JMIR Publications

ABSTRACT

Background:

Global health systems face increasing pressure due to population aging and recurrent pandemics, requiring a transition from Health 4.0 to Health 5.0. Although 4G technologies initiated the era of remote monitoring, their limitations in bandwidth and latency hinder critical real-time applications. Fifth-generation (5G) and sixth-generation (6G) networks, integrated with artificial intelligence (AI) and the Internet of Medical Things (IoMT), have emerged as key enablers of ultra-low-latency and highly reliable services in smart healthcare ecosystems.

Objective:

This scoping review aimed to map and synthesize scientific evidence on the use of 5G and 6G network technologies in healthcare, particularly in smart hospitals and eHealth services, and to identify related opportunities, challenges, and research gaps.

Methods:

We conducted a scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and the Arksey and O’Malley and Joanna Briggs Institute (JBI) frameworks. The research question was structured using the Population, Concept, Context (PCC) mnemonic. A systematic search was performed in Google Scholar using a comprehensive search string targeting 5G/6G, eHealth, smart hospitals, digital health, and telemedicine. Eligibility criteria included studies in English that explicitly addressed 5G or 6G infrastructure, architecture, or applications in healthcare contexts. Screening and data extraction were performed iteratively by reviewers, and studies were categorized according to implementation maturity, architectural advances, and security requirements.

Results:

Most identified studies were theoretical proposals (about 57%) or feasibility analyses, with a smaller proportion of real-world implementations. Practical evidence suggests that 5G can reduce emergency response times by up to 30% and enable in-transit imaging-based diagnosis, supporting the transformation of ambulances into advanced triage units. However, field tests report real-world 5G latency of approximately 10 ms, which is above the theoretical target of <1 ms and constrains latency-critical applications such as holographic telesurgery. Across studies, security and privacy—particularly for contextual and IoMT sensors—emerged as critical challenges, together with interoperability with legacy systems and the high cost of infrastructure.

Conclusions:

Advanced connectivity networks, particularly 5G and future 6G infrastructures, are positioned as foundational components for smart hospitals and digital health, supporting the transition from Health 4.0 to Health 5.0. Nonetheless, the evidence base is still dominated by conceptual works, and the full potential of these technologies is limited by technical, organizational, and economic barriers. Future work should prioritize explainable AI, end-to-end security, and sustainable business models to ensure safe, equitable, and clinically meaningful adoption of 5G/6G-enabled smart healthcare. Clinical Trial: This does not apply as it is a survey.