## 4 Mian Features and Challenges of IoMT and Healthcare 4.0  
### Specifications and Requirements of IoMT and Healthcare 4.0  
Healthcare 4.0 aims to improve patient outcomes and access to healthcare, increase efficiency, and reduce costs. It includes using EHRs, telemedicine, wearable devices, health information exchanges, big data analytics, and machine learning to provide personalized, preventive, and precise healthcare [1]. This promising paradigm, with IoMT, has numerous benefits for patients and healthcare workers, summarized as follows [75; 76]. 1. Better healthcare services: IoMT devices can monitor patients' health and vital signs, enabling healthcare providers to detect and address prospective problems. These processes are provided over a robust system since IoT has evolved in the past years. 2. Cost-efficient: By reducing hospital readmissions, minimizing unnecessary interventions, and optimizing the utilization of medical resources, IoMT devices can help reduce the cost of healthcare. The infrastructure of IoMT is cost-efficient, and the system does not involve medical workers all over time since the system automatically analyzes the results. 3. Enhanced patient engagement: IoMT devices can increase patient engagement in healthcare by allowing patients to monitor their health, assess their progress, and communicate with their healthcare providers. 4. Improved decision-making: Healthcare 4.0 can provide healthcare providers with real-time data and insights, allowing them to make more informed decisions and provide patients with more personalized care. 5. Better interaction efficiency: Healthcare 4.0 can assist healthcare providers in streamlining their workflows, enhancing communication, and increasing the efficiency of patient care. This new era of telemedicine has many requirements that can be summarized as follows [5; 77; 78]. 1. Advanced data analytics: The advanced data analytics capability is crucial to Healthcare 4.0. It enables the identification of anomalies and patterns that can assist in providing enhanced personalized care, thereby leading to better patient outcomes. 2. Ultra-reliable communication: It is a critical aspect of medical data transferred over Healthcare 4.0, enabling dependable, safe, and operational communication among healthcare actors. It ensures that data is communicated without any loss or breakdowns, providing reliable diagnosis, treatment decisions to physicians, patients, and caregivers. Ultra-reliable communication ensures that critical medical data, including vital signs, lab results, and medication information, are transmitted accurately and rapidly to the right recipients. Moreover, it can enable timely communication of alarm notifications, emergency calls, and other urgent messages, which can help prevent medical errors and reduce the risk of adverse events. Summing up, ultra-reliable communications are crucial in improving patient safety and clinical outcomes by enabling reliable and real-time communication between healthcare providers, patients, and medical devices. 3. High network availability: The high network availability of Healthcare 4.0 data refers to the healthcare system's ability to access and utilize data in real-time and without interruption. Having a highly available network ensures that healthcare providers always have access to patient records, medical images, and other vital data, which can save lives in critical situations. 4. Interoperability: Interoperability is essential in the Healthcare 4.0 environment. This necessitates that all systems and devices communicate with one another, allowing for the sharing and analysis of data. Healthcare 4.0 systems significantly rely on the ability to share patient data across systems. 5. Information consent: Patients should have control over their health data and how it is disseminated, per informed consent. Before using patients' data, healthcare organizations must ensure that patients are completely informed about how it will be utilized and obtain their consent. 6.