The Digital Physical Exam: A Pilot Exploring the Utility of Smartphone and Smartwatch Wearable Data for Hospital Medicine

Introduction: Wearable devices such as smartphones and smartwatches collect large volumes of biometric data on patients, yet their utility for admitting inpatient providers remains largely unexplored. Methods: This exploratory pilot screened patients admitted to Stanford University Hospital for use of smartphones or smartwatches. For patients reporting wearable use, preadmission biometric data were collected and analyzed in relation to inpatient outcomes, including admitting diagnosis and discharge disposition. Results: Among 137 screened patients, 27 reported smartphone or smartwatch use, and 16 had adequate preadmission wearable data for analysis. Step count was the most consistently recorded metric. Among those analyzed, a steep decline in step count prior to hospitalization was associated with discharge to a skilled nursing facility or need for home health services. Patients with cardiac diagnoses also exhibited more pronounced declines in step count compared to those with noncardiac conditions. Conclusion: Despite low rates of wearable usage, our findings suggest that trends in prehospital biometric data may offer early insights into patient functional status and discharge needs. As wearable adoption increases, such data could enhance inpatient decision-making and discharge planning.