The Inevitable Application of Internet of Things (IoT) to Healthcare: Transforming Baghdad Medical City into a Smart Hospital Ecosystem

Abstract

The aim of this study was to develop and validate a local health service IoT architecture for Baghdad Medical City using systematic application of mixed-methods baseline assessment, consensus processes undertaken by experts and a Health Technology Assessment standards proposed by the World Health Organization. The study was conducted as a sequential mixed-methods design during three consecutive phases from March to December 2024. An infrastructure audit with an accompanying clinician survey (n=52, 74.3% response rate) implemented in the first phase of the project was used to assess readiness for establishing baselines for technology implementation. In the second phase, a Delphi panel of 15 experts, along with Analytic Hierarchy Process and Technique for Order of Preference by Similarity to Ideal Solution analyses, was employed to validate the proposed five-layer IoT architecture. In phase three, WHO Health Technology Assessment criteria addressed elements of clinical effectiveness and cost-effectiveness (both direct and on equity), as well as safety, and were combined with the RE-AIM implementation framework. Hybrid Networking Solutions were also used for critical connectivity shortcomings identified by Baseline audits. The Delphi process resulted in a high level of consensus (Kendalls W = 0.78; p < 0.001). Health Technology Assessment results suggested that predictive maintenance could save 23-31% of costs, but these benefits are contingent on continuing training of the local workforce. Once the misunderstandings are cleared up, it is possible to set up a working IoT system that fits well within the Baghdad Medical City. To get to that point, it is necessary to address the poor infrastructure and maintain the strong control of the data within the area, as well as following the research methodology well to combat the resistance that will be met while implementing the system.