Emergency departments: an opportunity for wearable technology to transform patient safety and improve pathway efficiency

Wearable technology in emergency care is the latest focus of DigitalHealth.London’s Healthcare Challenges, a programme designed to bring together clinicians, innovators, NHS leaders, and people with lived experience to identify and accelerate solutions to priority health issues.

In this blog reflecting on a recent Health Innovation Network South London roundtable on the topic, Dr Matea Deliu (GP and Clinical Lead for Primary Care Digital Delivery and Clinical Safety Officer, NHS South East London) and Dr Ahmed Mahdi (Consultant in Emergency Medicine, St George’s University Hospitals NHS Foundation Trust) outline the significant challenges facing urgent and emergency treatment services in the UK, as well as highlighting some of the greatest opportunities for wearable technology to improve patient outcomes and ease operational pressures.

The reality of clinical care in emergency departments is that things are really difficult, and they have been for several years.

Overcrowding means patients are being cared for in corridors and other spaces. Trying to keep track of who has been seen, who is being monitored and who is still waiting to be seen in the context of an environment that is unpredictable at the best of times is extraordinarily challenging.

Almost every shift, we’re seeing instances of harm coming to patients while they are waiting. There is a huge opportunity to look at how wearable technology can significantly reduce that harm and allow for earlier, more targeted interventions.

Dr Ahmed Mahdi

Prolonged emergency department waits significantly increase patient safety risks. In 2024, more than 16,600 deaths were associated with long A&E waits before admission in England, a 20% increase compared to 2023. By March 2025, over 40% of patients waited more than four hours, and more than 10% waited longer than 12 hours.

Patient deterioration during waiting can escalate into complex and costly interventions such as hospital admission, emergency surgery, or treatment for complications like sepsis.

Current operational challenges also contribute to surging negligence claims, with 1,446 claims in 2023/24 making emergency medicine the speciality with the highest claim volume in the NHS. In 2020/21 alone, urgent care-related claims cost the NHS approximately £322 million in damages and legal expenses.

Protecting the most vulnerable: opportunities to make an immediate difference

Emergency departments treat a broad variety of people – from relatively low-acuity ambulatory patients, to those with immediately life-threatening conditions and significant complexities such as comorbidities or frailty.

Wearables have the potential to greatly improve how patients are monitored during their time within emergency departments – with groups at the greatest risk of deterioration or who would benefit from real-time continuous monitoring being obvious candidates to prioritise for wearable technology.

During our recent roundtable event, there was broad consensus on who some of these groups could be:

• Frail older patients, patients with significant comorbidities or those who are immunocompromised;
• Children at risk of sepsis;
• Patients requiring targeted continuous monitoring for parameters where proven solutions already exist, such as hyperglycaemia (monitored via Continuous Glucose Monitoring) or atrial fibrillation (monitored via ECG-certified wearables).

Integrating wearables into a broader culture shift around urgent care

From my work in the community, it’s clear that we need to make better use of technology to help people take charge of their own health.

We need to move away from a model in which patients rely so much on clinical actions in emergency departments. Wearables can help with that – supporting people in making decisions to manage their own health, or by integrating remote monitoring so deteriorations can be spotted earlier, enabling community or secondary care clinicians to lead interventions.

For patients who do need emergency treatment, wearables can serve as valuable decision-support tools, allowing clinicians to triage and prioritise based on genuine clinical need rather than time spent waiting. They can also support with improving discharge – letting patients get home while maintaining clinical oversight and keeping patients safe.

Dr Matea Deliu

Beyond the implementation of wearables into existing workflows, there is also the exciting prospect of using them to re-shape how we think about emergency care, enabling the transformative changes needed to create safer and more sustainable systems.

Wearables in emergency departments should not be viewed as technology in isolation; we see a future where they are part of a fully integrated pathway involving remote monitoring and other related technologies.

Smartwatches and other consumer-owned wearables are already helping the general population monitor their own health. Alongside these devices, specialised remote monitoring technology is increasingly being used to improve clinical oversight of patient groups with greater risks of deterioration.

Combined, these approaches can keep more people from needing to use urgent treatment services – and with full Electronic Patient Record (EPR) integration and integration with urgent care pathways, they can also provide emergency department clinicians with a much richer picture of incoming patients’ health if emergency intervention is necessary.

Getting implementation right: insights from experience

Many of the prerequisites for successfully introducing wearable technology into emergency departments are similar to other forms of MedTech.

Integration with existing systems such as EPR systems is critical, as is consideration of how devices will operate within clinical workflows which may differ between services. A recent example from the Countess of Chester Hospital shows the dramatic positive impact of interoperability.

Proper medical device certification is also vital – with many wearables still being held back by a lack of appropriate MHRA approval for use as decision support tools in real-world settings.

From a clinical perspective, choosing the right metrics to monitor is an important consideration. Devices focused on monitoring a single parameter are likely to be of less interest to services than those which cover a variety of vital signs, with NEWS2 as the general standard for multi-parameter monitoring.

Many of the above requirements are relatively straightforward to address, but there are also more nuanced implementation questions for innovators to decide their solution to.

For example, innovators need to balance the cost of higher-functioning wearable devices against the infection control measures and relatively high rates of loss or damage in emergency departments which may make re-use more difficult. Charging is another fundamental challenge to grapple with in the context of busy emergency departments.

Finally, innovators need to think about how their solutions will improve (rather than exacerbate) the issue of “alarm fatigue” – ensuring that any patient alerts built into their device are accurate and actionable within clinical workflows (particularly nursing). AI-based functionality is likely to play an important role in overcoming this barrier – alongside continued engagement with clinical “end users” during product development.

DigitalHealth.London Healthcare Challenges is funded by the UK Government via the UK Shared Prosperity Fund (UKSPF). It is delivered by the Health Innovation Network (HIN) South London in partnership with the Office of Life Sciences, CW+, NHS England and the Mayor of London.

For more information, please visit https://www.gov.uk/government/publications/uk-
shared-prosperity-fund-prospectus.