From Patterns to Policy: A Scoping Review Based on Bibliometric Analysis (ScoRBA) of Intelligent and Secure Smart Hospital Ecosystems

A team of four researchers has published a forward-looking review analyzing two decades of academic progress toward intelligent and secure smart hospitals. Their study, 'From Patterns to Policy,' employs a novel Scoping Review with Bibliometric Analysis (ScoRBA) methodology on 891 articles from the Scopus database, spanning 2006 to 2025. Using techniques like co-occurrence analysis and an Enhanced Strategic Diagram, the authors applied the PAGER framework to systematically link research Patterns, Advances, Gaps, Evidence, and policy Recommendations.

The findings reveal the field is coalescing around three major, interconnected clusters. The first is AI-driven intelligent healthcare systems, encompassing diagnostics and predictive analytics. The second is decentralized, privacy-preserving digital health ecosystems, heavily featuring blockchain for data security. The third is scalable cloud-edge computing infrastructures that support these services. The analysis shows a clear convergence toward integrated architectures where intelligence, trust, and infrastructure mutually reinforce each other.

Despite significant advances in core technologies like AI, blockchain, and cloud computing, the review identifies persistent critical gaps. These include a lack of real-world implementation studies, major interoperability challenges between systems, insufficient governance frameworks, and a need for better cross-layer integration of different technological components. Emerging research themes that require more focus are explainable AI (XAI), federated learning for privacy, and advanced cryptographic privacy mechanisms.

The study's primary contribution is bridging dense bibliometric data with actionable policy. It concludes with targeted recommendations for coordinated multi-stakeholder governance, investment in scalable and secure infrastructure, and the development of holistic data ecosystems. These insights are positioned as particularly vital for guiding smart hospital development in developing country contexts, helping policymakers and technologists make evidence-based decisions for the next generation of healthcare.