Neurocomputing 565 (2024) 127017

Contents lists available at ScienceDirect

Neurocomputing
journal homepage: www.elsevier.com/locate/neucom

A review of IoT applications in healthcare

Chunyan Li a, Jiaji Wang b, Shuihua Wang b, c, Yudong Zhang b, d, *
a
School of Informatics, Yunnan Normal University, Kunming 650500, China
b
School of Computing and Mathematical Sciences, University of Leicester, LE1 7RH, United Kingdom
c
Department of Biological Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, Jiangsu 215123, China
d
Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia

A R T I C L E I N F O A B S T R A C T

Keywords: Integrating Internet of Things (IoT) technologies in the healthcare industry represents a transformative shift with
IoT tangible benefits. This paper provides a detailed examination of IoT adoption in healthcare, focusing on specific
Healthcare sensor types and communication methods. It underscores successful real-world applications, including remote
Remote monitoring
patient monitoring, individualized treatment strategies, and streamlined healthcare delivery. Furthermore, it
delves into the intricate challenges to realizing the full potential of IoT in healthcare. This includes addressing
data security concerns, ensuring seamless interoperability, and optimizing the use of IoT-generated data. The
paper seeks to inspire practitioners and researchers by highlighting the practical implications of IoT in health­
care, emphasizing the ways IoT can enhance patient care, resource allocation, and overall healthcare efficiency.

1. Introduction Secondly, IoT technologies streamline healthcare operations by auto­

mating administrative tasks, which not only saves time but also reduces
The Internet of Things, abbreviated as the IoT, is a revolutionary and the need for an extensive administrative workforce, resulting in cost
rapidly evolving technology that has the promise to change the way we savings. Moreover, routine tasks like vital sign monitoring and medi­
interact with our surroundings [1–3]. It is estimated that by 2025, there cation dispensing can be automated, decreasing the risk of errors and
will be over 75 billion connected devices worldwide [4]. The healthcare lowering labor costs. Most significantly, IoT’s early detection and
industry is one of the sectors that is expected to benefit greatly from this continuous monitoring capabilities help in averting costly medical
growth. complications, reducing hospitalizations, and mitigating the need for
IoT involves the interconnection of different kinds of physical sub­ expensive interventions, ultimately lowering healthcare costs signifi­
jects, types of equipment, and sensors via the Internet, enabling them to cantly. It can also improve patient engagement [15] by giving patients
communicate with each other and share data [5,6]. In healthcare, IoT greater control over their healthcare, allowing them to track their health
technologies are already being used to improve patient care and out­ data and communicate more effectively with healthcare providers.
comes, offering new opportunities for remote monitoring [7,8], Wearables and apps monitor vital signs, while patient portals offer ac­
personalized treatment plans [9], and efficient healthcare delivery [10]. cess to medical records. Telemedicine and remote monitoring facilitate
The IoT is also transforming industries beyond healthcare, such as virtual appointments and real-time data sharing. Mobile apps help in
manufacturing [11], transportation [12,13], and agriculture [14], and self-management and data sharing, and secure messaging systems pro­
has the potential to reshape our society as a whole. As such, it is crucial mote direct communication with healthcare providers. IoT devices
to stay abreast of the latest developments in this exciting field and automatically transmit data. Education and training are essential to
explore the ways in which IoT can be leveraged for positive change. ensure users can confidently navigate these technologies. By utilizing
In addition to improving patient care, the IoT can substantially and these tools, individuals become active participants in their healthcare,
greatly reduce healthcare prices by streamlining processes, automating fostering better communication, engagement, and, ultimately, improved
routine tasks, and decreasing the need for expensive interventions. It health outcomes.
enhances patient care by enabling real-time data collection and moni­ The use of IoT in healthcare brings with it a host of challenges and
toring, thereby improving response times and patient outcomes. limitations that must be carefully navigated. These include concerns

* Corresponding author at: School of Computing and Mathematical Sciences, University of Leicester, LE1 7RH, United Kingdom.
E-mail address: yudongzhang@ieee.org (Y. Zhang).

https://doi.org/10.1016/j.neucom.2023.127017
Received 22 May 2023; Received in revised form 18 October 2023; Accepted 6 November 2023
Available online 9 November 2023
0925-2312/© 2023 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
C. Li et al. Neurocomputing 565 (2024) 127017

