Abstract Modern healthcare systems, especially in developing regions and smart city initiatives, increasingly rely on the integration of digital technologies to improve service delivery and emergency response. However, centralized architectures often struggle with data security, identity management, and timely intervention in critical scenarios. This paper presents a novel hybrid architecture that integrates blockchain technology for secure and decentralized authentication with artificial intelligence to enable real-time detection of medical emergencies based on data from wearable IoT sensors. The proposed system is tailored to address the infrastructural and socio-technical constraints found in contexts such as Libya. A pilot deployment at the Zawiya Polyclinic demonstrates the feasibility of the model in low-resource settings, showing improvements in data traceability, emergency response speed, and patient engagement. The framework supports resilient, scalable, and intelligent healthcare while maintaining data privacy and service continuity............... Keywords:........... Blockchain, Artificial Intelligence, Smart Healthcare Systems, Medical IoT.