Bridging Gaps in Patient Monitoring: The Rise of Wearables

Hospitals are increasingly turning to wearables to improve monitoring efficiency and earlier intervention.

These technologies are being integrated across inpatient medical-surgical units, emergency departments, and specialized areas such as oncology and perinatal care, as well as in patients’ homes.^[1] “Wearable monitoring has reached a turning point where its accuracy and portability are transforming patient care,” says Christina Canfield, MSN, APRN, ACNS-BC, CCRN, medical affairs program manager of acute care and monitoring for Medtronic. In this conversation, Canfield discusses the advantages, implementation strategies, and key considerations for hospitals looking to incorporate wearable monitoring into patient care.

Q: What is wearable monitoring, and where is it most commonly used?

Canfield: Wearable monitoring involves devices worn on the body, such as wristbands^[2] or adhesive patches—that collect heart rate, respiratory rate, oxygen saturation, temperature, and heart rhythm and movement data.^[3] These devices transmit information to dashboards, patient portals, and electronic health records (EHR)^[4], enabling continuous or near-continuous collection. In hospital inpatient medical-surgical areas, wearables augment manual checks by nurses and other clinicians, reducing the time spent on manual intermittent vital sign collection.^[5]

They are also used in emergency departments^[6] for triage and patient prioritization and in oncology^[7] and perinatal^[8] settings for specialized monitoring needs. Wearables are used in outpatient settings, most commonly for patients recovering from surgery^[9] or managing chronic conditions at home. Studies show patients are satisfied with wearable home monitoring as an extra layer of support. ^[10]

Q: What are the advantages of wearable monitoring?

Canfield: There are multiple advantages. In the hospital setting, wearable monitoring eliminates the gaps that occur with intermittent monitoring, with one study indicating that traditional vital sign spot-checks leave patients unmonitored 96% of the time.^[11] Wearables provide a more complete picture of patient health, helping clinicians detect early signs of deterioration.^[12],[13]

Wearables also reduce nursing workload. A typical 30-bed unit requires over 900 minutes of nursing time per day to monitor vital signs manually every four hours.⁵ Also, by automating data capture and integrating with the EHR at intervals, wearables free up staff to focus on direct patient care.^[14]

Accuracy is another major benefit. Studies show that manually counted respiratory rates often vary significantly, and sporadically charted values fail to capture the true variability of key indicators like respiratory rate and heart rate.^[15] Since respiratory rate is a leading indicator of patient decline,^[16] continuous monitoring enables early intervention, potentially reducing ICU transfers and rapid response calls, which may lead to fewer adverse outcomes.^[17]

In home settings, wearable monitoring contributes to patient comfort and recovery. One study finds that 75% of patients would prefer to leave the hospital a day earlier if they could be monitored at home.⁹

Q: What impact do hospitals and health systems see with wearable monitoring?

Canfield: Hospitals using wearables in medical-surgical units can experience many benefits, including reduced length of stay,¹⁸ lower rates of code blues,^[18] and decreased alert fatigue.¹³ Wearables connect all the right data points and, when integrated into the EHR, improve accuracy by minimizing manual entry errors. At home, alerts from wearables can reduce 30-day readmission rates by flagging early signs of complications.^[19]

Wearables also enhance clinician situational awareness.^[20] Devices can generate alerts when vital signs deviate from expected patterns, directing them to patients who need more in-depth assessments.¹³ Some models are tetherless, allowing patients to move freely while still being monitored.¹² Operationally, hospitals have implemented customized wearable monitoring solutions through command centers,^[21] central nursing stations, or by pushing alerts directly to nurses’ communication devices.

Q: What barriers to implementing wearable monitoring still exist, and how can they be mitigated?

Canfield: One challenge is ensuring hospitals deploy wearables in the right areas. While the technology is exciting, with facilities wanting to use it everywhere, it’s essential to carefully evaluate your needs and how frequently clinicians want or need to receive the data.²⁰ Consider focusing first on units with the greatest need, such as those with high rates of unplanned ICU transfers.^{[22], 17} A targeted approach allows organizations to refine workflows before expanding use.

Another consideration is alert fatigue. While wearables generate fewer alerts than telemetry systems,¹³ hospitals must customize dashboards and notification settings to avoid overwhelming clinicians. The good news is that research shows that wearable devices average fewer than one alert per patient per day. ¹³ Telemetry monitoring, on the other hand, is associated with an alert rate of over 50 total in a nurse's assignment per day.^[23]

Data connectivity is another hurdle, particularly in rural home settings where bandwidth may be limited.^[24] Providing patients with mobile hotspots can help mitigate this issue.

Finally, hospitals should evaluate their patient populations to determine the most appropriate monitoring approach. While telemetry remains critical for certain cardiac patients, wearable monitoring may be more appropriate in some spaces.^[25]Research suggests that many patients receiving cardiac telemetry monitoring do not meet the American Heart Association’s recommendations for its use,²⁵ highlighting an opportunity to reassess monitoring strategies.

Change takes time, and introducing a new way of monitoring patients is a shift for any clinical team. But thoughtful implementation and a clear strategy can help hospitals unlock the benefits of wearable monitoring while supporting staff through the transition.

Patient monitoring products should not be used as the sole basis for diagnosis or therapy and are intended only as an adjunct patient assessment.

The BioButton®* multi-parameter wearable device is not intended for critical care monitoring.

®*Third-party brands are trademarks for their respective owners. All other brands are trademarks of a Medtronic company.

Product usage represented may not be approved or cleared in all markets.