about data privacy and security [16], interoperability issues [17], and Table 2
the need for standardized protocols and regulations [18]. Data privacy A comparison of research on remote monitoring.
and security concerns are paramount, as the collection and transmission Reference Year Communication Advantage (s)
of sensitive medical data require stringent safeguards to protect patient
[95] 2022 Wifi ● Continuous monitoring of vital health
privacy. Interoperability issues can arise due to the multitude of vendors indicators
and technologies involved in the development of IoT devices, which can ● Prompt resolution of issues by
lead to data silos and inefficient communication [19]. Standardized healthcare professionals.
protocols and regulations are also critical to ensure that IoT devices can [96] 2022 Cloud ● Alert Notification for Abnormal Events
and Emergencies
seamlessly integrate with existing healthcare systems and networks. ● Validation of Effectiveness and
Overall, the IoT is an exciting technology that is important for Reliability
healthcare providers, policymakers, and researchers to stay abreast of [97] 2022 Wifi ● Integration of IoT and medical
the latest developments and work collaboratively to address the chal­ promotion platform
● Evaluation of accuracy and
lenges and limitations associated with its use. This paper aims to
performance
contribute to this effort by providing a comprehensive overview of the ● Identification of optimal body parts for
IoT in healthcare and its potential to transform the healthcare industry. temperature monitoring
[98] 2022 Cloud ● Promotion of the integration of IoT and
2. IoT technologies in healthcare healthcare
[99] 2023 - ● Remote delivery of healthcare services
with expert support,
2.1. Sensors ● Efficient data collection and mining
● The overall enhancement of patient
Sensors are an essential component of IoT devices. They can measure health surveillance efficiency.
[100] 2022 Cloud ● IoT Cloud Server Integration
and transmit data from various sources, such as temperature, blood
● Real-Time Data Collection and
pressure, heart rate, glucose levels, and more. These sensors can be in­ Analysis
tegrated into wearable devices, medical equipment, and even inside the ● Alert Mechanism
human body. Tables 1–4. ● Data Input Variety
Apart from these well-established sensor technologies, researchers [101] 2023 Cloud ● Focus on Post-Covid scenarios
● Co-morbidity monitoring
have been striving to create more cutting-edge ones. [102] 2023 Cloud ● Focused on emergency medical
The VITALS system [20] is an online life-signs sensor that uses four services
physiological indicators perceived by clinical equipment. It includes a ● Dependability and high success rate for
microcontroller, a wireless communication module, and a system for big IoT data broadcasts
● Exciting performance with high
data analysis. Life signs are extracted and transmitted to the analysis
accuracy in vital sign
system every half an hour. The system was implemented for one week [103] 2023 Cloud ● Store and learn knowledge for future
during the experiment and demonstrated improved care options, state prediction
particularly for those with restricted access to medical care. The pro­ ● Achieves an impressive accuracy rate
posed heart rate sensor [21] utilizes the MAX30102 sensor, which emits of 99.53 %
[104] 2023 Wifi ● Influenza Symptom-Based Detection
visual light in the 650–670 nm wavelength range. The sensor is worn on
● Broad Application Scope
the wrist and records the heart rate signal in the shape of a compara­
tively flat wave, which is then processed using the detrend method to
obtain precise data. This research [22] aims to develop a novel sensor Table 3
using micro pyramid-assisted piezoelectric film (MPF) technology to A comparison of research on locating.
constantly monitor blood pressure non-invasively. The results show that Reference Year Target Advantage (s)
the results measured in practice with this MPF sensor are comparable to
[105] 2023 Patients ● Development of a UAV-based radar
those obtained with the more proven industrial products available array system
currently. This study [23] presents a new method for continuous blood ● Weighted CRB-based source
pressure monitoring that requires the use of only one signal and no localization
additional sensors and does not require calibration. A pulse oximeter has [106] 2023 Healthcare ● Replacement of the existing barcode
Resources system
been created to measure heart rate, blood oxygen saturation, and body ● Smart specimen transport box
temperature [24]. The device uses infrared light and sensors to detect ● Cloud-based monitoring
body temperature without contact and displays it on an LCD screen and [107] 2023 Patients ● Integration of multiple sensing
web browser. The paper [25] describes a novel paper-based capacitive technologies
● User-friendly interface
humidity sensor that achieves ultra-high humidity sensitivity and high
[108] 2023 Patients ● Supporting complex functionalities and
address environment-wellness
Table 1 relationships
Common sensors. ● Environmental sensing and wellness
monitoring
Sensor Type Measurement Clinical Application (s) [8] 2023 Patients ● Tracks critical health parameters
Electrocardiogram Electrical activity of the Detecting arrhythmias, heart ● Provides timely medical decisions based
heart disease on abnormal values
Pulse Oximeter Oxygen saturation levels Monitoring oxygenation during [109] 2023 Patients ● In the context of the COVID-19
and heart rate surgery, COPD, asthma pandemic
Blood Pressure Blood pressure Monitoring hypertension and [110] 2023 Healthcare ● Potential Application in Healthcare
hypotension Resources ● Automatic Notification and Prompt
Glucose Glucose levels in the blood Monitoring diabetes Action
or interstitial fluid ● Web Server Integration
Temperature Body temperature Detecting fevers or
hypothermia
Respiratory Respiratory rate and Monitoring breathing disorders
rhythm such as sleep apnea

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Table 4 smartphones [7]. Wi-Fi facilitates efficient data sharing within health­
A comparison of research on personalized medicine. care facilities, enabling the transfer of electronic health records and
Reference Year Target Advantage (s) medical images. Cellular networks [26], including 4 G and 5 G, offer
broad coverage for remote patient monitoring and telemedicine,
[15] 2023 Customized treatment ● Fostering shared decision-
based on patient making ensuring healthcare providers have access to vital patient data regard­
populations less of location. Together, these technologies form a dynamic network
[111] 2022 Personalized diabetes ● Focus on Personalized that supports real-time communication, fosters timely decision-making,
management Diabetes Management and enhances patient care. However, data security and privacy remain
● Contribution to Prognosis
Improvement
paramount considerations in their implementation.
[112] 2022 Individualized dietary ● IoT-based mHealth There are several types of IoT communication technologies that are
recommendations Monitoring System commonly used in healthcare, including:
● Consideration of Physical
Activity
2.2.1. Wi-Fi
● Targeted at Children with
Type 1 Diabetes Wireless internet connectivity is commonly used to connect IoT de­
[113] 2022 Personalised dental ● incorporating personalized vices to the internet and allow data to be transmitted across short dis­
prediction and treatment medicine in dental care tances, as shown in Fig. 1. It was first presented in 1997 [27] and has
[114] 2023 Personalized diabetes ● Utilization of 5G technology since become one of the most widely used wireless communication
care for real-time monitoring of
diabetic patients’ health.
technologies, providing trustworthy and fast connectivity to billions of
● Personalized care based on devices globally [28]. This technology operates on the IEEE 802.11
real-time data. standard [29], which provides the technical specifications for wireless
[115] 2023 Personalized monitoring ● The development of a hybrid local area networks (WLANs). Wi-Fi allows multiple devices to connect
algorithm for optimal feature
and communicate with each other.
selection
[116] 2022 Personalized monitoring ● Enabling quick adaptation of In recent years, Wi-Fi technology has continued to evolve, with the
the well-generalized model introduction of new standards such as Wi-Fi 6 and Wi-Fi 6E [30]. These
standards provide faster speeds, corrected security, and increased ca­
pacity, allowing the advancement of new applications and services that
sensitivity with fast response/recovery. In addition, the proposed sensor require high-speed connectivity and low latency. As Wi-Fi continues to
exhibits great stability in the monitoring of breathing. It can provide an develop and improve, it is expected to play an increasingly important
accurate recording of the breathing rate and depth of the patient in each role in the medical industry and other sectors that require reliable and
respiratory pattern. fast wireless connectivity[31].

