Virtual Step-Down Care: How Continuous Monitoring Improves Patient Safety and Hospital Efficiency

Rethinking Telemetry Capacity

Telemetry beds are a limited resource in every hospital. Yet many post-ICU (intensive care unit) and postoperative patients still require close heart rhythm and oxygen monitoring. Traditionally, these patients compete for a limited number of monitored beds or rely on spot checks that can miss short but serious events.

Wearable devices connected over LoRaWAN® networks are helping to solve this challenge. With lightweight, wireless sensors such as TEKTELIC’s eBeat and eDoctor, hospitals can extend continuous monitoring beyond the ICU and into general wards, creating a “virtual step-down” unit.

In the sections below, we’ll explore what this means for patients and hospitals: why continuous monitoring matters, how it works in practice, and the measurable benefits it delivers.

Why Patient Safety Comes First

The strongest reason to expand continuous monitoring is better patient outcomes. Research shows that ward-wide surveillance programs reduce rescue events, unplanned ICU transfers, and even mortality rates¹,². For cardiac patients, early detection of atrial fibrillation (AF) is especially critical, since untreated AF can increase stroke risk up to fivefold⁴.

When we designed these solutions, our focus was on patient wellbeing first. Each feature was developed to address specific safety gaps clinicians face every day.

Key safety benefits include:

• Earlier arrhythmia detection: for patients, this means AF can be identified early enough to prevent strokes; for hospitals, it reduces the number of emergency ICU transfers¹,².
• Fewer unwitnessed desaturations: oxygen drops are caught immediately, protecting patients at risk¹.
• Continuous respiratory insight: chest-motion monitoring helps detect slowed or stopped breathing, even when oxygen therapy alone might hide the problem⁶.
• Preserved mobility: patients can walk and recover more naturally, which supports faster healing².

By meeting these needs directly on the ward, hospitals create safer environments and patients gain peace of mind during recovery.

What the Devices Offer

To understand how these wearables make a difference in practice, let’s look at what each device provides and why it matters.

• eBeat – A lightweight arm-worn sensor streaming continuous single-lead ECG (electrocardiogram), heart rate, oxygen saturation (SpO₂), respiration, and temperature.
• eDoctor – A discreet chest-worn device monitoring heart rate, chest motion, respiratory rate, body position, and temperature.
• LoRaWAN® Network – Wide coverage across hospital floors with minimal gateways and long battery life, ensuring patients remain mobile.
• Seamless Integration – Data feeds into Early Warning Scores (EWS) and nurse dashboards, with configurable alerts and escalation pathways.

Unlike traditional wired telemetry, these wearables keep patients connected while allowing them to move, rest, and recover comfortably.

For hospitals, this means expanded monitoring without the high cost of additional wired telemetry beds. For patients, it means continuous care that doesn’t interfere with mobility or comfort.

Clinical Workflow in Practice

In real-world deployments, continuous monitoring transforms daily workflows in ways that directly support both patient safety and clinical efficiency.

• Real-time arrhythmia alerts for AF, pauses, bradycardia (slow heart rate), ventricular tachycardia (VT), and oxygen desaturations³.
• Earlier and safer ICU discharge, expanding capacity without losing vigilance¹,².
• Seamless EWS integration, proactively escalating at-risk patients¹.
• Reduced alarm fatigue, when paired with careful tuning and adjustment cycles⁶.

What this really means for hospitals – nurses respond faster, doctors can discharge patients earlier, and patients receive safer care on general wards.

Benefits Across the Board

Every stakeholder experiences clear improvements when monitoring is extended beyond the ICU.

• For Patients: Continuous monitoring means dangerous arrhythmias or oxygen drops are detected in time to act¹,². A patient recovering from surgery, for example, can walk freely while still being protected—reducing anxiety and improving overall recovery.
• For Clinicians: Nurses and doctors no longer need to rely only on intermittent checks. Instead, they get real-time updates and alerts directly to their devices³, allowing faster interventions before situations escalate. This reduces stress and improves confidence in patient safety.
• For Hospitals: Expanding monitoring beyond a handful of telemetry beds reduces emergency ICU transfers, shortens stays, and improves safety scores¹,²,⁶. Hospitals can safely care for more patients with the same resources, helping them balance quality of care with financial sustainability.

Together, these benefits create a care environment where patients feel safer, clinicians work more effectively, and hospitals see measurable improvements in both outcomes and efficiency.

ROI as a Secondary Gain

While safety is always the first priority, hospitals also need sustainable solutions. That’s where the financial impact becomes important.

Avoided ICU transfers and shorter ICU stays generate meaningful savings¹,². Published analyses suggest programs often recoup investments within months⁶.

Another important gain is stroke prevention. By detecting AF early, hospitals can reduce the likelihood of AF-related strokes by around 64%⁵, preventing both suffering for patients and long-term treatment costs for healthcare systems.

Wearable solutions also shift monitoring from fixed, high-cost wired systems to flexible, low-maintenance infrastructure already supported by LoRaWAN®⁶,⁷.

For hospitals, this means they don’t just improve patient safety—they do it in a financially responsible way.

Blueprint for Implementation

Hospitals considering this model can follow a structured approach to ensure reliable deployment and smooth adoption.

1. Define patient groups – post-ICU transfers, patients with high AF risk scores, or those recovering from heart attack or procedures such as PCI (percutaneous coronary intervention).
2. Pair devices – eBeat for rhythm and oxygenation, eDoctor when breathing risk is elevated.
3. Integrate workflows – connect data to EHR/EWS systems and nurse consoles.
4. Tune alarms carefully – minimize false alerts with structured adjustment cycles⁶.
5. Engineer reliability – install backup gateways and set clear battery-swap routines.
6. Track outcomes – measure ICU transfers, code blues, alarm rates, and response times²,⁶.

This approach allows hospitals to expand monitoring in a controlled, step-by-step way while building staff confidence and trust.

Conclusion

Continuous ward monitoring should not be limited to a handful of wired telemetry beds. With wearable LoRaWAN® devices like eBeat and eDoctor, hospitals can safely expand surveillance across entire wards.

Ultimately, every feature and workflow is designed with the patient in mind—safer monitoring, earlier detection, and freedom to recover with dignity.

The main value is better outcomes for patients and safer workloads for clinicians. The added financial return—through fewer ICU transfers, shorter stays, and stroke prevention—makes adoption sustainable for hospitals.

Virtual step-down care is no longer a vision for the future. It’s a practical, evidence-based approach that improves safety today.

At TEKTELIC, we support healthcare providers in choosing the right mix of devices and network design to match their patient populations and workflows. If you’d like to explore how virtual step-down care could work in your facility, our team is here to help: info@tektelic.com 

References

¹ Taenzer AH, et al. Impact of pulse oximetry surveillance on rescue events and ICU transfers. Anesthesiology. 2010.
² Rowland BA, et al. Impact of continuous and wireless monitoring of vital signs on outcomes in the general ward. Br J Anaesth. 2024.
³ Steinhubl SR, et al. mSToPS randomized trial: immediate patch ECG increases AF detection and OAC initiation vs usual care. JAMA. 2018.
⁴ American Heart Association. Atrial Fibrillation and Stroke Risk. 2023 update.
⁵ Lowres N, et al. Anticoagulation in AF reduces stroke risk by ~64%. Eur J Prev Cardiol. 2019.
⁶ Khanna AK, et al. Continuous ward vital-sign monitoring: evidence and implementation. Br J Anaesth. 2025.
⁷ Benjamin EJ, et al. Heart Disease and Stroke Statistics—2024 Update. AHA/CDC report.