Context-Aware Hospital Building Intelligence: A Scoping Review of Smart-Building Pathways from Indoor Climate to Healthcare Outcomes

Healthcare buildings increasingly use sensing, analytics, digital twins and automated control, but technical performance alone does not establish healthcare benefits. This scoping review examines how publications connect indoor climate, patient and staff responses, clinical endpoints and smart-building functions. A PRISMA-ScR-informed search of Scopus, Web of Science, IEEE Xplore and PubMed yielded 82 publications, mapped across five non-exclusive domains and five endpoint categories describing outcome proximity: technical, environmental, occupant response, clinical risk/proxy and observed clinical outcome. Patient findings mainly concern thermal comfort, adaptation and perceived well-being, while staff findings concern comfort, work-related functioning and airborne exposure. Clinical findings are concentrated on outbreak observations, modelled infection risk and environmental or operational proxies. Across these heterogeneous publications, reported digital capabilities are not consistently followed through with an executed building response to evaluated occupant or clinical consequences. This discontinuity motivates Context-Aware Hospital Building Intelligence (CAHBI), a review-derived conceptual framework linking a person–space–activity–time context, explicit endpoint status, governed building action and post-action evaluation. Its components are traced to the mapped findings and proposed implementation requirements. The review provides an endpoint map and research agenda, bounded by the selected search terminology, database coverage and absence of formal quality appraisal in the synthesis. CAHBI requires stakeholder co-design and prospective evaluation before claims of healthcare effectiveness or transferability can be made.