Biointellisense Inc.

02/13/2026 | Press release | Archived content

Solving for Telemetry Overuse in Patient Monitoring with BioIntelliSense

Current challenges in patient monitoring

Telemetry has become a standard tool in hospitals for monitoring patients who require continuous ECG monitoring, but evidence shows it's widely overused. Up to 43% of hospital telemetry use occurs without indication1, while one study showed only 24% of telemetry days were determined to be appropriate based on practice standards.2

Despite usage guidelines by the AHA and recommendations by the Society of Hospital Medicine to adopt a protocol-driven approach to continuous ECG monitoring, overutilization remains a problem.1

One analysis found that telemetry ordered outside of AHA guidelines, had a documented benefit of less than 1%.3 Another study demonstrated that clinical care was changed for only 7% of patients on telemetry, as a result of their telemetry usage.4

These findings suggest that telemetry is often being used as part of a "defensive medicine" strategy, fueled by a fear of missing clinical events.5

Evidence shows telemetry is widely overused

43% of telemetry occurs without indication1

76% of telemetry days were determined to be inappropriate2

Less than 1% of telemetry orders outside of AHA guidelines had a benefit3

The hidden burden of overuse

Telemetry overuse creates ripple effects across healthcare systems in the form of operational strain, patient safety risks, and financial impact.

Operational strain

Unnecessary telemetry creates a high alarm burden for clinical teams, contributing to clinician cognitive overload.6,7 Alarm fatigue is a well-documented challenge in clinical care environments, driven in part by the sheer volume of alerts clinicians must process. In a study of 2,029 medical-surgical nurses, 84.6% reported feeling overwhelmed by the number of clinical alarms.8 Over time, this constant exposure can lead to alarm fatigue, which occurs when clinicians develop decreased reactivity and begin to tune out alarms.9

Beyond alarm burden, unnecessary telemetry also places strain on hospital operations. Its use can diminish hospital throughput and increase a patient's length of stay.4,11

84.6% medical-surgical nurses reported feeling overwhelmed by the number of clinical alarms8

Patient safety risks

While intended to protect patients, telemetry overuse can create unintended safety risks. This concern is reflected in national risk assessments, where overuse of telemetry was one of the top 10 ECRI digital health hazards in 2023.6

As clinicians become desensitized to frequent alarms, critical events may be missed.6,7The consequences of alarm fatigue vary widely, ranging from disturbed rest to missed periods of instability due to alarm desensitization.9

Telemetry can also disrupt patient sleep,5 and sleep disturbance has substantial potential impacts on patient recovery from illness and operation.10

Clinicians becoming desensitized to alarms may result in:

  • missed critical events
  • disturbed rest
  • missed periods of instability

Financial impact

Reducing inappropriate use of telemetry can reduce overall health care expenditure, as telemetry overutilization costs approximately $54 per patient per day.1,12In one analysis, reducing telemetry use by an average of 1.21 to 4.22 days resulted in calculated cost savings of $22,199 per month.4

Other analyses highlight the scale of unnecessary use driving these costs. Nearly a quarter of patients were placed on telemetry without indication, and 56% of the remaining patients stayed on telemetry longer than recommended, resulting in more than $500,000 in annualized costs associated with inappropriate telemetry use.13

More than $500,000 in annualized costs associated with inappropriate telemetry use in one analysis13

Why telemetry overuse persists

Despite awareness and published guidance, telemetry can persist as part of a "defensive medicine" strategy, fueled by a fear of missing clinical events and a fear of missing clinical arrhythmias.5 When telemetry is used for patients who do not require it, it can lead to patients overall being less effectively monitored.6

Bridging the gap with wearable technology

What has been missing is a scalable way to continuously monitor key vital signs for patients who do not require continuous ECG monitoring but still warrant oversight for signs of deterioration. One challenge to early recognition of patient decline is variation in the frequency of manual vital sign measurements, particularly during overnight hours.15 Because these measurements are intermittent, monitoring gaps occur, creating periods when changes in physiologic condition can go unnoticed.16 In fact, spot-checking can leave patients unmonitored 96% of the time.2

This is where technologies such as the BioButton® multi-parameter wearable device can play an important role.

The BioButton® provides continuous monitoring of vital signs with high clinical accuracy.17 It has demonstrated the ability to generate timely notifications for physiologic abnormalities, such as elevated heart rate or respiratory rate, which can precede clinical deterioration events
by several hours and may allow for earlier intervention.17

In addition, BioButton® detects the majority of events with a minimal frequency of alarms.17 Notifications generated by the BioButton® system have led to actionable changes in patient care, including new diagnoses and adjustments in treatment, demonstrating a measurable impact on clinical management.17

Finding balance through smart solutions

Telemetry plays a critical role in patient monitoring when used appropriately. However, when applied too broadly, telemetry overuse can create unintended consequences, including clinician cognitive overload and missed critical events, a high alarm burden, diminished hospital throughput, and increased patient length of stay.6,7,11,14

Finding the right balance means selecting the monitoring approach
that best matches the patient's clinical needs.

For patients who do not require continuous ECG monitoring, wearable monitoring devices provide an alternative that supports earlier recognition of clinical deterioration and may result in reduced rapid response team activations and fewer unplanned ICU admissions.18

Wearable solutions such as the BioButton® enable continuous monitoring of vital signs with high clinical accuracy and support early detection of patient deterioration.17

Interested in learning how wearable monitoring approaches like the BioButton® can support continuous vital sign monitoring within your patient care strategy? Contact us.

