Development a chat & voice calling application to facilitate communication between doctors and patients built on the android platform using android studio, Google firebase & sinch voice calling sdk.

1. 1
Mobile Based Doctor-Patient Consultation Application [E-Clinic]
Nahid Hasan Sany1
, Khalid Bin Rohani2
, Md. Sumon Mia3
1
Id: 151329, 2
Id: 151339
1,2
Bsc in Computer Science & Engineering, BAUET
3
Lecturer, Project Supervisor, Department of CSE, BAUET
1
nahidhasansany@gmail.com, 2
noyon.bauet@gmail.com, 3
sumon.ruetbd@gmail.com
Abstract— Today there are lots of Chat applications
available in market and this project is useful for
communication and sharing of data between doctor and
patient through internet.This project presents an application
that is developed based on the Android operating system,
using Android Studio, Firebase and Sinch. The project is
tested on an Android Emulator which is a tool that allows
developers to easily test an application without having to
install the application on a real device.
By using this application no appointment is needed to
consult with doctors. No waiting time, instant realtime chat
virtually with doctors. In this report, the main goal is to
develop a mobile health application that provides common
platform prospective patients and specialist doctors give free
consultation and health tips on health related conditions. It
reduces the extra paperwork, delay in timing and cost.
Keywords— Mobile, Internet, Online application,
Android, Firebase, Sinch, Hospital service, Sharing of data,
Doctor-patient communication.
I. INTRODUCTION
The development of Mobile health applications can lower the
costs of health care delivery and improve the quality of
healthcare as well as shift behavior to strengthen prevention
and treatment of reported cases at the, all of which can
improve health outcomes over the long term. One of the main
goals of using mobile technology in the health sector is to
improve the quality of and access to health care. Here we
present a doctor-patient communication system based on
Android. Using this application doctor and patient can
communicate with each other and doctor-patient can share
data between them. The whole data is stored on firebase
server. Doctor registration is done directly on firebase server
by administration and patient can register remotely using the
application. First based on specialization of doctor, patient
can send message and call through internet to particular
doctor from list of doctor. If doctor accept patient calling
request then they can communicate with each other.
II. CONCEPTUAL FRAMEWORK
a) Smartphone in Healthcare
The next few years will witness a rapid deployment in both
UMTS and mobile Internet based m-health systems with
pervasive computing technologies. The increasing data traffic
and demands from different medical applications and
roaming application will be compatible with the data rates of
3G systems in specific mobility conditions.[1]
The importance of smartphones in healthcare has become a
serious issue at present. In recent years, many studies have
been done and several processes were taken to develop
applications which will be used in a great deal in healthcare
[2]. Some studies proved that the usage of mobile phones in
telemedicine and remote healthcare brought about significant
changes in developing nations [4]. Usages of short message
service (SMS) text when it comes to management of behavior
change [5]. in sexual health education [6], and to improve
patients adherence to antiretroviral treatment [7].
Comparison of the use of mobile phone records against
traditional paper-based records in controlled drug trials is also
done in one study [8].
Some patient-centered applications are also developed and
these are capable of doing multiple functions. The
applications are managing communication, chronical
diseases and even self-diagnosis [9]. In the Android platform
alone, numbers of Android apps are available with verities of
functionalities, including self-monitoring blood glucose
recording, medication or insulin logs, and prandial insulin
dose calculators [10].
