Long-Term Reliability and Cost Analysis of an Internet of Things (IoT)Based Nurse Calling System in a Hospital Setting

Öz

Introduction: In healthcare facilities, communication between patients and healthcare personnel is facilitated through nurse call systems, which constitute an indispensable component of hospital infrastructure. However, the high installation and maintenance costs of commercial nurse call systems create a significant financial burden, particularly for public hospitals with budget constraints, negatively affecting sustainability.
Objective: This study aims to develop a low-cost nurse call system based on ınternet of things (IoT) technology and microcontroller architecture as an alternative to high-cost commercial products, to implement the system in a real hospital environment, and to evaluate its performance, reliability, and costs using long-term real-world operational data.
Method: A microcontroller-based hardware architecture was designed using low-cost, Wi-Fi-enabled embedded system components. The system consisted of bedside call buttons and a web-based central monitoring platform, utilizing the existing hospital Wi-Fi infrastructure for data transmission. The embedded software was developed in C/C++. The system was monitored for four years in a 32-bed physical therapy unit; performance metrics, failure records, and maintenance requirements were systematically analyzed. Reliability was assessed through the calculation of mean time between failures (MTBF) and failure rates, and cost analysis was conducted through comparison with commercial system quotations.
Results: During four years of operation, the system maintained 99.98% availability. The MTBF was calculated as 7,008 hours, with an hourly failure rate on the order of 10⁻⁴, and no critical hardware failures were observed. Compared with commercial system quotations, approximately 93% cost savings were achieved, with no additional expenses such as license renewals or central panel failures during the operation period.
Conclusion: The IoT- and microcontroller-based system provides a low-cost, sustainable, and reliable alternative for hospital environments. The technical and economic findings suggest

Anahtar Kelimeler

• IoT
• nurse call system
• embedded systems
• reliability assessment
• cost.

Etik Beyan

Ethics approval for this study was obtained from the Afyon Kocatepe Üniversitesi Fen ve Mühendislik Bilimleri Etik Kurulu (Decision No: 2022/13, Meeting No: 09).

Teşekkür

This study was conducted at Tavşanlı Doç. Dr. Mustafa Kalemli Devlet Hastanesi. We would like to thank the Hospital Administration for their institutional support during the planning and implementation phases of the study.

Hastane Ortamında Nesnelerin İnterneti Tabanlı Hemşire Çağrı Sisteminin Uzun Dönemli Güvenilirlik ve Maliyet Analizi

Öz

Giriş: Sağlık tesislerinde hasta ile sağlık personeli arasındaki iletişim hemşire çağrı sistemleri aracılığıyla sağlanmakta ve bu sistemler hastane altyapısının vazgeçilmez bir parçasını oluşturmaktadır. Ancak ticari hemşire çağrı sistemlerinin yüksek kurulum ve bakım maliyetleri, özellikle bütçe kısıtları bulunan kamu hastanelerinde önemli bir finansal yük oluşturmakta ve sürdürülebilirliği olumsuz etkilemektedir.
Amaç: Bu çalışmanın amacı, yüksek maliyetli ticari ürünlere alternatif olarak nesnelerin interneti (IoT) teknolojisi ve mikrodenetleyici mimarisi temelinde düşük maliyetli bir hemşire çağrı sistemi geliştirmek, sistemi gerçek hastane ortamında uygulamak ve uzun dönem saha verileriyle performans, güvenilirlik ve maliyetlerini değerlendirmektir.
Yöntem: Düşük maliyetli ve Wi-Fi destekli gömülü sistem bileşenleri seçilerek mikrodenetleyici tabanlı donanım mimarisi oluşturulmuştur. Sistem, her yatağa yerleştirilen çağrı butonları ve web tabanlı merkezi izleme biriminden tasarlanmış; veri iletiminde mevcut hastane Wi-Fi altyapısı kullanılmıştır. Gömülü yazılım C/C++ tabanlı geliştirilmiştir. Sistem, 32 yataklı bir fizik tedavi ünitesinde dört yıl süreyle izlenmiş; performans, arıza kayıtları ve bakım gereksinimleri düzenli olarak analiz edilmiştir. Güvenilirlik analizinde MTBF ve arıza oranları hesaplanmış, maliyet analizi ticari sistem teklifleriyle karşılaştırmalı yapılmıştır.
Bulgular: Dört yıllık kullanım süresince sistem %99,98 operasyonel süreklilik göstermiştir. MTBF 7008 saat, saatlik arıza oranı 10⁻⁴ mertebesinde hesaplanmış ve kritik donanım arızası gözlenmemiştir. Ticari sistem teklifleriyle karşılaştırıldığında yaklaşık %93 maliyet avantajı sağlanmış, işletme süresince ek lisans veya panel arızası gideri oluşmamıştır.
Sonuç: IoT ve mikrodenetleyici temelli geliştirilen sistem, hastane ortamında düşük maliyetli, sürdürülebilir ve güvenilir bir alternatif sunmaktadır. Elde edilen teknik ve ekonomik sonuçlar, daha geniş ölçekli uygulamalarda da önemli katkılar sağlayabileceğini göstermektedir.

