Citation: Kashyap, V.; Kumar, A.; Kumar, A.; Hu, Y.-C. A Systematic Survey on Fog and IoT Driven Healthcare: Open Challenges and Research Issues. Electronics 2022, 11, 2668. https://doi.org/10.3390/ electronics11172668 Academic Editor: Federico Alimenti Received: 11 July 2022 Accepted: 17 August 2022 Published: 26 August 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). electronics Review A Systematic Survey on Fog and IoT Driven Healthcare: Open Challenges and Research Issues Vijaita Kashyap 1,† , Ashok Kumar 2,† , Ajay Kumar 3,† and Yu-Chen Hu 4, * ,† 1 Chitkara University Institute of Engineering & Technology, Chitkara University, Rajpura 140401, Punjab, India 2 School of Computer Application, Lovely Professional University, Phagwara 144411, Punjab, India 3 Department of Computer Science and Engineering, Chandigarh University, Chandigarh 140413, India 4 Department of Computer Science and Information Management, Providence University, Taichung 43301, Taiwan * Correspondence: ychu@pu.edu.tw † These authors contributed equally to this work. Abstract: Technological advancements have made it possible to monitor, diagnose, and treat patients remotely. The vital signs of patients can now be collected with the help of Internet of Things (IoT)- based wearable sensor devices and then uploaded on to a fog server for processing and access by physicians for recommending prescriptions and treating patients through the Internet of Medical Things (IoMT) devices. This research presents the outcome of a survey conducted on healthcare integrated with fog computing and IoT to help researchers understand the techniques, technologies and performance parameters. A comparison of existing research focusing on technologies, procedures, and findings has been presented to investigate several aspects of fog computing in healthcare IoT- based systems, such as increased temporal complexity, storage capacity, scalability, bandwidth, and latency. Additionally, strategies, tools, and sensors used in various diseases such as heart disease, chronic disease, chikungunya viral infection, blood pressure, body temperature, pulse rate, diabetes, and type 2 diabetes have been compared. Keywords: Internet of Things; fog computing; healthcare; health monitoring; sensors 1. Introduction In the last two decades, electronic gadgets have revolutionised the world and have become an integral part of human life. Artificial intelligence and machine learning have made these electronic devices smart. Some of these smart devices are being used for health monitoring, diagnosis, and even treatment. For instance, now, a device can detect diabetes through an image of a patient’s iris [1]. The medical devices can be connected to healthcare information technology systems using networking technologies to make medical data quickly available to healthcare practitioners. The interconnection of medical devices, popularly known as the IoMT, is an amalgamation of medical devices and applications that lessens hospital visits and allows practitioners to observe patients remotely [2,3]. The proliferation of IoMT can be judged by increases in the sale of IoT-enabled medical devices. It is estimated that the world’s smart health market will expand at an average growth rate of 16.2% between 2020 and 2027 [4]. The reasons behind the proliferation of IoMT are high accuracy, low cost, and low delay in delivering healthcare services. The recent advancements in IoMT have made preliminary diagnostics possible at the patient’s home. For instance, blood tests and diabetic and blood pressure monitoring at the patient’s doorstep in real-time are viable. Due to this, healthcare is shifting from the hospital to a home-centric service [5,6]. Further, the developments in telecommunication services, body sensor networks, fog, and cloud computing have made monitoring and detection, medical consultations, and prescribing treatment possible at the doorstep [7,8]. The number of people globally requiring regular monitoring due to chronic diseases such as Electronics 2022, 11, 2668. https://doi.org/10.3390/electronics11172668 https://www.mdpi.com/journal/electronics