Continuous Patient Monitoring in Healthcare: A Comprehensive Review of Opportunities, Challenges, and Future Directions

Authors

  • K. Hima Bindu, MBBS, MD, FNB Critical Care, Consultant Critical Care, Apollo Hospitals Jubliee Hills, Hyderabad, India https://orcid.org/0009-0005-2386-5458
  • Sai Praveen Haranath, MBBS, MPH, FCCP Internal Medicine, Pulmonary and Critical Care Medicine https://orcid.org/0000-0001-9137-9201
  • Ravi Prakash Mahajan, MD, DM, FCAI (Hon), FRCA Director, Critical Care Integration and Transformation, Apollo Hospitals Group, Director, Research and Innovation, Apollo Hospitals Group, Professor Emeritus, University of Nottingham, UK https://orcid.org/0009-0000-3520-8141
  • Subba Reddy MBBS, MD, PDCC, IDCCM, EDIC, FICCM Senior Consultant, Head of Critical Care Medicine, Apollo Hospitals, Jubliee Hills, Hyderabad, India
  • Rahul Khandelwal; MBBS Chief Operating Officer - Special Projects, Apollo HospitalsHyderabad, Telangana, India https://orcid.org/0009-0000-9851-3928
  • Sneha Varahala, PharmD, MPH Mailman School of Public Health, Columbia University, Irving Medical Center, New York, New York, USA

DOI:

https://doi.org/10.30953/thmt.v10.562

Keywords:

Continuous monitoring, digital health, early warning systems, patient safety, remote patient monitoring, telemedicine, wearable sensors

Abstract

Abstract

While continuous vital sign monitoring is standard in intensive care units, patients in general wards often receive intermittent monitoring, potentially delaying the detection of clinical deterioration. Wearable sensors offer a promising solution by enabling continuous, real-time data capture for a wide range of physiological parameters. This review examines the potential of wearable technology to enhance patient care in various healthcare settings, highlighting its capacity for personalized interventions, improved patient outcomes, and reduced alarm burdens. We discuss the advantages, challenges, and future directions of wearable technology in remote patient monitoring, emphasizing the need for further clinical research to validate its impact on clinical outcomes and optimize its integration into existing healthcare systems.

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References

Joshi M, Ashrafian H, Aufegger L, Khan S, Arora S, Cooke G, et al. Wearable sensors to improve detection of patient deterioration. Expert Rev Med Devices [Internet]. 2019;16(2):145–54. Available from: http://dx.doi.org/10.1080/17434440.2019.1563480

Brown H, Terrence J, Vasquez P, Bates DW, Zimlichman E. Continuous monitoring in an inpatient medical-surgical unit: a controlled clinical trial. Am J Med [Internet]. 2014;127(3):226–32. Available from: http://dx.doi.org/10.1016/j.amjmed.2013.12.004

Downey CL, Chapman S, Randell R, Brown JM, Jayne DG. The impact of continuous versus intermittent vital signs monitoring in hospitals: A systematic review and narrative synthesis. Int J Nurs Stud [Internet]. 2018;84:19–27. Available from: http://dx.doi.org/10.1016/j.ijnurstu.2018.04.013

Centre for Clinical Practice at NICE (UK): acutely ill patients in hospital: recognition of and response to acute illness in adults in hospital. National Institute for Health and Clinical Excellence: guidance. 2007.

Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PWB. The impact of the use of the Early Warning Score (EWS) on patient outcomes: a systematic review. Resuscitation [Internet]. 2014;85(5):587–94. Available from: http://dx.doi.org/10.1016/j.resuscitation.2014.01.013

Downey CL, Tahir W, Randell R, Brown JM, Jayne DG. Strengths and limitations of early warning scores: A systematic review and narrative synthesis. Int J Nurs Stud [Internet]. 2017;76:106–19. Available from: http://dx.doi.org/10.1016/j.ijnurstu.2017.09.003

Michard F, Gan TJ, Kehlet H. Digital innovations and emerging technologies for enhanced recovery programmes. Br J Anaesth [Internet]. 2017;119(1):31–9. Available from: http://dx.doi.org/10.1093/bja/aex140

