The Internet of Things (IoT) paradigm has been extensively applied to several sectors in the last years, ranging from industry to smart cities. In the health domain, IoT makes possible new scenarios of healthcare delivery as well as collecting and processing health data in real time from sensors in order to make informed decisions. However, this domain is complex and presents several technological challenges. Despite the extensive literature about this topic, the application of IoT in healthcare scarcely covers requirements of this sector. A literature review from January 2010 to February 2021 was performed resulting in 12,108 articles. After filtering by title, abstract, and content, 86 were eligible and examined according to three requirement themes: data lifecycle; trust, security, and privacy; and human-related issues. The analysis of the reviewed literature shows that most approaches consider IoT application in healthcare merely as in any other domain (industry, smart cities…), with no regard of the specific requirements of this domain. Future efforts in this matter should be aligned with the specific requirements and needs of the health domain, so that exploiting the capabilities of the IoT paradigm may represent a meaningful step forward in the application of this technology in healthcare.

Continuity of care requires the exchange of health information among organizations and care teams. The EU General Data Protection Regulation (GDPR) establishes that subject of care should give explicit consent to the treatment of her personal data, and organizations must obey the individual’s will. Nevertheless, few solutions focus on guaranteeing the proper execution of consents. We propose a service-oriented architecture, backed by blockchain technology, that enables: (1) tamper-proof and immutable storage of subject of care consents; (2) a fine-grained access control for protecting health data according to consents; and (3) auditing tasks for supervisory authorities (or subjects of care themselves) to assess that healthcare organizations comply with GDPR and granted consents. Standards for health information exchange and access control are adopted to guarantee interoperability. Access control events and the subject of care consents are maintained on a blockchain, providing a trusted collaboration between organizations, supervisory authorities, and individuals. A prototype of the architecture has been implemented as a proof of concept to evaluate the performance of critical components. The application of subject of care consent to control the treatment of personal health data in federated and distributed environments is a pressing concern. The experimental results show that blockchain can effectively support sharing consent and audit events among healthcare organizations, supervisory authorities, and individuals.

Frailty syndrome is an independent risk factor for serious health episodes, disability, hospitalization, falls, loss of mobility, and cardiovascular disease. Its high reversibility demands personalized interventions among which exercise programs are highly efficient to contribute to its delay. Information technology-based solutions to support frailty have been recently approached, but most of them are focused on assessment and not on intervention. This paper describes a sensor-based mHealth platform integrated in a service-based architecture inside the FRAIL project towards the remote monitoring and intervention of pre-frail and frail patients at home. The aim of this platform is constituting an efficient and scalable system for reducing both the impact of aging and the advance of frailty syndrome. Among the results of this work are: (1) the development of elderly-focused sensors and platform; (2) a technical validation process of the sensor devices and the mHealth platform with young adults; and (3) an assessment of usability and acceptability of the devices with a set of pre-frail and frail patients. After the promising results obtained, future steps of this work involve performing a clinical validation in order to quantify the impact of the platform on health outcomes of frail patients.