Proactive Defence in IoT Networks for Digital Health Systems: A Scoping Review

The Internet of Things (IoT) plays a significant role in digital health systems, supporting applications such as implantable devices, wearables, activity trackers and ingestibles. However, the rapid expansion of IoT networks has outpaced security measures, introducing significant security challenges. This scoping review examines the extent to which existing IoT security frameworks provide comprehensive coverage and identify key security elements that contribute to proactive defence in digital health environments. The specific research questions addressed are as follows: (1) Are there any IoT network security frameworks to provide comprehensive protection for IoT networks and digital health systems specifically? (2) What key security elements are currently used to develop a robust, proactive IoT security framework? Following the PRISMA-ScR guidelines, a systematic search of four databases was conducted to identify peer-reviewed studies from 2015 to 2024. This review included 255 studies, comprising 50 framework papers and 205 non-framework papers. The results reveal that some frameworks address discrete security areas but generally provide limited integrated security coverage. Key security elements identified include vulnerability assessments, threat modelling, feedback loops and the integration of artificial intelligence (AI) for proactive security measures in IoT networks. This review provides a structured synthesis, highlights research gaps and may inform the future development of more integrated and proactive security frameworks for IoT-enabled digital health systems.