**Abstract**

In healthcare systems, the adoption of logistics 4.0 main technologies in the processes flows is essential to avoid unnecessary movements and manual work performed by people who could be performing tasks that require logical reasoning. In the context of the COVID pandemic, the adoption of new technologies to replace people in manual processes had become even more usual. This paper aims to demonstrate through simulation, the opportunities of improvement with lean manufacturing concepts and industry 4.0 technologies the hospital flows. After describing the problem and the need of improvements in hospital logistics, a literature review with concepts of Industry 4.0, Lean Manufacturing, and Logistics 4.0 will be presented. The hybrid approach used in the development of a decision aid tool that combines real data and methods of machine learning and problem-solving will be then, an example will be given for illustrating the concepts and methods elaborated.

**Keywords:** Healthcare logistics, Industry 4.0, Lean manufacturing, Robotics, Digital twin, Decision aided system, Artificial intelligence