References

  1. Yeow, R. Y., G. W. Strohbehn, C. M. Kagan, et al. "Eliminating Inappropriate Telemetry Monitoring: An Evidence-Based Implementation Guide." JAMA Internal Medicine, vol. 178, no. 7, 2018, pp. 971-978. https://doi.org/10.1001/jamainternmed.2018.2409.
  2. Curry, J. P., and C. R. Jungquist. "A Critical Assessment of Monitoring Practices, Patient Deterioration, and Alarm Fatigue on Inpatient Wards: A Review." Patient Safety in Surgery, vol. 8, 2014, article 29. https://doi.org/10.1186/1754-9493-8-29.
  3. Brownell, J., B. Yenigalla, et al. "Abstract 205: Does Overuse of Telemetry Impede Cost-Effective Patient Care?" Circulation, vol. 141, suppl. 1, 2020, p. 205. https://www.ahajournals.org/journal/circ.
  4. Pendharkar, S. S., I. B. Barry, S. Patibandla, et al. "AHA Telemetry Guidelines Improve Telemetry Utilization in the Inpatient Setting." American Journal of Managed Care, vol. 26, no. 11, 2020, pp. 476-481. https://www.ajmc.com/.
  5. Varnika, FNU, S. Vummaneni, P. Munjal, B. P. Walters, V. Gupta, and R. Jain. "Untangling the Wire: Exploring the Overuse of Continuous Telemetry on Regular Nursing Floors." Cardiology in Review, 2025. https://journals.lww.com/cardiologyinreview/.
  6. ECRI. Top 10 Health Technology Hazards for 2023: Executive Brief. ECRI, 2023. https://www.ecri.org/.
  7. Srinivasa, E., J. Mankoo, and C. Kerr. "An Evidence-Based Approach to Reducing Cardiac Telemetry Alarm Fatigue." Worldviews on Evidence-Based Nursing, vol. 14, no. 4, 2017, pp. 265-273. https://onlinelibrary.wiley.com/journal/17416787.
  8. Ruppel, H., M. Dougherty, C. P. Bonafide, et al. "Alarm Burden and the Nursing Care Environment: A 213-Hospital Cross-Sectional Study." BMJ Open Quality, vol. 12, 2023, e002342. https://doi.org/10.1136/bmjoq-2023-002342.
  9. Hravnak, M., T. Pellathy, L. Chen, et al. "A Call to Alarms: Current State and Future Directions in the Battle Against Alarm Fatigue." Journal of Electrocardiology, vol. 51, no. 6, suppl., 2018, pp. S44-S48. https://doi.org/10.1016/j.jelectrocard.2018.07.024.
  10. Hillman, D. R. "Sleep Loss in the Hospitalized Patient and Its Influence on Recovery from Illness and Operation." Anesthesia & Analgesia, vol. 132, no. 5, 2021, pp. 1314-1320. https://doi.org/10.1213/ANE.0000000000005323.
  11. Chen, S., and S. Zakaria. "Behind the Monitor-The Trouble with Telemetry: A Teachable Moment." JAMA Internal Medicine, vol. 175, no. 6, 2015, pp. 963-964. https://doi.org/10.1001/jamainternmed.2015.0837.
  12. Benjamin, E. M., R. A. Klugman, R. Luckmann, D. G. Fairchild, and S. A. Abookire. "Impact of Cardiac Telemetry on Patient Safety and Cost." American Journal of Managed Care, vol. 19, no. 6, 2013, pp. e225-e230. https://www.ajmc.com/.
  13. Chong-Yik, R., A. L. Bennett, R. V. Milani, and D. P. Morin. "Cost-Saving Opportunities with Appropriate Utilization of Cardiac Telemetry." American Journal of Cardiology, vol. 122, no. 9, 2018, pp. 1567-1573. https://doi.org/10.1016/j.amjcard.2018.07.016.
  14. Chaudhary, R., T. Kingsley, S. Sarkar, et al. "Telemetry: Appropriateness of Initial Assignment and Duration in Nonintensive Setting." American Journal of Managed Care, vol. 26, no. 11, 2020, pp. 459-460. https://doi.org/10.37765/ajmc.2020.88524.
  15. Stellpflug, C., L. Pierson, D. Roloff, et al. "Continuous Physiological Monitoring Improves Patient Outcomes: A Nurse-Led Initiative Enhances Vital Sign Assessment Using Digital Devices." American Journal of Nursing, vol. 121, no. 4, 2021. https://journals.lww.com/ajnonline/.
  16. Vroman, H., D. Mosch, F. Eijkenaar, et al. "Continuous Vital Sign Monitoring in Patients after Elective Abdominal Surgery: A Retrospective Study on Clinical Outcomes and Costs." Journal of Comparative Effectiveness Research, vol. 12, 2023, e220176. https://doi.org/10.2217/cer-2022-0176.
  17. Weller, G. B., J. Mault, M. E. Ventura, et al. "A Retrospective Observational Study of Continuous Wireless Vital Sign Monitoring via a Medical Grade Wearable Device on Hospitalized Floor Patients." Journal of Clinical Medicine, vol. 13, 2024, article 4747. https://doi.org/10.3390/jcm13164747.
  18. Eddahchouri, Y., R. V. Peelen, M. Koeneman, et al. "Effect of Continuous Wireless Vital Sign Monitoring on Unplanned ICU Admissions and Rapid Response Team Calls: A Before-and-After Study." British Journal of Anaesthesia, vol. 128, no. 5, 2022, pp. 857-863. https://doi.org/10.1016/j.bja.2022.01.036.

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Biointellisense Inc. published this content on February 13, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on February 26, 2026 at 10:06 UTC. If you believe the information included in the content is inaccurate or outdated and requires editing or removal, please contact us at [email protected]