A unified IoT architectural model for smart hospitals: enhancing interoperability, security, and efficiency through clinical information systems (CIS)

The integration of Internet of Things (IoT) technologies in healthcare has enabled the development of smart hospitals. However, fragmented infrastructures and inefficiencies but lacks concrete examples (e.g., legacy systems causing data silos). Existing architectures fail to unify Clinical Information Systems (CIS) with IoT workflows, creating inefficiencies in critical care. This paper proposes a unified IoT architectural model for a smart hospital centered on the Clinical Information System (CIS) to address these challenges. The architecture comprises five horizontal layers (perception, network, IoT gateway, knowledge, and application) and three vertical aspects (security, management, and cloud platforms). The Knowledge Layer integrates AI and big data analytics for predictive diagnostics and intelligent decision-making. The IoT Gateway Layer uses edge computing to reduce data latency compared to cloud-only systems. Security Framework is aligned with GDPR and EU health data policies (e.g., EHDS), ensuring secure interoperability. The architecture is evaluated using stakeholder-prioritized ATAM scenarios. It demonstrates improved interoperability, reduced unauthorized access, enhanced patient care, and lower costs. Future work focuses on real-world pilots and integration with emerging technologies to validate scalability and adaptability in diverse healthcare environments.