2.2. Communications 2.2.2. Bluetooth

The name "Bluetooth" was inspired by Harald Bluetooth, a Viking
Communication technologies such as Bluetooth, Wi-Fi, and cellular king who unified Denmark and Norway in the 10th century. The name
networks are crucial for enabling data transfer between IoT devices and symbolizes the idea of uniting different devices through wireless
healthcare providers. These technologies help establish a seamless and communication. Developed by the Swedish telecommunications com­
real-time communication network between patients, healthcare pro­ pany Ericsson in 1994, this wireless communication technology is often
viders, and medical equipment. Communication technologies such as used to connect IoT devices and smartphones or other mobile devices.
Bluetooth, Wi-Fi, and cellular networks are instrumental in the seamless Bluetooth technology uses the frequency-hopping spread spectrum
integration of IoT devices within healthcare. Bluetooth enables close- (FHSS) [32] to avoid interference from other wireless devices operating
range, low-power connections, perfect for wearable health gadgets, in the same frequency range. The technology operates in the unlicensed
allowing real-time monitoring and data transmission to patient industrial, scientific, and medical frequency bands, typically within the

Router
Internet

Fig. 1. Data transmitted across short distances through Wi-Fi.

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range of 2.4–2.4835 GHz [33]. healthcare professionals to make more informed decisions and improve
patient outcomes.
2.2.3. Zigbee
Zigbee is a low-power wireless communication protocol normally 2.4. Artificial Intelligence (AI)
used for low data rate and long battery life IoT applications, such as
remote patient monitoring devices. Zigbee was developed in the early AI algorithms have emerged as powerful tools in healthcare,
21st century [34], and the first version of the standard was released in particularly when combined with data from IoT devices. By leveraging
2004 [35]. Zigbee uses a mesh network topology, which gives. Key the vast amount of data these devices generate, AI algorithms can pro­
features of Zigbee include low power consumption, support for mesh vide real-time insights into patient health and enable personalized
networking, a focus on low data rates, and a cost-effective approach. It’s healthcare interventions.
known for its ability to enable devices to communicate wirelessly while Machine learning models [48], a subset of AI, can analyze and
conserving energy, making it well-suited for battery-powered IoT de­ identify patterns in IoT data to predict disease progression and suggest
vices. This is achieved through the use of sleep modes, in which devices personalized treatment plans. These models can learn from historical
can turn off their radios and consume very little power when they are not data and detect subtle changes or anomalies in a patient’s health pa­
actively sending or receiving data. Zigbee also uses a collision avoidance rameters, allowing for early detection of potential health issues.
technique called CSMA-CA to reduce the likelihood of data collisions In the context of IoT in healthcare, AI algorithms can analyze data
[36]. from wearable devices and other IoT sensors to monitor life functions,
activity rates [49], sleep patterns [50], and other relevant metrics. By
2.2.4. Near Field Communication (NFC) continuously monitoring and analyzing this data, AI algorithms can
Near Field Communication (NFC) [37] is a short-range wireless provide clinicians with early warnings of health deteriorations or re­
communication technology that allows devices to communicate with lapses, enabling timely interventions and improved patient outcomes.
each other over a distance of a few centimeters, as shown in Fig. 2. NFC Furthermore, AI algorithms can utilize the collected IoT data to
is based on Radio Frequency Identification (RFID) technology, which generate individualized care schemes [51]. By considering individual
uses electromagnetic fields to transfer data wirelessly between two de­ patient characteristics, medical history, and real-time data, these algo­
vices. NFC technology enables a wide range of applications, such as rithms can analyze large datasets to identify optimal treatment strate­
contactless payments, access control, and data exchange between de­ gies tailored to each patient’s specific needs.
vices [38]. Incorporating the synergistic capabilities of AI and IoT will unveil a
transformative healthcare model poised with improved streamlining
2.3. Cloud and a steadfast focus on patient-centric methodologies. This evolution is
characterized by marked advancements in predictive preciseness,
While the cloud itself is not a communication technology, Cloud underpinned by a nuanced, personalized approach to therapeutic stra­
[39–41] provides a platform for storing [42], managing[43], and tegies, signifying a monumental shift towards a future of healthcare
analyzing colossal amounts of healthcare data generated by IoT devices imbued with technological innovation and customized care pathways.
[44], as shown in Fig. 3. It has revolutionized the way businesses and
individuals access and use computing resources, making it easier and 2.5. Blockchain
more cost-effective to store and process large amounts of data.
The origins of cloud computing can be traced back to the 1960s [45], The combination of blockchain technology [52–54] and IoT in
when early versions of utility computing were first developed. However, healthcare holds tremendous potential for enhancing data security and
it wasn’t until the late 1990s that the concept of cloud computing began facilitating seamless data sharing among healthcare providers. Via
to take shape [46]. harnessing the blockchain’s decentralized and immutable nature [55],
In the context of healthcare IoT, by using cloud computing to store patient data can be safeguarded against unauthorized access, tampering,
and process medical data, healthcare providers can reduce costs, and breaches. Through its distributed ledger system, blockchain ensures
improve patient outcomes, and enhance the overall quality of care. For that each transaction or data entry is cryptographically secured and
example, cloud computing can be used to store electronic health records linked to previous records, creating an unalterable chain, as shown in
securely [47], making it easier for healthcare professionals to access and Fig. 4. This not only preserves the integrity of patient data but also
share patient data across different organizations and systems [43]. It can provides transparency and accountability in data management.
also be used to store and analyze large amounts of data from wearable With blockchain, healthcare professionals can securely access and
devices and other medical IoT devices, allowing healthcare providers to exchange relevant patient information, regardless of geographical or
detect and treat diseases more effectively. Additionally, cloud organizational boundaries. This streamlined data sharing promotes
computing can provide real-time insights into patient health, enabling better care coordination, as it allows healthcare providers to have a