Mobile applications are also available when it comes to
mental health and psychological aspects of human. There is
an application that randomly prompts the patient to self-
report psychotic symptoms multiple times throughout the day
and helps psychiatric patients to improve his/her overall
condition [11, 3]. Another app is made for the patients who
suffer from sickle cell disease to make a dairy so that they can
keep track of their pain and other syndromes [12, 5]. There is
also an app developed for monitoring the patients affected
with COPD (chronic obstructive pulmonary disease) [13, 5]
b) Survey Of Similar Systems
1) Teladoc Teladoc connects you with a board-certified
doctor 24/7/365 through the convenience of phone or video
consults. Within minutes, a doctor will contact you ready to
listen and resolve your issue. If medically necessary a
prescription will be sent to your pharmacy of choice. It’s
healthcare when and wherever you want it.Talk to a doctor –
Within minutes, a state-licensed doctor reviews your medical
history and contacts you via phone or video. Teladoc consults
have no time limit; you can speak to the doctor for as long as
you’d like.Pick up prescription – The doctor discusses the
issue with you, answers questions and recommends next
steps. If medically necessary, a prescription can be submitted
to a local pharmacy of your choice. [14]
2) Vodafone Health Line App This app provides real-
time health information through smartphones and tablets.The
interactive app, which has been developed for all mobile
networks, is available on Android and provides tips and facts
on health conditions including HIV/AIDS, Tuberculosis,
Retinal Migraines and Acne, among others. [15]
3) Free Doctor, Doctor Gratis App Free online Doctor,
Free Doctor, Free medical consultation for any medical issues
(Doctor Gratis / Dokter Gratis). No appointment needed

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instant live chat with our General Physicians. No waiting
time. [16]
4) TopDoctorsOnline (TDO) App This is a health
service that enables you to find a complete solution to your
health concerns using the app. The TDO way is to understand
users’ health concern completely before we recommend your
health services to resolve your health concern. [17]
5) Superdoc - Ask A Doctor Online App Superdoc is
the best free app to ask a doctor online. Superdoc allows you
to chat with a doctor online for free.It’s very simple! Use
Superdoc to ask a doctor about your health or medical queries
and get answers instantly! You can also live chat with a
doctor, attach a picture of your affected area or your latest lab
reports and get answers in few taps. Your answer arrives in
less than 15 minutes. You get the benefit of doctor
consultation from the convenience of your home and for free.
You can also get a second opinion using Superdoc. [18]
6) Doctor On Demand Doctor On Demand is open to
everyone. See exactly what your visit will cost before you
connect. There are no monthly fees. Faster and less expensive
than a walk in clinic or ER, you can chat with a doctor
virtually 24/7, nights and weekends included. Just like an in-
person visit, your doctor will take your history and
symptoms, perform an exam, and may recommend treatment
- including prescriptions and lab work. They can also provide
a doctor’s note, if needed. [19]
III. METHODOLOGY
a) The scope of this chat application development
1) Text-based communication system with multiple user
connection development on android operating system based
on the java programming language (Android Studio IDE
Integrated Development Environment version 3.0.1),
Android SDK-Software Development Kit, and Android API
Level 27.
2) The user interface is developed in XML-Extensible
Mark-Up language.
3) The user interfaces include, login interface, chat
interface, chat list interface, doctor list for patient, patient list
for doctors.
4) The backend development is based on google firebase
real-time communication and database.
5) Sinch sdk provide calling interface which integrated
with Android Studio IDE & firebase database.
The application requirements can be divided into Functional
and Non-Functional requirements. Functional requirements
define the capabilities and functions that a system must be
able to perform successfully. Non-Functional requirements
define the qualities and criteria that can be used to judge the
operation of a system.
b) Functional Requirements
1) The Users must be able to sign up & system shuold
generate unique id of each users.
2) Manager must create account for certified doctors
3) Users must be able to log into the system.
4) Users must be able to logout of the system at any time.
5) System must provide an error message in case of login
failure for certain number of times
6) System must provide a chat list of doctors online.
7) System must allow all users to send and receive
messages.
8) System must allow sign-in users to access doctor’s
profile.
9) System must publish health related articles and tips.
10) Any user (both normal users and doctors) will be able
to enter the system using his own unique ID and password.
c) Non-Functional Requirements
1) The graphical user interface and sub interfaces of the
application must be user friendly The system should show
clear and detailed notification messages to the user.
2) The system must have lack of bugs and inform the user
of every wrong operation.
3) The system will be able to run on all Android devices.
4) The system will request a password for each user
account.
5) The system supports simultaneous users.
6) User manual must be developed to help a new user
understand the usage of the system.
d) Use Case Diagram For Proposed System
Actors: Doctors, Normal users, manager
Use cases
1) Logging into the system
2) Signing Up users
3) Logging Out of the system
4) Send a message
5) Receive a message
6) Access doctor & patients profile
7) App to app calling
e) A further illustration is the use case diagram in figure
below
Figure A Use case diagram of E-clinic
Figure A above depicts the use case diagram proposed for
the E-Clinic App.The Actors include Manager who has
administrative rights or privileges to create accounts or sign
up doctors on the system so as to ensure that a certified or
qualified doctors. As observed in figure A above the,
Doctors have access rights to Log-in, Send and Receive
messages and also Log-out of the system. The Normal user

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however has the access right to Sign-up, Log-in, Log-out,
Send and Receive messages, Access Doctors lists as well as
Access Doctor’s Profile.The mapping of communication
between the Doctor to the user is is many-tomany because
several Doctors could interact with the users simultaneously
while several users could interact with several Doctors at
the same time.
f) 3.3.2 Class Diagram E-Clinic (Logical View)
A class diagram in the Unified Modeling Language (UML) is
a type of static structure diagram that describes the structure
of a system by showing the system's classes, their attributes,
operations (or methods), and the relationships among objects.
