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Over the past years, numerous Internet of Things (IoT)-based healthcare systems have been developed to monitor patient health conditions, but these traditional systems do not adapt to constraints imposed by revolutionized IoT technology. IoT-based healthcare systems are considered mission-critical applications whose missing deadlines cause critical situations. For example, in patients with chronic diseases or other fatal diseases, a missed task could lead to fatalities. This study presents a smart patient health monitoring system (PHMS) based on an optimized scheduling mechanism using IoT-tasks orchestration architecture to monitor vital signs data of remote patients. The proposed smart PHMS consists of two core modules: a healthcare task scheduling based on optimization and optimization of healthcare services using a real-time IoT-based task orchestration architecture. First, an optimized time-constraint-aware scheduling mechanism using a real-time IoT-based task orchestration architecture is developed to generate autonomous healthcare tasks and effectively handle the deployment of emergent healthcare tasks. Second, an optimization module is developed to optimize the services of the e-Health industry based on objective functions. Furthermore, our study uses Libelium e-Health toolkit to monitors the physiological data of remote patients continuously. The experimental results reveal that an optimized scheduling mechanism reduces the tasks starvation by 14% and tasks failure by 17% compared to a conventional fair emergency first (FEF) scheduling mechanism. The performance analysis results demonstrate the effectiveness of the …