Rectifier

+
NFC Device Power

- Load

Controller
Clock

Fig. 2. NFC architecture.

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Cloud Platform

Gateways

Wearable Devices

Fig. 3. Cloud computing in IoT.

A record is requested A block representing the report The block is sent to every node
is created in the network

A block representing the report The block is added to the existing blockchain
is created and the record is complete

Fig. 4. How blockchain works.

comprehensive view of a patient’s medical history and make informed between the device and a distant cloud server [60]. This enables
decisions. Patients can have more control over their own data by real-time or near-real-time analysis of healthcare data, crucial in
granting permission for specific healthcare providers to access their time-sensitive applications such as remote patient monitoring, emer­
information. The use of smart contracts, a self-executing code on the gency response systems, and continuous health monitoring [61].
blockchain, automates data-sharing agreements and ensures compliance Furthermore, the introduction of edge computing significantly bol­
with privacy regulations, giving patients greater transparency and sters the integrity and confidentiality of data within IoT healthcare in­
control over their data. frastructures. By ensuring that sensitive health-related information is
retained and processed directly on the devices, edge computing mini­
mizes the vulnerability to unauthorized intrusions and potential data
2.6. Edge computing compromise. In the realm of healthcare, where the sanctity of data is
held in the highest regard, such an enhancement is instrumental in
Edge computing [56,57] plays a pivotal role in IoT in healthcare, fortifying the resilience of information systems against breaches,
offering significant advantages in real-time data processing and thereby safeguarding patient data with reinforced security protocols.
improved performance. This approach underscores a meticulous consideration of privacy, sub­
In the context of IoT in healthcare, edge computing addresses the stantiating a robust framework where data security is meticulously
challenges posed by network latency and the need for fast response upheld.
times [58]. Traditionally, IoT devices would transmit data to centralized Additionally, edge computing enables offline operation and resil­
cloud servers for processing and analysis, which can introduce delays in ience to network failures [62]. In scenarios where internet connectivity
critical healthcare applications. However, with edge computing, data is intermittent or unavailable, edge devices can continue to function and
processing occurs at the edge of the network, near the data source itself. process data locally, ensuring uninterrupted healthcare services and
One of the key benefits of edge computing in healthcare is reduced critical operations.
network latency [59]. By processing data locally on IoT devices, edge
computing minimizes the time required for data to travel back and forth

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2.7. 5G adjustments to ensure a comfortable and safe environment for patients