Figure B Class diagram of E-clinic
IV. ANDROID, ANDROID STUDIO & SDK
a) Android, What is it?
Android is a mobile operating system developed by Google.
It is based on a modified version of the Linux kernel and other
open source software, and is designed primarily for
touchscreen mobile devices such as smartphones and
tablets[20]. It is open source and freely available to
manufacturers for customization, there are no fixed hardware
and software configurations.[21]
b) Features of android architecture
Feature Description
Beautiful UI Android OS basic screen
provides a beautiful and
intuitive user interface.
Connectivity GSM/EDGE, IDEN, CDMA,
EV-DO, UMTS, Bluetooth,
Wi-Fi, LTE, NFC and
WiMAX.
Storage Firebase, SQLite, a
lightweight relational
database, is used for data
storage purposes.
Media support H.263, H.264, MPEG-4 SP,
AMR, AMR-WB, AAC, HE-
AAC, AAC 5.1, MP3, MIDI,
Ogg Vorbis, WAV, JPEG,
PNG, GIF, and BMP
Messaging SMS and MMS including text
messaging, C2DM, GCM for
push messaging service.
Multi-touch Android has native support
for multi-touch which was
initially made available in
handsets such as the HTC
Hero.
Multi-tasking User can jump from one task
to another and same time
various application can run
simultaneously.
Multi-Language Supports single direction and
bi-directional text.
Wi-Fi Direct A technology that lets apps
discover and pair directly,
over a high-bandwidth peer-
to-peer connection.
Resizable widgets Widgets are resizable, so
users can expand them to
show more content or shrink
them to save space
Voicebased features Google search through Voice
has been available since
initial release. Voice actions
for calling, texting,
navigation etc. are supported
on Android 2.2 onwards.
Video calling Supports real time video
calling
c) Android Application Architecture
The following application services are the architectural
cornerstones of all Android applications, providing the
framework to be using by developer. [22]
1) Activity ManagerControls the life cycle of activities,
including management of the activity stack.
2) Views are used to construct the user interfaces for
activities.
3) Notification ManagerProvides a consistent and non-
intrusive mechanism for signaling users.
4) Content ProvidersLets the user applications share data
between applications.
5) Resource ManagerSupport's non-code resources like
strings and graphics to be externalized.
6) AndroidManifest.xml, which is an XML file
describing the application being built and what components ,
activities, services, etc. are being supplied by that application.
7) Intents are system messages, running around the inside
of the device, notifying applications of various events, from
hardware state changes
8) Gradle is an advanced build system as well as an
advanced build toolkit allowing to create custom build logic
through plugins.
V. FIREBASE REALTIME DATABASE
a) Firebase, What is it?
Firebase is a fully managed platform for building iOS,
Android, and web apps that provides automatic data
synchronization, authentication services, messaging, file
storage, analytics, and more. Starting with Firebase is an

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efficient way to build or prototype mobile backend services.
Firebase is developed by Firebase, Inc. in 2011, then acquired
by Google in 2014. [23] As of October 2018, the Firebase
platform has 18 products,[24] which are used by 1.5 million
apps.[25]
b) Working process of Firebase
1) Firebase is essentially a real time database. The data
appears as JSON files and allows real time changes to occur
on the connected client side. When you build cross-platform
apps using iOS, Android, JavaScript SDKs, your clients end
up getting all the data that was updated.
2) Firebase has support for the web, iOS, OS X, and
Android clients. It has a Node.Js and a Java library designed
for server-side use.
3) Developers install firebase by including a library in
their applications. This library provides a data structure that
is automatically synchronized between all of your clients and
with our servers.
4) If one client changes a piece of data, every other client
observing the same piece of data will be updated as well
within milliseconds. [26]
c) Adding Firebase to our Android project
1) Create a Firebase project in the Firebase console.
2) If you already have an existing Google project
associated with your mobile app, click Import Google
Project. Otherwise, click Create New Project.
3) Click Add Firebase to your Android app and follow
the setup steps. If you're importing an existing Google
project. Download the config file. When prompted, enter
your app's package name.
4) At the end, you'll download a google-services.json file.
5) If you haven't done so already, copy this into your
project's module folder, typically app.[27]
d) Firebase Cloud Messaging
Firebase Cloud Messaging (FCM) is a cross-platform
messaging solution that lets you reliably deliver messages at
no cost.
