The Internet of Healthcare Things: A European Perspective and a Review of Ethical Concerns
Abstract:The Internet of Things (IoT) is a disruptive technological paradigm that is at the center of the digital evolution by integrating physical and virtual worlds leading to the creation of extended interconnected ecosystems that are characterized as smart environments. The concept of the IoT has a broad range of applications in different industries including the healthcare sector. The Internet of Healthcare Things (IoHT), a branch of the IoT, is expected to bring promising benefits to all involved stakeholders and accelerate the revolution of the healthcare sector through a transition towards preventive and personalized medicine. The socio-economic challenges that the healthcare sector is facing further emphasize the need for a radical transformation of healthcare systems in both developed and developing countries with the role of pervasive technological innovations, such as IoHT, recognized as key to counteract the relevant challenges. Besides the number of potential opportunities that IoHT presents, there are fundamental ethical concerns that need to be considered and addressed in relation to the application of IoHT. This paper contributes to the discussion of the emerging topic of IoHT by providing an overview of the role and potential of IoHT, highlighting the characteristics of the current and future healthcare landscape, reporting on the up-to-date status of IoHT in Europe and reflecting upon existing research in the ethics of IoHT by incorporating additional ethical dimensions that have been ignored which can provide pathways for future research in the field.
 GrowthEnabler, Market Pulse Report, Internet of Things (IoT) - Discover Key Trends & Insights on Disruptive Technologies & IoT Innovations. UK, 2017.
 Deloitte Centre for Health Solutions, Medtech and the Internet of Medical Things – How connected medical devices are transforming health care. London, UK, 2018.
 N. Marriott, Why the Internet of Medical Things is the future of healthcare. European Pharmaceutical Review, 2017. Available: https://www.europeanpharmaceuticalreview.com/article/47692/imot-healthcare/ (5 December 2018)
 Y. Shelke, The Internet of Medical Things in Healthcare. Proqis, 2017. Available: https://www.healthcaretechnologies.com/the-internet-of-medical-things-internet-of-things-health (5 December 2018).
 D. Verzijl, K, Dervojeda, L. Probst, and L. Frideres, Internet of Things –Smart Health. Business Innovation Observatory, European Union, 2015.
 R. Davies, The Internet of Things Opportunities and Challenges. European Parliamentary Research Service, European Union, 2015.
 D. Popescul and Y. M. Bayer, “Ethical Concerns and Solutions in Health Internet of Things,” in Proc. of International Conference on Informatics in Economy (IE 2018), Romania, 2018.
 B. Mittelstadt, “Ethics of the Health-related Internet of Things: A Narrative Review,” Ethics Inf. Technol. J., vol. 19, pp. 157–175, July 2017.
 B. Mittelstadt, “Designing the Health-related Internet of Things: Ethical Principles and Guidelines,” Information J., vol. 8, no. 77, July 2017.
 D. V. Dimitrov, “Medical Internet of Things and Big Data in Healthcare” Healthcare Informatics Research. J., vol. 22, no. 3, pp. 156–163, July 2016.
 S. B. Baker, W. Xiang, and I. Atkinson “Internet of Things: Technologies, Challenge, and Opportunities,” IEEE, vol. 5, pp. 26521–26544, November 2017.
 European Union, Digitising European Industry: Working Group 2 - Digital Industrial Platforms, August 2017. Available: https://ec.europa.eu/futurium/en/implementing-digitising-european-industry-actions/report-wg2-digital-industrial-platforms-final (5 December 2018).
 Intel, The Internet of Things and Healthcare Policy Principles. Available: https://www.intel.co.uk/content/www/uk/en/healthcare-it/solutions/documents/iot-healthcare-policy-principles-paper.html (5 December 2018).
 B. Farahani, F. Firouzi, V. Chang, M. Badaroglu, N. Constant and K. Mankodiya, “Towards fog-driven IoT eHealth: Promises and challenges of IoT in medicine and healthcare,” Future Generation Computer Systems, vol. 78, pp. 659-676, 2018.
 EC, eHealth priorities and strategies in European countries – eHealth ERA report, 2007. Available: https://ec.europa.eu/digital-agenda/en/news/ehealth-priorities-and-strategies-european-countries (5 December 2018).
 EC, eHealth Action Plan 2012-2020 – Innovative healthcare for the 21st century, 2012. Available: http://ec.europa.eu/digital-agenda/en/news/ehealth-action-plan-2012-2020-innovative-healthcare-21st-century (5 December 2018).
 S. M. R. Islam, D. Kwak, MD. H. Kabir, M. Hossain, and K-S. Kwak “The Internet of Things for Health Care: A Comprehensive Survey,” IEEE, vol. 3, pp. 678–708, June 2015.
 EC, mHealth, 2017. Available: https://ec.europa.eu/digital-single-market/en/mhealth (5 December 2018).
 EC, Communication from the Commission to the European Parliament, the Council, The European Economic and Social Committee and the Committee of the Regions on enabling the digital transformation of health and care in the Digital Single Market; empowering citizens and building a healthier society, 2018. Available: https://ec.europa.eu/digital-single-market/en/news/communication-enabling-digital-transformation-health-and-care-digital-single-market-empowering (5 December 2018).
 European Commission, Research & Innovation in Internet of Things. Available: https://ec.europa.eu/digital-single-market/en/research-innovation-iot (5 December 2018).
 Inter-IoT, European Platforms Initiative. Available: https://iot-epi.eu/project/inter-iot/ (5 December 2018).
 ACTivating InnoVative IoT Smart Living Environments for AGEing well, European Large-Scale Pilots Programme. Available: https://european-iot-pilots.eu/project/activage/ (5 December 2018).
 European Group on Ethics in Science and New Technologies to the European Commission, The ethical implications of new health technologies and citizen participation, European Commission, 2015. Available: http://ec.europa.eu (5 December 2018).
 World Health Organization, Summary World Report on Disability, 2011. Available: (5 December 2018).