and staff while also promoting energy efficiency and reducing the risk of
In the context of IoT in healthcare, 5G networks enable real-time healthcare-associated infections. This research [84] focuses on an in­
communication [63], allowing healthcare providers to monitor door system for IoT healthcare using visible light communication. It
remotely [64] and interact with patients in a continuous manner. The investigates a MIMO VLC system that monitors indoor environments,
enhanced speed and low latency of 5G networks ensure that data can be collects data, and employs different modulation techniques for reliable
transmitted and received almost instantaneously, enabling timely re­ communication. It offers an efficient solution for monitoring various
sponses to critical healthcare situations. data types in IoT healthcare applications.
One of the key advantages of 5G networks is their ability to support a In terms of security and emergency response, IoT in indoor health­
vast number of connected devices [65]. This scalability is crucial in care environments facilitates the implementation of advanced surveil­
healthcare settings where numerous IoT devices are interconnected. The lance systems, access control, and emergency call systems. These
high capacity of 5G networks ensures that a large volume of data can be technologies enhance security measures, prevent unauthorized access,
transmitted simultaneously, enabling healthcare providers to efficiently and enable swift responses to emergencies, ensuring the safety of pa­
collect and analyze real-time patient data. tients, staff, and assets within the facility.
The reliability of 5G networks [66] ensures uninterrupted connec­ In hospitals, IoT devices such as wearable sensors and smart beds
tivity, which is essential in healthcare applications where continuous [85] can continuously monitor patient health, alerting healthcare pro­
monitoring and real-time communication are critical. This reliability is viders to changes in vital signs or patient activity. This can help reduce
particularly beneficial in remote areas or during emergency situations the risk of adverse events and improve patient outcomes.
where access to healthcare services may be limited. With 5G networks,
healthcare providers can deliver high-quality care remotely and bridge 3.2. Outdoor healthcare environments
the gap between patients and medical experts. The reduced delay in data
transmission ensures that healthcare providers can access and analyze In addition to personal localization and remote patient monitoring,
patient information promptly, enabling timely diagnoses, treatment the integration of smart and IoT-enabled facilities in outdoor healthcare
adjustments, and interventions. environments plays a pivotal role in enhancing the well-being of
Furthermore, 5G networks provide the foundation for advanced individuals.
technologies in healthcare, such as augmented reality (AR) [67,68], Public spaces such as parks, recreational areas, and transportation
virtual reality (VR) [69,70], and telepresence [71,72]. These technolo­ hubs are now equipped with advanced healthcare amenities that
gies have the potential to revolutionize medical education [73,74], leverage IoT technology to provide seamless healthcare access [86].
surgical training [75,76], and remote patient care [77,78] by enabling These smart facilities are designed to meet the diverse healthcare needs
immersive experiences and remote collaboration among healthcare of the public efficiently.
professionals. One notable aspect of smart outdoor healthcare environments is the
utilization of IoT-enabled kiosks. These interactive kiosks serve as in­
3. IoT in different healthcare settings formation hubs, offering real-time data on nearby healthcare providers,
medication dispensaries, and emergency contact numbers [87]. In­
3.1. Indoor healthcare environments dividuals can access personalized health information, locate the nearest
healthcare facilities, and receive immediate assistance in case of
In indoor healthcare environments such as hospitals, IoT devices can emergencies.
be used to monitor patients, manage medical equipment, and track in­ Furthermore, it is anticipated that in the future, smart parks and
ventory. IoT sensors can also monitor environmental factors such as recreational areas could be equipped with fitness stations featuring IoT-
temperature, humidity, and air quality, which can help prevent the connected exercise equipment [88]. These envisioned smart fitness
spread of infections. stations would have the potential to monitor users’ activity, provide
In indoor healthcare environments, IoT offers helpful functions for personalized exercise recommendations, and track vital health metrics.
tracking the location of patients and healthcare staff. Through utilizing It is envisioned that users may access these anticipated facilities through
wearable devices, RFID tags [79], or smartphone-based solutions, smartphone apps, potentially allowing for a tailored fitness experience
real-time monitoring of individuals’ movements becomes possible. This based on individual health goals and preferences.
technology facilitates efficient navigation, optimizes workflow, and Transportation hubs also benefit from IoT integration. Automated
enhances emergency response times, leading to improved patient care. external defibrillators (AEDs) [89] are now equipped with IoT sensors
This paper [80] proposes a deep CNN-LSTM architecture for indoor that continuously monitor their functionality. In case of any issues or
location estimation using a Passive Infrared (PIR) sensor in IoT health­ malfunctions, automatic alerts are sent to healthcare providers, ensuring
care systems. This paper [81] focuses on the use of an IoT model to that these life-saving devices are always ready for use.
analyze audience behavior in a resort, specifically emphasizing the in­ In summary, outdoor healthcare environments are evolving to
door system for tracking individuals’ movements and identifying their embrace smart and IoT-enabled facilities that enhance the healthcare
behavioral patterns. experience in public spaces. From interactive kiosks to connected fitness
Furthermore, indoor location technology enables the tracking and equipment and advanced navigation systems, these technologies ensure
management of medical equipment and assets. By attaching RFID tags or that healthcare resources are readily accessible, personalized, and
utilizing sensor networks, healthcare providers can efficiently monitor responsive to the unique needs of individuals in outdoor settings.
medical devices’ location, usage, and maintenance needs, ensuring their
availability when needed and reducing costs associated with equipment 3.3. Remote patient monitoring
loss or misplacement. This research [82] proposes a non-intrusive in­
door location framework using wireless sensor networks for IoT IoT devices such as wearables and remote monitoring systems can be
healthcare. Through blockchain-based smart contracts, it implements used to monitor patient health outside of traditional healthcare settings.
role-based access control for system security. Remote patient monitoring can help improve patient outcomes by
IoT-based indoor localization systems also contribute to environ­ detecting changes in health status early and enabling healthcare pro­
mental monitoring in healthcare facilities. By deploying sensor net­ viders to intervene quickly [90].
works, parameters such as temperature, humidity, air quality, and Remote Patient Monitoring(RPM) utilizes technology, such as
occupancy can be monitored in real-time [83]. This enables automated wearable devices, sensors, and telecommunication tools, to remotely

