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The Technological Pillars of Smart Hospitals: A 2022-2025 Review of IoMT, Wearables/RTLS/RFID, Robotics (IORT), and VR/AR

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4

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2025

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Abstract

Smart hospitals are rapidly evolving into hyperconnected care environments that blend Internet of Medical Things (IoMT), sensing-centric wearables with RTLS/RFID, assistive and soft robotics within the Internet of Robotic Things (IoRT), and immersive VR/AR applications. This review (2022-2025) synthesizes three complementary streams: (i) IoMT architectures and security, highlighting perception-edge/fog-cloud layering and hardware-anchored trust such as PUFs, alongside blockchain-enabled integrity and SDN-based network control; (ii) continuous patient monitoring and operational intelligence via wearable sensors, RFID, and RTLS for asset/patient tracking, workflow optimization, and error reduction; and (iii) robotics/IoRT and VR/AR for telepresence and remote examinations, logistics and UV-based disinfection, personalized soft-robotic rehabilitation, clinician training, analgesia/anxiolysis, and early <tex xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">$\mathbf{5 G}$</tex>-enabled telesurgical use cases. Cross-cutting challenges persist around interoperability/standardization, privacy/cybersecurity, and explainable AI, cost and change-management barriers, and the scarcity of longitudinal, system-level evaluations in real-world hospital deployments. Building on the integrated evidence base, we propose a unified taxonomy and a four-layer system blueprint that links multimodal sensing and edge analytics to governance-grade integration, and we present a consolidated comparison table (advantages vs. challenges) across IoMT, Wearables/RTLS/RFID, IoRT robotics, and VR/AR. We conclude with a forward agenda prioritizing standards-based interoperability, robust security/ethical frameworks, cost-benefit analyses, and prospective clinical evaluations to advance scalable, outcome-driven adoption in smart hospital ecosystems.

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