© 2020, The Author(s).Currently, rapidly developing digital technological innovations affect and change the integrated information management processes of all sectors. The high efficiency of these innovations has inevitably pushed the health sector into a digital transformation process to optimize the technologies and methodologies used to optimize healthcare management systems. In this transformation, the Internet of Things (IoT) technology plays an important role, which enables many devices to connect and work together. IoT allows systems to work together using sensors, connection methods, internet protocols, databases, cloud computing, and analytic as infrastructure. In this respect, it is necessary to establish the necessary technical infrastructure and a suitable environment for the development of smart hospitals. This study points out the optimization factors, challenges, available technologies, and opportunities, as well as the system architecture that come about by employing IoT technology in smart hospital environments. In order to do that, the required technical infrastructure is divided into five layers and the system infrastructure, constraints, and methods needed in each layer are specified, which also includes the smart hospital’s dimensions and extent of intelligent computing and real-time big data analytic. As a result of the study, the deficiencies that may arise in each layer for the smart hospital design model and the factors that should be taken into account to eliminate them are explained. It is expected to provide a road map to managers, system developers, and researchers interested in optimization of the design of the smart hospital system.