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monitor patients’ health status, collect relevant health data, and facili­ environmental factors affecting public health, such as air pollution and
tate virtual consultations between patients and healthcare providers. disease outbreaks. Smart urban planning promotes active lifestyles with
This approach allows for ongoing monitoring of vital signs, medication green spaces and efficient transportation systems. Moreover, these cities
adherence, symptoms, and other health indicators without the need for incorporate public health monitoring and control mechanisms. They can
frequent in-person visits. proactively track and manage health risks in public spaces, including
One of the significant benefits of RPM is its ability to provide early warning systems for potential disease outbreaks and real-time air
healthcare services to patients in remote or underserved areas [91]. quality alerts. Ultimately, smart cities create a healthier and more
Patients living in rural or geographically isolated locations may face accessible healthcare ecosystem that benefits both individuals and the
challenges accessing specialized healthcare services. RPM bridges this broader public, improving overall well-being.
gap by enabling remote monitoring and consultations, allowing
healthcare providers to deliver timely interventions and guidance. 4. IoT applications in healthcare
Moreover, RPM offers a convenient solution for patients with limited
mobility, such as those with physical disabilities or chronic conditions 4.1. Remote monitoring
that make travel difficult. By leveraging remote monitoring technolo­
gies, patients can receive the necessary healthcare support from the In the dynamic landscape of healthcare technology, the integration
comfort of their own homes. Healthcare providers can remotely assess of the IoT into remote health monitoring represents a pivotal advance­
their condition, adjust treatment plans, and provide guidance without ment, setting a novel paradigm in patient care and medical data man­
the need for frequent hospital visits. agement. Recent models leverage IoT to craft a nexus where portable
For patients with paralysis or other mobility limitations, RPM pro­ physiological monitoring seamlessly intertwines with sophisticated
vides a lifeline to healthcare. They can use wearable devices [92], such expert systems [95], thus enabling an ecosystem that fosters accuracy,
as smartwatches or wireless sensors, to track their health parameters, immediacy, and reliability in diagnosis and patient care. Navigating
including heart rate, blood pressure, glucose levels, and more. The through the latest literature unveils a spectrum of innovations that
collected data is transmitted securely to healthcare professionals who collectively contribute to refining the reliability and efficiency of remote
can analyze it and provide appropriate medical interventions. health monitoring systems. These developments are instrumental in
By implementing RPM, healthcare providers can ensure regular driving forward the boundaries of technological integration in health­
monitoring and early detection of health issues, reducing the risk of care, catalyzing a phase marked by unprecedented precision and effec­
complications and hospital readmissions. This proactive approach to tiveness in patient monitoring and care.
care management improves patient outcomes and enhances the overall This study [96] presents a remote long-suffering monitoring system
quality of life for patients with limited mobility. using IoT and cloud computing for accurate and constant health moni­
toring, abnormality detection, and alarm reports. The system includes a
3.4. Smart cities portable function for data visualization, loading, and real-time remote
monitoring. It has been proven to measure biological parameters and
IoT technologies can be used to create smart cities that support tested for reliable performance in real-time data transmission.
healthier lifestyles. Smart cities can incorporate IoT devices such as The research [97] emphasizes the monitoring of remote patients’
smart traffic lights, air quality monitors, and noise sensors, which can body temperature using embedded infrared sensors and WiFi connec­
help reduce the risk of respiratory illness, noise pollution, and accidents. tivity in an IoT-based system. The prototype demonstrates accurate
Governments have recognized the potential benefits of RPM in temperature measurement and offers guidance on the optimal body
improving healthcare outcomes, reducing healthcare costs, and parts for effective temperature monitoring.
enhancing patient satisfaction. As a result, they have taken various ac­ The proposal [98] suggests a secure and private integration of IoT
tions to support and advance the adoption of RPM in healthcare systems. with healthcare units to achieve a reliable and secure remote patient
Governments have been actively involved in establishing robust monitoring system. It utilizes secure authentication, communication,
policies and regulations that prioritize patient data privacy and security and privacy measures, including a smartwatch, server, and smartphone
in the context of RPM [93]. They enforce compliance with data pro­ application for monitoring vital signs.
tection laws, develop guidelines for secure data transmission and stor­ ML-based algorithms [99] enhance patient health surveillance
age, and promote the use of encryption and authentication measures to through remote monitoring, efficient data mining, and improved
safeguard patient information. healthcare services.
Additionally, governments allocate substantial funding and financial This study [100] presents a convenient electrocardiogram moni­
support to healthcare organizations to facilitate the implementation and toring system that links patients and doctors through a cloud server. It
integration of RPM into existing healthcare systems. They also invest in allows remote monitoring, investigation, and alarms, reducing hospital
infrastructure development, such as broadband connectivity and tele­ appointments. Experimental results demonstrate trustworthiness and
communication networks, to ensure remote monitoring services are comparisons with existing techniques, followed by a system perfor­
accessible even in remote or underserved areas. Moreover, governments mance demonstration.
actively foster collaborations and partnerships among healthcare pro­ The paper [101] proposes using IoT-based remote patient moni­
viders, technology companies, and research institutions to drive inno­ toring with medical IoT wearables and ML algorithms to monitor
vation, share best practices, and develop standardized protocols for RPM Post-Covid patients and provide immediate medical assistance.
[94]. These collective efforts demonstrate governments’ commitment to This paper [102] presents the implementation of a private backend
creating an environment that supports RPM adoption, improves server software for an IoT health monitoring system. The system uploads
healthcare delivery, and ultimately enhances patient outcomes. data to a cloud server after detecting vital signs. Compared to existing
For individuals, smart cities offer personalized healthcare experi­ patient monitoring systems, the system demonstrates impressive per­
ences through technologies like telemedicine and wearable health de­ formance and accuracy, achieving a high success rate for IoT data
vices. These tools provide remote access to medical professionals and broadcasts.
real-time health monitoring, empowering individuals to actively The proposed framework in this study [103] utilizes a Convolutional
manage their well-being. Additionally, smart cities facilitate convenient Neural Network with Long-Short Term Memory (CNN-LSTM) to create a
access to medical services, making healthcare more accessible. Patient Activity Monitoring System for accurate human action recog­
On a public scale, smart cities contribute to better population health nition. The results demonstrate a high accuracy rate of 99.53 %, sur­
through data-driven insights. They can detect and mitigate passing existing algorithms by at least 4.73 %.

