F., Fratu, O., Drăgulinescu, L. (2022). LoRa-based medical IoT system architecture and testbed. Wireless Personal Communications, 126(1), 25–47. https://doi.org/10.1007/s11277-020-07235-z
10. Fortino, G., Galzarano, S., Gravina, R., Li, W. (2015). A framework for collaborative computing and multi-sensor data fusion in body sensor networks. Information Fusion, 22, 50–70. https://doi.org/10.1016/j.inffus.2014.03.005
11. Gordon, W. J., Catalini, C. (2018). Blockchain technology for healthcare: Facilitating the transition to patient-driven interoperability. Computational and Structural Biotechnology Journal, 16, 224–230. https://doi.org/10.1016/j.csbj.2018.06.003
12. Iman, U. R., Zada, M., Basir, A., Hayat, S., Lim, Y.-H., Yoo, H. (2024). IoT-enabled real-time health monitoring via smart textile integration with LoRa technology across diverse environments. IEEE Transactions on Industrial Informatics, 20(11), 12803–12813. https://doi.org/10.1109/TII.2024.3424517
13. Islam, M. S., Islam, M. T., Almutairi, A. F., Beng, G. K., Misran, N., Amin, N. (2019). Monitoring of the human body signal through the Internet of Things (IoT) based LoRa wireless network system. Applied Sciences, 9(9), 1884. https://doi.org/10.3390/app9091884
14. Jawad, H. F., Al-Askery, A., Ali, A. H. (2022). Design and implementation of a healthcare monitoring system based on LoRa. Journal of Techniques, 4(4), 80–94. https://doi.org/10.51173/jt.v4i4.792
15. Kharel, J., Reda, H. T., Shin, S. Y. (2019). Fog computing-based smart health monitoring system deploying LoRa wireless communication. IETE Technical Review, 36(1), 69–82. https://doi.org/10.1080/02564602.2017.1406828
16. Lee, H.-C., Ke, K.-H. (2018). Monitoring of large-area IoT sensors using a LoRa wireless mesh network system: Design and evaluation. IEEE Transactions on Instrumentation and Measurement, 67(9), 2177-2187. https://doi.org/10.1109/TIM.2018.2814082
17. Lousado, J. P., Pires, I. M., Zdravevski, E., Antunes, S. (2021). Monitoring the Health and Residence Conditions of Elderly People, Using LoRa and the Things Network. Electronics, 10(14), 1729. https://doi.org/10.3390/electronics10141729
18. Mazzeo, R. S., Cavanagh, P., Evans, W. J., Fiatarone, M. A., Hagberg, J., McAuley, E., Startzell, J. (1998). ACSM position stand: Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 30(6), 992–1008. https://doi.org/10.1097/00005768-199806000-00033
19. Mdhaffar, A., Chaari, T., Larbi, K., Jmaiel, M., Freisleben, B. (2017). IoT-based health monitoring via LoRaWAN. (IEEE EUROCON 2017) 17th International Conference on Smart Technologies, pp. 519–524. https://doi.org/10.1109/EUROCON.2017.8011165
20. Mitropoulos, S., Rimpas, D., Katsoulis, S., Hloupis, G., Christakis, I. (2025). Integrated low cost, LoRa-based, real time fluid infusion flask monitoring system. Electronics, 14(5), 869. https://doi.org/10.3390/electronics14050869
21. Mukhopadhyay, S. C. (2015). Wearable sensors for human activity monitoring: A review. IEEE Sensors Journal, 15(3), 1321–1330. https://doi.org/10.1109/JSEN.2014.2370945
22. Petäjäjärvi, J., Mikhaylov, K., Hämäläinen, M., Iinatti, J. (2016). Evaluation of LoRa LPWAN technology for remote health and wellbeing monitoring. 10th International Symposium on Medical Information and Communication Technology, pp. 1–5. https://doi.org/10.1109/ISMICT.2016.7498898
23. Pradeesh, D. A., Subiramaniyam, N. P. (2025). IoT-enabled smart health monitoring system with deep learning models for anomaly detection and predictive health risk analytics integrated with LoRa technology. International Journal of Engineering Trends and Technology, 73(1), 14–46. https://doi.org/10.14445/22315381/IJETT-V73I1P102
24. Quadagno, J. (1999). Aging and the life course: An introduction to social gerontology. New York, NY: McGraw-Hill.
25. Ryczek, S., Sobieraj, M. (2025). Secure LoRa-based transmission system: An IoT solution for smart homes and industries. Electronics, 14(24), 4977. https://doi.org/10.3390/electronics14244977
26. Sadek, I., Codjo, J., Ul Rehman, S., Abdulrazak, B. (2022). Security and privacy in the internet of things healthcare systems: Toward a robust solution in real-life deployment. Computer Methods and Programs in Biomedicine Update, 2, 100071. https://doi.org/10.1016/j.cmpbup.2022.100071
27. Sidorov, M., Nhut, P. V., Matsumoto, Y., Ohmura, R. (2019). LoRa-based precision wireless structural health monitoring system for bolted joints in a smart city environment. IEEE Access, 7, 179235-179251. https://doi.org/10.1109/ACCESS.2019.2958835
28. Van Norman, K. A. (1995). Exercise programming for older adults. Champaign, IL: Human Kinetics.
29. Verma, N., Singh, S., Prasad, D. (2023). Performance analysis and comparison of machine learning and LoRa-based healthcare model. Neural Computing and Applications, 35(18), 12751–12761. https://doi.org/10.1007/s00521-023-08411-5
30. Wu, F., Qiu, C., Wu, T., Yuce, M. R. (2021). Edge-based hybrid system implementation for long-range safety and healthcare IoT applications. IEEE Internet of Things Journal, 8(12), 9970–9980. https://doi.org/10.1109/JIOT.2021.3050445
31. Wu, F., Redouté, J.-M., Yuce, M. R. (2018). WE-Safe: A self-powered wearable IoT sensor network for safety applications based on LoRa. IEEE Access, 6, 40846–40853. https://doi.org/10.1109/ACCESS.2018.2859383
32. Wu, F., Wu, T., Yuce, M. R. (2019). An internet-of-things (IoT) network system for connected safety and health monitoring applications. Sensors, 19(1), 21. https://doi.org/10.3390/s19010021