[Digital Instead of Discontinuous - How Wearables Create New Opportunities in the Struggle Against Failure to Rescue]

Medical wearables are considered a promising solution for mobile and continuous vital sign monitoring in general wards, with the objective of significantly reducing the existing monitoring deficit for high-risk patients in German hospitals and consequently lowering post-operative mortality and "failure to rescue" rates. The integration of wearables into early warning systems such as the NEWS (National Early Warning Score) and their intelligent combination with predictive algorithms, has the potential to provide new perspectives, but such integration has not yet been implemented. Technical challenges include the high incidence of false alarms and the subsequent issue of alarm fatigue. The utilisation of artificial intelligence (AI) for the detection of artefacts presents a viable solution to this issue; however, it necessitates the development and validation of complex, device-specific software. In addition to these challenges, there are structural issues that require attention, including the inadequate digitalization of many hospitals, the high investment and maintenance costs that are yet to be reimbursed, and concerns regarding data protection and the clarification of responsibilities in the domain of IT security. Despite these challenges, the potential is widely acknowledged, particularly in terms of enhancing patient safety and reducing the workload of nursing staff. Numerous visions for the future, including non-invasive haemodynamic or biochemical monitoring, are already being developed, but clinically reliable sensors are not yet ready for use. Prospective studies, regulatory guidelines and a clear roadmap for digital transformation are required. It is asserted that the transition of medical wearables from a niche market to standard care can only be achieved through a combination of technical innovation, clinical validation and political decision-making.