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C. Li et al. Neurocomputing 565 (2024) 127017

This research [104] proposes a smart system using IoT technology to treatment to the unique genetic, environmental, and lifestyle factors of
assist patients with influenza symptoms in determining their COVID-19 individual patients, holding the promise of more effective and precise
infection status. The system enables quick medical care and tracking of healthcare. To gain a deeper understanding of the current state of this
patient mobility to analyze suspected behaviors, with potential appli­ evolving field, we delve into a comprehensive study that explores the
cations in medical institutions, quarantine units, and airports. latest advancements and trends in personalized medicine.
This study [15] validates the relationship between IoT adoption and
4.2. Locating systems patient care service engagement. The findings highlight the importance
of personalized medicine and the need for a reliable computing envi­
Through real-time locating systems (RTLS), healthcare providers can ronment to ensure privacy and security. The study provides a framework
quickly locate the position of patients, particularly in emergency and for healthcare providers to empower patients and improve the patient
critical situations, enabling timely medical assistance and reducing the care delivery environment, fostering shared decision-making and supe­
risk of patient harm. The research on RTLS extends beyond patient rior care services.
location and encompasses accurate and up-to-date information on This paper [111] focuses on utilizing the Latent Dirichlet allocation
healthcare resource locations. By implementing RTLS, healthcare facil­ (LDA) model in the context of personalized diabetes management. The
ities can effectively manage and track vital medical resources such as aim is to predict future treatment approaches. This emphasizes the po­
equipment, medications, and supplies, ensuring their timely availability, tential of personalized diabetes management to enhance patient prog­
reducing search time, and preventing inventory shortages or delays in noses and signifies a noteworthy advancement in healthcare
patient care. decision-making.
This study [105] proposes an approach that leverages deep neural The target group of this study [112] is children with type 1 diabetes.
networks and spatial-spectrum fitting to achieve precise and effective The system considers the effect of activity on the extent of the patient’s
source localization within UAV networks with radar arrays. The method illness, allowing doctors to provide individualized dietary recommen­
enhances both the accuracy and real-time processing capabilities. dations based on predicted changes in blood glucose levels. This study
This study [106] utilizes RFID and NB-IoT technology to precisely emphasizes the potential of IoT and mHealth technologies in delivering
track and monitor medical resources in the context of specimen logistics personalized healthcare solutions for pediatric diabetes management.
in a hospital. By integrating IoT capabilities such as real-time location This paper [113] presents a personalized dental caries prediction
tracking and environmental condition monitoring, the system enhances model using machine learning. This personalized approach eliminates
the efficiency and reliability of specimen transport. It effectively ad­ the hard detection process and enables dentists and patients to assess the
dresses the challenges associated with the logistics and management of risk of future severe dental infections.
medical resources. This project [114] utilizes 5G technology to monitor diabetic pa­
This work [107] proposes a wearable device system suitable for in­ tients’ health in real-time, providing early alerts and personalized care.
dividuals who are prone to getting lost, such as those with Alzheimer’s This study [115] introduces a system that utilizes exhaled VOC
disease. The system enables location tracking and step detection both analysis for personalized monitoring and disease diagnosis. It provides
indoors and outdoors. Data is documented and accessed through a user various benefits, including early diagnosis, cost reduction, and improved
web application, allowing for anomaly detection, patient positioning, quality of care.
and warnings to caregivers. The system aims to enhance independence This study [116] proposes a meta-learning-based personalization
and provide peace of mind to caregivers. approach for individualized health monitoring, which realizes better
The study [108] demonstrates the use of sensor-agnostic APIs and accuracy than accessible approaches in detecting vital signs and human
ontology modules to support complex functionalities and address activity.
environment-wellness relationships. It focuses on location-based appli­
cations, such as environmental sensing and wellness monitoring, and 5. Discussion
proposes an ontology-based approach.
This research [8] tracks critical health parameters in the direct. Data IoT has brought tremendous advancements to healthcare, empow­
is conveyed to the cloud storing system and displayed to practitioners ering healthcare providers, patients, and systems alike. By harnessing
and affected roles through a mobile application. The system allows the potential of IoT technology, the healthcare industry can improve
timely medical decisions based on abnormal values. The study [109] patient outcomes, optimize resource utilization, and transform health­
implemented similar functionality in the context of the COVID-19 care delivery into a more personalized and proactive approach. How­
pandemic. ever, it is imperative to address security and privacy concerns to ensure
The IoT-enabled embedded device [110], integrated with health care IoT’s responsible and ethical implementation in healthcare.
systems, monitors the trash levels in public bins. This IoT solution en­ Medical IoT devices collect and transmit a large amount of sensitive
sures timely waste management, reducing the city’s risk of unsanitary information, including personal health data, medical history, and bio­
conditions and potential health hazards. metric measurements. In research settings, scholars must establish clear
The IoT-enabled embedded device, integrated with health care sys­ and transparent privacy policies and consent mechanisms to inform
tems, not only monitors the trash levels in public bins but also holds the patients about the collected data, how it will be used, and with whom it
potential for future applications in managing medical waste in hospitals. will be shared. Patients should have control over their data and be able
By leveraging IoT technology, hospitals can implement similar moni­ to provide informed consent for its usage. Anonymization techniques
toring systems for medical waste disposal. This would ensure efficient such as de-identification [117] or differential privacy [118] can be
management of biomedical waste, reduce the risk of contamination, and employed to protect patient privacy further while allowing for data
maintain a hygienic environment within healthcare facilities. The analysis and research. This involves implementing robust authentication
adoption of IoT in hospital waste management can improve infection and access control mechanisms to ensure that only authorized in­
control practices and promote the safety and well-being of patients and dividuals can access the devices and data. Encryption techniques should
healthcare workers. be employed to protect data during transmission and storage, preventing
interception or tampering. Regular security audits and vulnerability
4.3. Personalized medicine assessments are necessary to identify and address any weaknesses or
vulnerabilities in the system.
In the realm of healthcare, the concept of Personalized Medicine has This is an area that many scholars are currently dedicated to
emerged as a groundbreaking frontier. This approach tailors medical researching. Progress has been made in the development of security

