Wearable Devices in Emergency Departments: A Systematic Review of Uses, Workflow, and Outcomes

Wearable devices offer continuous physiologic monitoring that may enhance emergency department (ED) triage and care beyond traditional settings. Their clinical impacts and integration challenges remain poorly defined. We systematically reviewed their use across the ED care continuum.

We searched PubMed, Embase, and Web of Science for English-language studies from January 1, 2017 to July 3, 2025. Two reviewers independently screened studies in Covidence. We included studies evaluating non-invasive, body-worn devices that wirelessly transmit physiologic or contextual data and were actively used in ED care. Devices had to be worn by patients or providers; implanted devices, self-report tools, and telehealth-only interventions were excluded. We extracted data on device type, clinical application, outcomes, and study quality. Risk of bias was assessed using RoB 2, ROBINS-I, or QUADAS-2. Outcomes included time to escalation or disposition (primary), diagnostic accuracy, workflow burden, length of stay, adoption, and utilization. Findings were synthesized narratively by device type and quality.

From 1205 records, 35 studies met inclusion. Devices included wrist-worn trackers, multiparameter adhesive patches, and single-metric biosensors. Use cases included sepsis detection, cardiovascular monitoring, toxicology, triage support, and remote follow-up. Several studies reported faster recognition of deterioration and reduced time to escalation or disposition (e.g., sepsis patches identified deterioration 5.5 hours earlier than standard checks). Effects on length of stay, admissions, and return visits varied. Barriers included data quality, alarm fatigue, interoperability, staff adherence, and cost.

Wearables may improve early detection and decision making in the ED. However, mixed outcomes and implementation challenges limit broad applicability. Standardized endpoints and comparative studies are needed.