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Item How to develop IoT cloud e-health systems based on fiware: A lesson learnt(MDPI AG, 2020) Celesti, Antonio; Fazio, MariaNowadays, the penetration of sensors and actuators in different application fields is revolutionizing all aspects of our daily life. One of the major sectors that is taking advantage of such cutting-edge cheap smart devices is healthcare. In this context, Remote Patient Monitoring (RPM) at home represents a tempting opportunity for hospitals to reduce clinical costs and to improve the quality of life of both patients and their families. It allows patients to be monitored remotely by means networks of Internet of Things (IoT) medical devices equipped with sensors and actuators that collect healthcare data from patients and send them to a Cloud-based Hospital Information System (HIS) for processing. Up to now, many different proprietary software systems have been developed as stand-along expensive solutions, presenting interoperability, extensibility, and scalability issues. In recent years, the European Commission (EC) has promoted the wide adoption of FIWARE technology, launching 16 Industrial Accelerators focusing on different application fields. One of these, i.e., FICHe, is specialized in healthcare, providing the guidelines on how to develop eHealth systems. This paper focuses on how to compose new cutting-edge IoT and Cloud-based Cyber Physical Health Sytem (CPHS) services and applications interconnected with remote medical sensors and actuators using FIWARE technology in the context envisioned by FICHe. In particular, we discuss the design and development of an RPM system implemented through the collaboration between the Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “Bonino Pulejo” (i.e., a clinical and research healthcare centre specialized in the treatment of neuro lesions), University of Messina, IBM Research, Telefónica, and the University of the Western Cape in South Africa. The description of our best practice provides a model and guidelines for the development of lightweight and low cost RPM services for rural and isolated areas, with the expectation of expanding healthcare to the developing world and in general allows us to outline how to deal with the real adoption of the FIWARE technology in an e-health project.