The connected patient: towards remote monitoring beyond critical care

The concept of the connected patient offers a novel approach to continuous monitoring beyond critical care in the perioperative setting. Despite a substantial reduction in surgical mortality over recent decades, approximately 4.2 million patients still die each year within one month of surgery. The majority of these deaths occur outside critical care units, often in patients who were never admitted to them, highlighting a major issue of delayed detection of complications, or failure to rescue.
In most cases, postoperative complications begin with a silent phase, during which the pathological process is underway but not yet clinically apparent. At this early stage, these subtle signs are poorly detected by conventional monitoring, which remains intermittent and therefore ill-suited to a continuous risk. These observations support a shift in paradigm towards more intensive and automated monitoring.
Early warning systems and connected monitoring technologies can improve the detection of clinical deterioration and enable earlier therapeutic interventions. Their potential impact extends to mortality, length of stay, and complication rates, while also potentially improving care pathways, quality of life, and cost-effectiveness.
However, the level of evidence supporting these benefits remains limited, and alarm fatigue represents a significant barrier to implementation. There is therefore a need to train healthcare professionals and to refine deployment strategies.
Through these developments, monitoring becomes a continuous thread throughout the patient pathway, from hospital to home: it is no longer a place, but a function serving surgical care pathways and patient outcomes