Alert burden when monitoring patients' vital signs continuously at home

Continuous monitoring of vital signs after hospital discharge may support early recognition of deviating vital signs. However, the utility may be challenged by high alert frequencies. This exploratory study aimed to assess the impact of evidence-based augmented filtering algorithms on alert frequency following discharge. Adult patients (≥ 18 years) discharged after acute medical admission were monitored continuously using wearable devices that measured heart rate, respiratory rate, blood pressure, and oxygen saturation. The primary outcome was the number of alerts per patient per day. We compared outcomes across three filtering strategies: (1) no filtering, (2) artefact removal, and (3) filtering with artefact removal and clinical criteria based upon severity and duration. Ninety-eight patients were enrolled; the total vital sign alert frequency was reduced from a median of 74 [IQR 36-125] to 5 [IQR 1-13] alerts/patient/day following application of the clinical criteria filters, corresponding to an 84% reduction (p < 0.001). Alert frequency following the three filtering approaches was 74 [IQR 36-125], 67 [IQR 33-103], and 5 [IQR 1-13] alerts/patient/day, respectively, p < 0.001. Artefact removal and the application of filters based on severity and event duration significantly reduced alert frequency in patients continuously monitored at home after hospital discharge. Further studies are needed to evaluate clinical safety and predictive value.