Exploring healthcare in smart cities: projects, deployments and challenges

Abstract Integrating wearable devices into smart city infrastructures offers a transformative potential for healthcare, promoting a shift from a reactive model to a proactive paradigm. Although not new, the literature today does not present surveys and studies that discuss the intersection of smart cities and healthcare, especially taking advantage of devices that are more and more incorporated into citizens’ daily lives. Thus, this article contributes to the state of the art by providing a holistic review that links the clinical requirements of wearables with the architectural challenges of large-scale implementations. The work presents a comprehensive analysis of the current landscape, including: (i) a review and comparison of leading commercial wearables and the vital signs they monitor; (ii) an analysis of existing innovative health projects, such as Brescia Smart Living, City4Age, and Minha História Digital; and; (iii) a detailed correlation table that maps changes in multiple vital signs to dozens of pathologies and their associated symptoms. The analysis confirms that data fusion can assist in detecting conditions such as sepsis early. Still, it also exposes a critical technological gap: the absence of continuous cuffless blood pressure measurement. In addition, systemic challenges such as the lack of interoperability and the need for robust privacy frameworks remain significant barriers. We conclude that progress in smart health depends on overcoming these interconnected gaps to leverage wearable data to improve individual and population health fully.