Continuous physiological monitoring using wearable technology to inform individual management of infectious diseases, public health and outbreak responses

Abstract

Optimal management of infectious diseases is guided by up-to-date information at the individual and public health levels. For infections of global importance, including emerging pandemics such as COVID-19 or prevalent endemic diseases such as dengue, identifying patients at risk of severe disease and clinical deterioration can be challenging, considering that the majority present with a mild illness. In our article, we describe the use of wearable technology for continuous physiological monitoring in healthcare settings. Deployment of wearables in hospital settings for the management of infectious diseases, or in the community to support syndromic surveillance during outbreaks, could provide significant, cost-effective advantages and improve healthcare delivery. We highlight a range of promising technologies employed by wearable devices and discuss the technical and ethical issues relating to implementation in the clinic, focusing on low- and middle- income countries. Finally, we propose a set of essential criteria for the rollout of wearable technology for clinical use.

Figure 1

Potential roles for healthcare wearable devices in providing continuous real-time physiological monitoring for: (a) hospital setting to provide early warning in clinical deterioration; (b) ambulatory patient management or follow up of patients discharged at home; (c) deployment to healthy individuals at risk of disease outbreak to provide real-time syndromic surveillance information. The data is connected securely to cloud-based systems and integrated with other sources such as rapid diagnostics and healthcare utilization data. The information is then used for direct patient monitoring, or aggregated at a public health level for surveillance to inform public health measures.