Asian Journal of Current Research

Background: Hospitals are increasingly described as smart when connected information systems, sensors, analytics and automation are integrated into care and operations. The proposed cognitive hospital extends this idea towards organisation-wide sensing, learning, anticipation and adaptation. The evidence supporting this transition has not been systematically reconciled across conceptual, implementation and outcome studies.

Objective: To examine how smart and cognitive hospitals were defined, implemented and evaluated, and to assess the evidence for patient care, safety, experience, workforce, operational performance, governance and organisational learning.

Methods: An openly accessible, web-indexed evidence search was conducted on 19 August 2026 for peer-reviewed reports published from 1 January 2016 to 30 June 2026. Public web searches targeted PubMed- and PubMed Central-indexed pages, publisher and repository pages, implementation reports and citation-led exact-title retrieval. One reviewer performed deduplication, screening, extraction and design-appropriate methodological appraisal. Findings were grouped and synthesised without statistical meta-analysis, with a structured confidence assessment.

Results: Fifty-five records were captured; 10 duplicates were removed, 45 records were screened, 21 reports were assessed in full text and 17 studies were included. Nine studies primarily developed definitions, maturity concepts, forecasts or implementation frameworks, and eight evaluated technical or organisational implementations. The literature converged on interoperability, real-time data, workflow integration, human-centred design, governance and learning capacity as core attributes. Several single-site studies reported shorter workflows, high satisfaction or improved service indicators, but most lacked concurrent comparators, clear denominators or uncertainty estimates. Patient-safety and clinical outcomes were sparse. No included study demonstrated a validated, end-to-end cognitive hospital that continuously learned and adapted across clinical, operational and governance domains.

Conclusions: Smart hospitals are best understood as socio-technical organisations rather than collections of digital devices. Available evidence supports a progression from digitised and connected systems to integrated, predictive services, but evidence for full cognitive capability and improved clinical outcomes remains limited. Multicentre prospective evaluations with common outcomes, safety surveillance, workforce measures and lifecycle governance are required.