A Survey on Internet of Medical Things (<scp>IoMT</scp>): Enabling Technologies, Security and Explainability Issues, Challenges, and Future Directions

ABSTRACT Internet of Medical Things (IoMT) paradigm refers to the process of collection, transmission and analysis of healthcare data using communication and information systems over the internet. IoMT consist of medical devices that can link to the internet or other networks, including wearables, sensors, monitoring tools and other medical appliances. IoMT data can be utilised to lower costs, increase the effectiveness of healthcare delivery and improve the patient health status. In addition to the potential benefits IoMT may provide, the impact of COVID19 pandemic has also strengthened the desire to collect patient data remotely and pushed a lot of medical professionals to utilise IoMT applications such as telemedicine, telehealth, remote patient monitoring, remote patient diagnostics and distant consultations etc. The expectation is that IoMT market size and the usage will increase dramatically and IoMT will change the conventional healthcare systems significantly in the upcoming years. Motivated with that growth expectation, this study aims to analyse the IoMT, its components, enabling technologies and applications by emphasising the fundamental pillars (sensing, communication, data analytics, and security) essential for developing a reliable, dependable, and secure IoMT ecosystem. Furthermore, this study conducts a detailed analysis of recent major cyberattacks targeting the healthcare industry, evaluating their impact and discussing the key lessons derived from these incidents by employing DOTMLPFI approach. Additionally, this survey offers a concise overview of the emerging technologies that complement IoMT in the development of smart healthcare systems and explores potential future directions within this evolving field.