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The emerging Internet of Things (IoT) technology has revolutionized existing medical devices to act smartly towards creating digital world related to health. IoT endeavors an enormous promise in the area of electronic health (e-health) where existing technologies have been deployed to provide rapid access to patient care. IoT based e-health systems involve significant technologies and connected things to monitor, identify, track, manage and store patients' information for ongoing healthcare. A mechanism is required that assures interoperability between devices for processing and use of resources in an efficient manner for the successful deployment of IoT within e-health. The study has coined a unique idea through an exclusive induction of e-governance layer in the concept and implementation of IoT based e-health systems. Therefore, the study targets to develop a novel architecture for incorporation of IoT in the e-health systems by intensively focusing its different layers i.e., sensing, application, transmission, fog and e-governance for having emphasis to get quick response and secured transmission with improved healthcare services. An exploratory study has been conducted to investigate existing literature regarding cutting-edge developments in the arena of e-health. The proposed IoT based e-health architecture is extremely impressive novelty with much comprehensiveness of the concept with the inclusion of very a crucial but previously unnoticed component of Emergency Medical Services (EMS) having its integration through blockchain technology. Another novelty has been presented with the idea of explicitly defining the e-governance layer that encompasses all layers of the proposed architecture in order to achieve quality healthcare services.

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The amazing fusion of the internet of things (IoT) into traditional health monitoring systems has produced remarkable advances in the field of e-health. Different wireless body area network devices and sensors are providing real-time health monitoring services. As the number of IoT devices is rapidly booming, technological and security challenges are also rising day by day. The data generated from sensor-based devices need confidentiality, integrity, authenticity, and end-to-end security for safe communication over the public network. IoT-based health monitoring systems work in a layered manner, comprising a perception layer, a network layer, and an application layer. Each layer has some security, and privacy concerns that need to be addressed accordingly. A lot of research has been conducted to resolve these security issues in different domains of IoT. Several frameworks for the security of IoT-based e-health systems have also been developed. This paper introduces a security framework for real-time health monitoring systems to ensure data confidentiality, integrity, and authenticity by using two common IoT protocols, namely constrained application protocol (CoAP) and message query telemetry transports (MQTT). This security framework aims to defend sensor data against the security loopholes while it is continuously transmitting over the layers and uses hypertext transfer protocols (HTTPs) for this purpose. As a result, it shields from the breach with a very low ratio of risk. The methodology of this paper focuses on how the security framework of IoT-based real-time health systems is protected under the tiers of CoAP and HTTPs. CoAP works alongside HTTPs and is responsible for providing end-to-end security solutions.