Smartwatch Monitoring Identifies Abnormal Vital Signs Before Routine Checks

Intermittent manual observations can also delay recognition of early physiological changes. A new smartwatch-based inpatient monitoring program now offers continuous observation, identifying changes up to two hours earlier while reducing patient disruptions in a hospital pilot.

At the National University Hospital (NUH) in Singapore, continuous smartwatch-based monitoring will be expanded following a month-long pilot that concluded in June. Over the coming year, up to 10% of suitable inpatient vital signs monitoring is planned to be supported by this approach. The pilot was conducted by the Department of Surgery with surgical ward nurses, operations staff, and university researchers.

Patients wore a smartwatch with Health Sciences Authority (HSA)-approved capabilities to continuously track blood pressure, pulse rate, and blood oxygen saturation. Nurses continued routine bedside checks by documenting smartwatch readings at the usual hourly or four-hourly intervals. When abnormal readings appeared, nurses verified them with standard equipment before escalating care under existing protocols.

No critical clinical events were missed during smartwatch monitoring, and abnormalities were identified up to two hours earlier than routine observations. Earlier detections included 14 episodes of low systolic blood pressure below 100 mmHg, two episodes of high systolic blood pressure above 160 mmHg, one episode of pulse rate below 50 beats per minute, and one episode of reduced oxygen saturation below 95%. All affected patients were promptly reviewed, and none progressed to clinical deterioration.

Patients reported fewer sleep disruptions linked to routine measurements. Among 30 patients using the smartwatch, 7% attributed nighttime awakenings to vital signs checks compared with 17% of 30 patients under conventional monitoring, while both groups woke an average of about three times nightly. NUH plans to integrate smartwatch data with its EPIC electronic medical record (EMR) system to automate documentation, which is expected to shorten each observation from about two minutes to roughly 40 seconds and allow nurses to redirect time to direct care.

“Routine vital signs monitoring is a critical component of post-surgical care, but it can also be time-consuming and repetitive. Wearable technology enables continuous patient monitoring while reducing unnecessary interruptions. By replacing conventional wired monitoring with a wearable device, patients can move more comfortably with fewer attachments, supporting early mobilisation during recovery. At the same time, nurses can devote more time to patients who require closer observation and more direct, personalised care,” said Nurse Manager Lim Pooi See.

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National University Hospital (NUH)