Hernandez-Silveira M, Ahmed K, Ang S-S, Zandari F, Mehta T, Weir R, et al. Assessment of the feasibility of an ultra-low power, wireless digital patch for the continuous ambulatory monitoring of vital signs. BMJ Open [Internet]. 2015;5(5):e006606. Available from: http://dx.doi.org/10.1136/bmjopen-2014-006606

Haller G, Myles PS, Wolfe R, Weeks AM, Stoelwinder J, McNeil J. Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients. Anesthesiology [Internet]. 2005;103(6):1121–9. Available from: http://dx.doi.org/10.1097/00000542-200512000-00004

Kaboli PJ, Rosenthal GE. Delays in transfer to the ICU: a preventable adverse event? J Gen Intern Med. 2003;18:155–6.

Beckett D, Gordon C, Paterson R, Chalkley S, Macleod D, Bell D. Assessment of clinical risk in the out of hours hospital prior to the introduction of Hospital at Night. Acute Med. 2009;8(1):33–8

Chan M, Estève D, Fourniols J-Y, Escriba C, Campo E. Smart wearable systems: current status and future challenges. Artif Intell Med [Internet]. 2012;56(3):137–56. Available from: http://dx.doi.org/10.1016/j.artmed.2012.09.003

McGloin H, Adam SK, Singer M. Unexpected deaths and referrals to intensive care of patients on general wards. Are some cases potentially avoidable? J R Coll Physicians Lond. 1999;33(3):255–9.

Goldhill DR, White SA, Sumner A. Physiological values and procedures in the 24 hours before ICU admission from the wards. Anaesthesia. 1999;54:529–34.

Mapp ID, Davis LL, Krowchuk H. Prevention of unplanned intensive care unit admissions and hospital mortality by early warning systems. Dimens Crit Care Nurs [Internet]. 2013;32(6):300–9. Available from: http://dx.doi.org/10.1097/DCC.0000000000000004

Ludikhuize J, Borgert M, Binnekade J, Subbe C, Dongelmans D, Goossens A. Standardized measurement of the Modified Early Warning Score results in enhanced implementation of a Rapid Response System: A quasi-experimental study. Resuscitation [Internet]. 2014;85(5):676–82. Available from: http://dx.doi.org/10.1016/j.resuscitation.2014.02.009

Weenk M, Koeneman M, van de Belt TH, Engelen LJLPG, van Goor H, Bredie SJH. Wireless and continuous monitoring of vital signs in patients at the general ward. Resuscitation [Internet]. 2019;136:47–53. Available from: http://dx.doi.org/10.1016/j.resuscitation.2019.01.017

Boatin AA, Wylie BJ, Goldfarb I, Azevedo R, Pittel E, Ng C, et al. Wireless vital sign monitoring in pregnant women: A functionality and acceptability study. Telemed J E Health [Internet]. 2016;22(7):564–71. Available from: http://dx.doi.org/10.1089/tmj.2015.0173

Zubiete ED, Luque LF, Rodríguez AVM, González IG. Review of wireless sensors networks in health applications. Annu Int Conf IEEE Eng Med Biol Soc [Internet]. 2011;2011:1789–93. Available from: http://dx.doi.org/10.1109/IEMBS.2011.6090510

Darwish A, Hassanien AE. Wearable and implantable wireless sensor network solutions for healthcare monitoring. Sensors (Basel) [Internet]. 2011;11(6):5561–95. Available from: http://dx.doi.org/10.3390/s110605561

Ohashi K, Kurihara Y, Watanabe K, Ohno-Machado L, Tanaka H. Feasibility evaluation of Smart Stretcher to improve patient safety during transfers. Methods Inf Med [Internet]. 2011;50(3):253–64. Available from: http://dx.doi.org/10.3414/ME0616

Noah B, Keller MS, Mosadeghi S, Stein L, Johl S, Delshad S, et al. Impact of remote patient monitoring on clinical outcomes: an updated meta-analysis of randomized controlled trials. NPJ Digit Med [Internet]. 2018;1(1):20172. Available from: http://dx.doi.org/10.1038/s41746-017-0002-4

Sahandi R, Noroozi S, Roushan G, Heaslip V, Liu Y. Wireless technology in the evolution of patient monitoring on general hospital wards. J Med Eng Technol [Internet]. 2010;34(1):51–63. Available from: http://dx.doi.org/10.3109/03091900903336902

