A survey of blockchain enabled IoT frameworks for smart healthcare systems

The integration of Blockchain technology with the Internet of Things (IoT) has emerged as a promising paradigm for addressing security, privacy, and data integrity challenges in smart healthcare systems. While several studies have explored Blockchain–IoT (BIoT) solutions for healthcare, the existing literature remains fragmented, with limited critical analysis of architectural designs, consensus mechanisms, and healthcare-specific constraints. This survey presents a structured survey of Blockchain-enabled IoT frameworks for smart healthcare applications including electronic health record management, remote patient monitoring, and medical supply chain management, covering primary studies from 2018 to 2022 with additional coverage of recent 2023–2024 works. The paper classifies existing solutions based on system architecture, blockchain type, and security objectives, and provides a comparative discussion of commonly adopted consensus mechanisms with respect to scalability, latency, and suitability for healthcare environments. Furthermore, key open challenges such as interoperability, regulatory compliance, energy efficiency, and real-time performance are critically examined. Finally, the survey highlights future research directions aimed at developing scalable, privacy-preserving, and intelligent Blockchain–IoT healthcare systems.