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Healthcare IoT, a fast-growing field, could revolutionize patient monitoring and intervention. This interconnection raises new security concerns, requiring real-time anomaly detection to protect patient data and device integrity. This study presents a novel security framework that uses combination of Hidden Markov Models (HMM) and Support Vector Machine (SVM) to detect anomalies in real-time healthcare IoT environments with high accuracy. The framework prioritizes real-time strength and efficiency. Sensor data from wearables, medical devices, and other IoT devices is carefully segmented into time intervals. Features are carefully derived from each segment, including statistical summaries, patterns, and frequency domain characteristics. Feature engineering is essential for accurate anomaly detection. Integrating HMM and SVM capabilities is the framework's core. HMM accurately represent concealed states within divided data sequences and analyze patterns of change over time. After that, an independent-trained SVM examines each state. Using proximity to a decision hyperplane in feature space, this SVM can classify data points as normal or anomalous. This method augments HMM temporal capabilities with SVM classification efficiency, increasing sensitivity to anomalous patterns and reducing false positives. The framework's exceptional performance is shown by extensive evaluations on the PhysioNet Challenge 2017 dataset, which includes diverse ECG recordings with labeled anomalies. HMM-SVM outperforms Naive Bayes, LSTM, and Random Forest with 98.66% accuracy. The framework also has high precision, recall, and F1-score, indicating a refined ability to detect real anomalies and reduce false alarms. The framework prioritizes real-time understanding and application alongside its remarkable precision. HMM-SVMs reveal hidden data state changes, revealing context and possible causes of anomalies. Modular design and efficient algorithms enable seamless integration of real-time functionality in low-resource IoT devices, enabling quick and effective security responses. To conclude, this study introduces an HMM-SVM framework for fast Healthcare IoT abnormality detection. The framework emphasizes comprehensibility and real-time applicability while achieving high accuracy. This framework can protect patient data, improve device security, and create a more reliable healthcare IoT ecosystem. [ABSTRACT FROM AUTHOR]