Using FCM, you can notify a client app that new email or
other data is available to sync. You can send notification
messages to drive user re-engagement and retention. For use
cases such as instant messaging, a message can transfer a
payload of up to 4KB to a client app. [28]
Send notification
messages or data
messages
Send notification messages that are
displayed to your user. Or send data
messages and determine completely
what happens in your application code.
Versatile message
targeting
Distribute messages to your client app in
any of 3 ways—to single devices, to
groups of devices, or to devices
subscribed to topics.
Send messages
from client apps
Send acknowledgments, chats, and other
messages from devices back to your
server over FCM’s reliable and battery-
efficient connection channel.
e) Real time Databases
The Firebase Realtime Database is a cloud-hosted database.
Data is stored as JSON and synchronized in realtime to every
connected client. When you build cross-platform apps with
our iOS, Android, and JavaScript SDKs, all of your clients
share one Realtime Database instance and automatically
receive updates with the newest data.
1) Realtime: Instead of typical HTTP requests, the
Firebase Realtime Database uses data synchronization—
every time data changes, any connected device receives that
update within milliseconds. Provide collaborative and
immersive experiences without thinking about networking
code.
2) Offline: Firebase apps remain responsive even when
offline because the Firebase Realtime Database SDK persists
your data to disk. Once connectivity is reestablished, the
client device receives any changes it missed, synchronizing it
with the current server state.
3) Accessible from client devices: The Firebase
Realtime Database can be accessed directly from a mobile
device or web browser; there’s no need for an application
server. Security and data validation are available through the
Firebase Realtime Database Security Rules, expression-
based rules that are executed when data is read or written.
[29]
Figure C Application Database
VI. APPLICATION USER INTERFACE
a) Login & Registration
E-Clinic Uses Android Getting Started with Firebase – Login
& Registration with Authentication. While app starting there
are two different activity comes, LOGIN and another one is
REGISTER.
Figure D Login & Registration
Emails concerning password resets are the most common
types of emails all over the world. If you don’t remember
your password or when you are logged out from your E-

5. 5
Clinic account, you can change it from the login screen by
clicking “Forgot Your Password?”
1) Ask the user to provide the registered email id.
2) The system checks the provided email id is available
in the DB or not.
3) If email id is there in the DB then system send link to
reset the password but if email id is not there in the DB then
system show the alert messaged.
4) The user provide strong password for security purpose
while resetting the forgot password.
5) Password reset successfully and is also change in the
DB with respect to the email id.
Figure E Reset password
b) What is fragment?
Fragment you can think of it like a sub activity, which sits
with in an activity and which contributes its own UI to the
activity screen. Fragments are always part of an activity. With
out an activity, a fragment will not exist. So your fragment
life cycle will always be affected by activity life cycle. An
activity can contain more than one fragment.
The projects Main activity shows 3 fragment
o Fragment Chat
o Fragment Doctor List
o Fragment Profile
c) The basic purpose of fragments
1) Fragments are designed to use the device UI space
efficiently.
2) fragments are designed as a reusable UI components
between more than one activity.
Figure F Main user interface with 3 fragment
Figure G Fragment doctorlist with onclickview profile &
chat activity button
d) Chat activity
1) Instant Messaging: This is the basis of this app’s
success, and a basic feature of all chat apps. It operates largely
through a user’s connection to the internet, and even when
they go offline, users are able to get message when they go
back online.
2) Real Time Connectivity: Linked to the ‘instant’ in
instant messaging, real time connectivity is the preferred
medium for this apps, because message delivery happens
promptly and immediately, without any distance barriers,
making users feel closer to each other.
When a user stay logged on the system, then his status turned
on online mode and a green signal is showing with his used
avatar. After a successful messaging if user is not in online
mode than it delivered to the server and when receiver seen
the message, sender will able to know that message is seen or
not.
Figure H Getting started with real time messaging
User can send and receive photos in Messages. There are two
ways to send photo messages with this application. Tap the

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Camera icon to take a picture, or tap the Gallery icon to
browse for a photo to attach.
Figure I Send message from camera and gallery
e) Calling activity
Every profile contains a calling button. During touch on call
button a alert dialogbox is opened and makes a outgoing call.
Alert dialogbox contains a hangup button which works for
terminate the call on progress. On other hand for incoming
call also contains a alert dialogbox which contains two
button, one for receive call another one is for reject.