Buist MD, Jarmolowski E, Burton PR, Bernard SA, Waxman BP, Anderson J. Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to intensive care. A pilot study in a tertiary-care hospital. Med J Aust [Internet]. 1999;171(1):22–5. Available from: http://dx.doi.org/10.5694/j.1326-5377.1999.tb123492.x

Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest [Internet]. 1990;98(6):1388–92. Available from: http://dx.doi.org/10.1378/chest.98.6.1388

Tarar A. Wearable Skin Sensors and Their Challenges: A Review of Transdermal, Optical, and Mechanical Sensors. Biosensors. 2020;10(6).

Khatsenko K, Khin Y, Maibach H. Allergic contact dermatitis to components of wearable adhesive health devices. Dermatitis [Internet]. 2020;31(5):283–6. Available from: http://dx.doi.org/10.1097/DER.0000000000000575

Weenk M, Bredie SJ, Koeneman M, Hesselink G, van Goor H, van de Belt TH. Continuous monitoring of vital signs in the general ward using wearable devices: Randomized controlled trial. J Med Internet Res [Internet]. 2020;22(6):e15471. Available from: http://dx.doi.org/10.2196/15471

Prgomet M, Cardona-Morrell M, Nicholson M, Lake R, Long J, Westbrook J, et al. Vital signs monitoring on general wards: clinical staff perceptions of current practices and the planned introduction of continuous monitoring technology. Int J Qual Health Care [Internet]. 2016;28(4):515–21. Available from: http://dx.doi.org/10.1093/intqhc/mzw062

Kowalski R, Capan M, Lodato P, Mosby D, Thomas T, Arnold R, et al. Optimizing usability and signal capture: a proactive risk assessment for the implementation of a wireless vital sign monitoring system. J Med Eng Technol [Internet]. 2017;41(8):623–9. Available from: http://dx.doi.org/10.1080/03091902.2017.1382589

Kooij L, Peters GM, Doggen CJM, van Harten WH. Remote continuous monitoring with wireless wearable sensors in clinical practice, nurses perspectives on factors affecting implementation: a qualitative study. BMC Nurs [Internet]. 2022;21(1):53. Available from: http://dx.doi.org/10.1186/s12912-022-00832-2

Leenen JPL, Leerentveld C, van Dijk JD, van Westreenen HL, Schoonhoven L, Patijn GA. Current evidence for continuous vital signs monitoring by wearable wireless devices in hospitalized adults: Systematic review. J Med Internet Res [Internet]. 2020;22(6):e18636. Available from: http://dx.doi.org/10.2196/18636

Weenk M, van Goor H, Frietman B, Engelen LJ, van Laarhoven CJ, Smit J, et al. Continuous monitoring of vital signs using wearable devices on the general ward: Pilot study. JMIR MHealth UHealth [Internet]. 2017;5(7):e91. Available from: http://dx.doi.org/10.2196/mhealth.7208

Ruppel H, Funk M, Whittemore R, Wung S-F, Bonafide CP, Powell Kennedy H. Critical care nurses’ clinical reasoning about physiologic monitor alarm customisation: An interpretive descriptive study. J Clin Nurs [Internet]. 2019;28(15–16):3033–41. Available from: http://dx.doi.org/10.1111/jocn.14866

Dash S, Shakyawar SK, Sharma M, Kaushik S. Big data in healthcare: management, analysis and future prospects. J Big Data [Internet]. 2019;6(1). Available from: http://dx.doi.org/10.1186/s40537-019-0217-0

Sendelbach S, Funk M. Alarm Fatigue. AACN Advanced Critical Care. 2013;24:378–86.

Published

2025-07-09

How to Cite

KOTAMARTHY, H. B., Dr Sai Praveen Haranath, Mahajan, P. R. P., Kesavarapu Subba Reddy, Khandelwal, D. R., & Varahala, S. (2025). Continuous Patient Monitoring in Healthcare: A Comprehensive Review of Opportunities, Challenges, and Future Directions. Telehealth and Medicine Today, 10(1). https://doi.org/10.30953/thmt.v10.562

Issue

Section

Narrative/Systematic Reviews/Meta-Analysis