## 6 Open Concerns and Potential Developments
### Issues  
Smart healthcare management based on IoT faces the following issues:  
1. Trust and Privacy: Trust and privacy management is a significant open problem in IoT-based healthcare systems for data ingress and storage. Controlling access to credentials, protecting the privacy of patients and service providers, and preventing unauthorized access to any of these are all examples of trust. IoT-based systems for the healthcare industry are developed based on the data collected by IoT devices. As IoT devices are connected to the network, their susceptibility to data breaches rises [43]. However, the analyzed studies show that only a few papers have properly assessed this important parameter. As a result, trust and privacy are extremely difficult to sustain, as open concerns. Reducing the risk of critical data being hacked and improving data security is especially tough. \begin{table}
\begin{tabular}{p{113.8 pt} p{113.8 pt}} \hline \hline
**Attributes** & **Explanation** \\ \hline Response time & The reaction time of a task is the amount of time that passes between when a task is entered into the system and when it is completed. \\ \hline Cost & The cost of running or maintaining the IoT at a particular time. \\ \hline Flexibility & Flexibility is the ease with which IoT responds to unpredictability. \\ \hline Scalability & The ability of an IoT system to handle a growing number of subscribers is referred to as scalability. \\ \hline Security & Security prevents unauthorised access to or misdirection of the services provided by IoT devices’ hardware, software, or data. \\ \hline Efficiency & Efficiency is the ratio of productive labour to IoT resources, which translates to the output-to-input ratio for a fog device. \\ \hline Real-time & The medical system requires quick action. Real-time data production, evaluation, and monitoring are crucial for tracking critical health issues, keeping tabs on outbreaks and pathogens, and hastening the adoption of remedies before the healthcare system becomes overburdened. \\ \hline Overhead & In addition to the immediate costs of providing an item or service, overhead also refers to the ongoing costs of running a firm. \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Attributes of IoT-based healthcare systems. 2. Power Management: Reduced energy usage, according to the reviewed literature, is the key to minimizing high operational costs and large carbon emissions in HIoT systems. Furthermore, a typical HIoT network is made up of tiny devices with limited battery life. As a result, fundamental features such as data migration and systematic standby control are critical to minimizing energy consumption while maintaining the quality of smart healthcare services. As a result, low-power devices must be developed in order to extend the life of HIoT systems and limit the likelihood of patients being disconnected. As a result, another challenge for HIoT is power management [44]. 3. Fog Computing: Fog computing, which is location-aware and dependent on environment, context, and application needs, is an integral part of healthcare IoT. Furthermore, low and predictable latency is required to deliver services to end users in emergency situations, to save bandwidth, and save battery usage while essential data are delivered to the fog for processing and storing, and to diminish the volume of data transposed to the cloud. More activities are required to fulfil the aforementioned needs in HIoT systems, despite considerable advancements in this field. Fog computing is therefore exceedingly difficult for researchers. 4. Resource Management: HIoT nodes' assignments are enormous despite their modest computational and storage capacity. Therefore, in the HIoT context, managing and effectively deploying smart healthcare equipment is essential. In general, resource management might result in greater research and analysis. Furthermore, resource management should successfully enact a wide range of services in order to make the most use of existing resources and deliver relevant services in HIoT.