To address critical pain points in medical equipment management within large public hospitals, such as ‘blind spots in asset supervision’, ‘passive maintenance response’ and ‘single-dimensional performance evaluation’, this study explores the construction of an internet of things (IoT)-based refined management system. The goal is to achieve intelligent monitoring and scientific decision-making throughout the full lifecycle of medical equipment.

A five-layer architecture (perception, data, services, application, presentation) was implemented. Sensing terminals were deployed to collect the real-time operational status of equipment, which were then deeply integrated with hospital information systems to form a data-driven closed-loop management system. On this basis, two parallel business lines were constructed: ‘Lifecycle Management’ and ‘Operational Monitoring & Performance Analysis’.

Since the official launch of the system in December 2024, significant results have been achieved. The comparative analysis conducted before the system launched (from January to December 2024) and after the system launched (from January to December 2025) reveals that the consistency rate between asset accounts and physical stock increased from 94.84% to 100.00% (P<0.001). The operational saturation of large equipment increased from 49.30% to 52.33% (P=0.043). Furthermore, maintenance timeliness surged from 75.20% to 96.96% (P<0.001).

The IoT-enabled refined management system successfully facilitates a paradigm shift in hospital equipment management from a ‘passive, experience-based’ model to an ‘active, data-driven’ model. This approach not only enhances asset operational efficiency and compliance but also provides a reproducible and scalable practical pathway for the construction of smart hospitals.