Medwings: A Remote Warning Monitoring System for Clinical Deterioration Detection

Clinical deterioration (CD) is a vital sign decline and a significant challenge in healthcare, particularly for vulnerable populations such as the elderly and chronically ill patients. A warning monitoring system (WMS) detects CD occurrences using an early warning score (EWS). It monitors multiple vital signs and alarms before or at the moment of CD, usually in the hospital. Developing a remote warning monitoring system (RWMS) for home care using multiple medical sensors is an ongoing challenge. This study presents the development of the Medwings system, an RWMS designed for continuous monitoring and EWS calculation of outpatients. Medwings integrates EWS with intermittent data collection from multiple wearable devices: ScanWatch, BPM Core, and Thermo (Withings, Issy-les-Moulineaux, France). In a usability trial, a user applied Medwings in 24/7. It calculates EWS in 61% of interactions and successfully identifies abnormalities across vital signs: blood pressure, body temperature, heart rate, and SpO2. However, Medwings has some challenges, such as synchronization delays with the Withings cloud and user reluctance to perform measurements in public, which highlights the areas for improvement. These findings underscore the potential of RWMSs like Medwings to revolutionize patient care by enabling early intervention and optimizing healthcare resource utilization. Future developments should address technical and user-related barriers to maximize the system's impact on patient outcomes.