Smart Emergency Assistance System With Pre-Entry Access for Older Adults Living Alone: Simulation-Based Implementation Report

Older adults living alone are at increased risk during medical emergencies, particularly due to delayed detection, information transmission, and physical access to the home. Digital health and Internet of Things (IoT)-based technologies offer opportunities to strengthen emergency response systems; however, evidence on the real-world implementation and performance of integrated home-based emergency assistance platforms remains limited.

This study aims to describe the deployment and performance of a smart emergency assistance system for older adults living alone, and to evaluate key implementation outputs and performance indicators in a simulated environment.

We implemented an emergency assistance system integrating the IoT, 5G technology, and mobile internet. An intelligent distress button served as the core user-facing device, while a hospital-based rescue management platform functioned as the central coordination hub. The implementation strategy focused on rapid signal transmission, automated multichannel notification, and precise location tracking to support home-based emergency response. System performance was assessed using predefined key performance indicators, including response time, notification success, positioning accuracy, and operational efficiency.

When the intelligent distress button was pressed continuously for at least 3 seconds, distress signals were transmitted to the hospital rescue management platform within 5 seconds. Notifications were automatically sent to the emergency medical services (EMS) and family contacts via SMS, with confirmation feedback completed within 10 seconds. The platform detected the GPS location of the person in distress with an error of less than 10 meters. Upon arrival of rescue personnel at the scene, system-enabled door unlocking was completed within 1 minute. The system demonstrated low hardware cost and low power consumption, with a distress trigger success rate of 97.78% (44/45) in simulated testing and 100% antimisoperation effectiveness.

This implementation demonstrates the feasibility and scalability of a smart emergency assistance system for older adults living alone. By integrating emergency alerting, access control, and hospital-side coordination, the system supports rapid and efficient home-based emergency response and shows potential for scalable deployment in aging communities. However, several barriers to large-scale implementation remain, including incomplete integration with formal emergency dispatch systems, unvalidated hardware durability, and a lack of real-world user testing. Addressing these issues in future pilot deployments will be essential to transitioning from technical feasibility to operational readiness.