# Smart Healthcare Network Management: A Comprehensive Review
## 1 Introduction
This proactive approach ensures continuous system operation, minimizes downtime, and enhances the reliability of healthcare services [8]. Additionally, self-healing network architectures that dynamically adjust routing paths or reallocate computational resources improve resilience against unexpected failures, particularly in environments with life-critical applications. Healthcare 4.0 brings about a paradigm shift in how healthcare systems operate. It emphasizes interoperability, scalability, and intelligence across all healthcare processes. Integrating cloud and edge computing enables distributed processing and real-time decision-making, reducing latency and improving efficiency. Additionally, advanced analytics and machine learning algorithms enhance the predictive capabilities of healthcare systems, enabling early intervention and personalized care. This holistic approach redefines healthcare into a smart, connected, and adaptive ecosystem [9]. Despite numerous research studies that have addressed IoT-based network management, there are several open issues, especially in the healthcare field. Smart healthcaresystems' device and network management needs a well-defined design strategy before considering their technical problems. The strategy should consider all organizations involved in providing end-to-end services to end-users. For instance, if a healthcare provider remotely monitors a patient at home, the end-to-end connection includes different segments of network authorities. The first segment is located on the patient's premises, which usually consists of sensors, actuators, gateways, and Wi-Fi networks. The connection between the patient's premises and the healthcare provider may go through several Internet Service Providers (ISPs). Finally, the healthcare provider segment may include network elements, wireless and wired connections, and backend servers. Therefore, the entities involved should cooperate and support the end-to-end solution to guarantee a reliable and secure service. The design strategy should articulate all technical and medical requirements that should be handled in the implementation to cope with the constraints of IoT objects and the sensitivity of smart healthcare applications. In addition, deploying IoT-based smart healthcare systems on a massive scale would raise other issues. Patients and elderly individuals will rely on the service to monitor their health and daily wellness, while caregivers should provide reliable, secure, effective, and well-performed services. If an IoT-based smart healthcare system is not effective, reliable, and secure, patients' and elderly individuals' health becomes prone to risk. In addition, if it does not provide a reasonable return on investment, the caregiver's business model will be unsatisfactory. This research includes a literature review of IoT-based smart healthcare systems and management solutions referenced in [10]. We comprehensively reviewed network management protocols that suit IoT-based smart healthcare systems based on telecommunications management standards. Moreover, we propose a reference architecture to support network management protocols in smart healthcare network management. The main contributions of the paper are as follows:  
1. This paper explores the integration of various smart network management protocols to enhance the efficiency and reliability of IoT-based healthcare systems. It evaluates protocols that facilitate real-time monitoring, secure data transmission, and efficient device management in resource-constrained environments. 2. This paper introduces a reference architecture designed to manage the end-to-end network of smart healthcare systems. It ensures sustainable service delivery for both patients and caregivers while addressing challenges such as fault management, security, and scalability. The architecture integrates emerging technologies like software-defined networking (SDN) and deep learning (DL) to enhance network adaptability and predictive management. 3.