Anahtar Kelimeler

• IoT
• hemşire çağrı sistemi
• gömülü sistemler
• güvenilirlik değerlendirmesi
• maliyet

Etik Beyan

Bu çalışma için Etik Kurul izni Afyon Kocatepe Üniversitesi Fen ve Mühendislik Bilimleri Etik Kurulu'ndan alınmıştır (Karar No: 2022/13, Toplantı Sayısı:09).

Teşekkür

Bu çalışma Tavşanlı Doç. Dr. Mustafa Kalemli Devlet Hastanesi’nde yürütülmüştür. Çalışmanın planlanması ve uygulanması sürecinde kurumsal destek sağlayan Hastane Yönetimine teşekkür ederiz.

Kaynakça

1. Abdulmalek, S., Nasir, A., Jabbar, W., Almuhaya, M., Bairagi, A., Khan, M., &Kee, S. (2022). IoT-based healthcare-monitoring system towards improving quality of life: A review. Healthcare, 10, 1993. https://doi.org/10.3390/healthcare10101993
2. Abdulkalamazad, G., Loknath, P., Kavin, A., Logesh, S., &Kowshick, C. (2025). IoT-based smart healthcare system for real-time patient monitoring and care. International Journal of Science and Research Archive, 14(1), 456-463. https://doi.org/10.30574/ijsra.2025.14.1.0123
3. Ahmad, A. (2024). Enhancing hospital efficiency through IoT and AI: A smart healthcare system. Journal of Computer Science Application and Engineering (JOSAPEN), 12(2), 45-53.
4. Al-Rawashdeha, M., Keikhosrokiani, P., Belaton, B., Alawida, M.&Zwiri, A. (2024). Effective factors for the adoption of IoT applications in nursing care: A theoretical framework for smart healthcare. Journal of Building Engineering, 86, 108765. https://doi.org/10.1016/j.jobe.2024.108765
5. Aref, M., El-Shinnawi, A. A., &Sharawi, A. A. (2018). Wireless nurse call system in medical institutions. American Journal of Biomedical Research, 6(2), 40-45. https://doi.org/10.12691/ajbr-6-2-2
6. Astutik, R., Winarno, H., &Wahyuni, R. (2021). Wireless nurse call system using IoT implementation. 2021 3rd International Conference on Research and Academic Community Services (ICRACOS) (pp. 50-55). IEEE. https://doi.org/10.1109/icracos53680.2021.9702044
7. Avaji, G., & N, D. (2024). IoT innovations in healthcare: Enhancing patient care and operational efficiency. International Journal of Research Publication and Reviews, 5(7), 1234-1241.
8. De Rosa, I., Pepino, A., Giaconia, G., &Guarino, M. (2020). Bedside communication and management of vital parameters and alarms in care-intensive environments: Simulation model development for the clinical effectiveness analysis of an innovative technology. Global Clinical Engineering Journal, 3(1), 12-21.