Figure J Alert dialogbox of incoming and outgoing calling
f) Options menu and menu items
Menus are a common user interface component in many types
of applications. To provide a familiar and consistent user
experience, you should use the Menu APIs to present user
actions and other options in your activities. The options menu
is the primary collection of menu items for an activity. Here
this application holds a option menu with three case items for
user logging out which works for disconnect for server and
placed the user in start activity. Another one is health tips that
provide rules, how to stay healthy and fit. Third item About
is for software information, providers, copyright and licenses
agreement.
Figure K Menu items activity
VII. SINCH SDK (VOICE CALLING)
a) Sinch, What is it?
Sinch provides the best video chat API that enriches your
app with voice, video, verification and real time
communication APIs. It gives mobile app developers an
excellent way to add communication in their app. The
platform also let developers integrate voice into their app in
no time using a few lines of code. For optimum audio quality
and video selection, Sinch uses an adaptive codec selection
and WebRTC API.
b) Sinch Voice
Sinch offers a platform for real time communication over
the Internet. It consists of different software development kits
– the Sinch SDKs – that you integrate with your smartphone
or web application and cloud based back-end services. Sinch
back-end services also integrate with the public switched
telephone network(PSTN) in form of high quality voice
termination at low rates, making it possible to connect calls
to any phone number in more than 150 countries. [30]
c) Sinch different voice services
When using Sinch for Voice calling, the Sinch platform
can be seen as a big telephony switch. It receives incoming
phone calls, sets up outgoing phone calls and bridges the two.
The incoming call may come from a mobile or web
application (over data) or through a local phone number.
Similarly, the outgoing call can be terminated to another
mobile or web application (over data) or to a phone number
(via the PSTN network), hence the following classification:
o App to app calling
o App to phone calling
o Phone to phone calling
This project use the methodology of app to app calling for
doctor patient communication. For that first set up a new
application using the Dashboard, where you can then obtain
an Application Key and an Application Secret. The "key" is
your user ID, and the "secret" is your password. They just use

7. 7
the "key" and "secret" terms because that's how they've
implemented it. [47]
Figure L Adding apps to sinch service to generate
environment, app key and app secret
d) App to app Calling
The Sinch SDK available for Android, makes this project
easy to add app-to-app calling. First set the library function
to access the sinch sdk named “sinch-android-rtc-3.12.9.aar”
file and compile “ 'sinch-android-rtc', version: '+', ext: 'aar' “
function in app level dependencies to integrate environment
with android studio. We Integrate VoIP into this app & start
using voice calls to talk to anyone with a connection.
Figure M Sinch .aar file and environment
e) Sinch Analytics
Sinch analytics charts for voice & video Shows ratio of total
calls, answered calls and duration. Get up to date call data
with the real time dashboard for every client. The ratio holds
daily activity of calling. Manager will also able to view ratio
of monthly and yearly activities.
Figure N Analytics diagram of calling
f) Result Of Call Log
Call logging is the tracking of telephone calls and deciphering
the information. Call logging does not focus on the actual
content of the phone calls, but rather on the statistical and
technical data about telephone calls. There are many benefits
associated with call logging. In addition to analysis of the
number of calls, the call costs, date and time of calling, call
logging can provide information on instances of telephone
fraud.
Figure O Call log result, time and type of call
VIII. CONCLUSION
The goals of the project were to development a chat
application to facilitate communication between doctors and
patients built on the android platform. The main goal was
accomplished as well as their related functional and non-
functional requirements were met.To begin with, in our
project we created a real-time chat communication
application that can enable person who medical attention
need be able to have access to a doctor via the internet. We
have developed a healthcare App which is very user friendly
and efficient in communication and reporting. The
application developed has met all the objectives that were
delineated as the advantages of the proposed system. By
deploying the application on mobile phones we have been
able to bring the healthcare App on the palm of every
individual. This application improves the communication
between doctor and patient. In this app Patient can
communicate with doctor via internet calling. It reduces the
extra paperwork, delay in timing and cost.
IX. FUTURE WORK
As our next tasks, at first, we to improve the efficiency of our
model so that it can play an advanced role in healthcare in
Bangladesh. We will try to make the doctor-patient
communication more accurate. One of our prime focuses will
be to make the system as reliable as possible. In addition to
that, we will try to develop a realtime chat application. Also,
we have the plans to add more features including- doctors
rating, a process by which user can rate their doctors whom
they visited, Video calling for face to face communication,
GPS Location for hospital finding, Patient can request for
appointment and try to adding blog & blood bank. Also, we
have future plans to build desktop and apple ios of our
software for mass use.
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