8
C. Li et al. Neurocomputing 565 (2024) 127017

protocols, encryption algorithms, and privacy-enhancing technologies enabling smooth data exchange and communication, healthcare pro­
specific to the healthcare domain. The paper [119] introduces a viders can leverage the full potential of IoT to enhance care coordination
healthcare architecture that utilizes blockchain technology to tackle and improve patient outcomes.
data management and security concerns and identify unauthorized ac­
tivities in the communication chain. The experimental findings reveal a 6.2. Robust security and privacy measures
significant success rate in detecting hostile IoT devices.
This study [120] proposes a new key exchange protocol for health­ Identity and access management serve as critical components in
care applications. The protocol utilizes secure algorithms to ensure data reducing security risks [124]. Multifactor authentication and stringent
security without compromising performance. It effectively blocks key access controls are pivotal in bolstering security measures[125]. These
exchange attacks and realizes improved performance. protocols guarantee that only authorized individuals can access patient
This research [121] introduces Medi-Block, a secure healthcare data, reducing the risk of unauthorized breaches. Additionally, it is vital
system combining Blockchain and IoT. It enables remote patient moni­ not to overlook the security of the IoT devices themselves. Device
toring and provides an additional security layer for personalized manufacturers must integrate security features, such as secure boot and
healthcare. The framework ensures privacy and maximizes the value of hardware-based security modules [126]. Consistent patching and firm­
healthcare. ware updates are also essential to counter emerging security vulnera­
For healthcare providers, it is crucial to establish robust security bilities and threats. Data privacy represents yet another essential
protocols, including data encryption, access control mechanisms, and dimension. Techniques like data anonymization and de-identification
secure communication channels [122], to prevent unauthorized access protect patient privacy while still permitting valuable data analysis
and data breaches. Respecting patient privacy rights helps build trust [127]. The incorporation of differential privacy methods further en­
within healthcare organizations and maintains ethical standards. hances privacy by introducing controlled noise into datasets. Healthcare
The healthcare IoT ecosystem faces unique challenges in ensuring organizations must place high priority on compliance with
security and privacy. It involves various devices and systems with industry-specific regulations. These regulations establish stringent
different security functionalities and vulnerabilities. Healthcare pro­ standards for patient data security and privacy, underlining the legal
viders must deal with the complexity of integrating and protecting these aspects of data protection. Promoting user training and awareness is a
devices while complying with regulatory requirements, such as the crucial endeavor. Informed healthcare staff and patients actively
Health Insurance Portability and Accountability Act (HIPAA) [123] in contribute to threat detection and reporting. Moreover, a well-defined
the United States or similar data protection laws in other coun­ incident response plan is imperative. This plan should delineate the
tries/regions. The interoperability of different IoT devices and platforms necessary steps to take in the event of a security breach, assigning spe­
also poses challenges in maintaining consistent security levels cific responsibilities to individuals or teams for each action. Lastly,
throughout the ecosystem. third-party vendor assessment is a pivotal facet of healthcare IoT secu­
Establishing clear and transparent privacy policies and consent rity. Rigorously evaluating the security practices of third-party vendors
mechanisms or legislation is crucial at the government level. Govern­ and service providers ensures their alignment with stringent security
ments should develop privacy protection laws and regulations for standards and protocols.
healthcare IoT, clearly defining data collection, usage, and sharing
principles. Additionally, appropriate regulatory bodies should be 6.3. Data analytics and real-time insights
established to oversee and enforce privacy protection policies while
imposing penalties for violations of privacy regulations. IoT generates vast amounts of data that, when properly analyzed, can
Governments and relevant institutions should also provide education provide valuable insights for healthcare decision-making. By leveraging
and training to enhance the privacy awareness and skills of healthcare advanced analytics techniques, such as machine learning and artificial
professionals, enabling them to properly handle and protect sensitive intelligence, healthcare providers can gain real-time insights from IoT-
data. Furthermore, public education initiatives should be launched to generated data. These insights can support early detection of health
raise awareness among individuals about privacy protection. conditions, proactive intervention, and personalized treatment plans,
In the realm of interoperability, aligning various IoT devices and ultimately improving patient outcomes and operational efficiency.
platforms to uphold consistent security benchmarks across the
ecosystem presents another layer of complexity. Therefore, a cohesive 6.4. Scalability and flexibility
strategy that encapsulates comprehensive legislation, clear privacy
policies, and robust enforcement mechanisms is essential to navigate the As IoT technologies continue to evolve, healthcare organizations
multifaceted security challenges intrinsic to the healthcare IoT must ensure scalability and flexibility in their implementation. This in­
landscape. volves designing IoT infrastructure that can accommodate future growth
and the integration of new devices and applications. Scalable cloud-
6. Optimizing IoT applications in healthcare: key strategies and based platforms and architectures provide the necessary flexibility to
implementation measures adapt to changing healthcare demands, allowing for the seamless
addition and management of IoT devices and data streams.
Optimizing IoT applications in healthcare requires the implementa­
tion of key strategies and measures to ensure the effective and efficient 6.5. Government support and strategic location selection
utilization of this technology. By adopting the following approaches,
healthcare organizations can maximize the benefits of IoT and enhance Government involvement plays a crucial role in the successful
patient care: implementation of IoT in healthcare. Governments can support the
establishment of smart hospitals by providing incentives, funding, and
6.1. Seamless integration and interoperability regulatory frameworks that encourage the adoption of IoT technologies.
Additionally, the selection of suitable locations for smart hospitals is
One of the key strategies is to ensure the seamless integration of IoT important. Governments can support the establishment of smart hospi­
devices and systems within the existing healthcare infrastructure. This tals by providing incentives, funding, and regulatory frameworks that
involves developing standardized protocols and interfaces [116] that encourage the adoption of IoT technologies. Factors such as proximity to
facilitate interoperability between different IoT devices, electronic healthcare facilities, availability of robust connectivity infrastructure,
health records (EHR) systems, and other healthcare applications. By and accessibility to a skilled workforce should be considered to ensure

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