9. E, M., Suman, N., & C, B. (2023). A lowpower, long range, portable wireless nursecall system. 2023 3rd International Conference on Advances in Computing, Communication, Embedded and Secure Systems (ACCESS) (pp. 1-5). IEEE. https://doi.org/10.1109/access57397.2023.10201200
10. Islam, M., Rahaman, A., &Islam, M. (2020). Development of smart health care monitoring system in IoT environment. SN Computer Science, 1(3), 185. https://doi.org/10.1007/s42979-020-00195-y
11. Kanan, R., &Elhassan, O. (2016). A combined battery less radioand WiFi indoor positioning for hospital nursing. Journal of Communications Software and Systems, 12(1), 34-44. https://doi.org/10.24138/jcomss.v12i1.89
12. Kartika, W., Santoso, I., &Supriyadi, K. (2021). Simple wireless nursecall on distance measurement. Journal of Robotics and Control, 2(3), 145-147. https://doi.org/10.18196/jrc.2368
13. Li, C., Wang, J., Wang, S., & Zhang, Y. (2024). A review of IoT applications in healthcare. Neurocomputing, 565, 127017. https://doi.org/10.1016/j.neucom.2023.127017
14. Megantoro, P., &Winarno, H. (2020). EKA v1: Emergency call auto-register, an emergency warning system based on internet of things for intensive care patient at hospital. IOP Conference Series: Materials Science and Engineering, 835, 012033. https://doi.org/10.1088/1757-899x/835/1/012033
15. Mehta, N., &Pandit, A. (2018). Concurrence of big data analytics and healthcare: A systematic review. International Journal of Medical Informatics, 114, 57-65. https://doi.org/10.1016/j.ijmedinf.2018.03.013
16. Nursuwars, F., & Rahmatulloh, A. (2019). RFID for nurse activity monitoring in the hospital’s nurse call system with internet of thing (IoT) concept. IOP Conference Series: Materials Science and Engineering, 550, 012025. https://doi.org/10.1088/1757-899x/550/1/012025
17. Paul, L., Ahmed, S., &Karmakar, K. (2022). A smart multi-user wireless nurse calling system and e-notice board for health care management. In Proceedings of International Conference on Smart Computing and Cyber Security (pp. 421-431). Springer. https://doi.org/10.1007/978-981-16-7597-3_35
18. Rejeb, A., Rejeb, K., Treiblmaier, H., Appolloni, A., Alghamdi, S., Alhasawi, Y., &Iranmanesh, M. (2023). The internet of things (IoT) in healthcare: Taking stock and moving forward. Internet of Things, 22, 100721. https://doi.org/10.1016/j.iot.2023.100721
19. Riyad, O., Sharif, A., Suhan, A., &Khan, M. (2021). An IOT based nurse calling system for real-time emergency alert using local wireless network. 2021 IEEE 12th Annual Ubiquitous Computing, Electronics& Mobile Communication Conference (UEMCON) (pp. 0924-0929). IEEE. https://doi.org/10.1109/uemcon53757.2021.9666705
20. Rodríguez, E., Fernandez, L., Orta, G., Horta, A., Barco, C., Barrionuevo, K., Cama-Pinto, D., Arrabal-Campos, F., Martínez-Lao, J., & Cama-Pinto, A. (2022). A platform for inpatient safety management based on IoT technology. Inventions, 7(4), 116. https://doi.org/10.3390/inventions7040116
21. Salcedo, A., Baena, C., &González, C. (2019). Design of a nursing call system: An alternative. VisiónElectrónica, 13(1), 78-85.
22. Upadhyay, S., Kumar, M., Upadhyay, A., Verma, S., Kaur, M., Khurma, R., &Castillo, P. (2023). Challenges and limitation analysis of an IoT-dependent system for deployment in smart health care using communication standards features. Sensors, 23(15), 6789. https://doi.org/10.3390/s23156789
23. Wang, B., Shi, X., Han, X., &Xiao, G. (2024). The digital transformation of nursing practice: An analysis of advanced IoT Technologies and smart nursing systems. Frontiers in Medicine, 11, 1398765. https://doi.org/10.3389/fmed.2024.1398765
24. Yadegari, F., &Asosheh, A. (2025). A unified IoT architectural model for smart hospitals: Enhancing interoperability, security, and efficiency through clinical information systems (CIS). Journal of Big Data, 12(1), 45. https://doi.org/10.1186/s40537-025-00999-8