Enhancing Surgical Outcomes Through Digital Biomarkers

The increasing integration of digital health technologies into perioperative care has created new opportunities to optimise surgical outcomes. Digital biomarkers—quantifiable indicators derived from wearable devices and mobile applications—offer clinicians real-time insights into patients’ physiological and behavioural status across all stages of surgery. These tools support a continuum of care, ranging from prehabilitation and intra-operative monitoring to post-operative recovery. Although their use shows considerable promise, implementation remains limited due to challenges such as data accuracy, privacy concerns and the traditionally slow adoption of new technologies in healthcare. Exploring their applications throughout the surgical process provides a clearer understanding of their potential impact and the barriers that must be addressed to enable broader uptake. 

Optimising Patients Before Surgery 

In the pre-operative stage, digital biomarkers serve an essential function by helping to prepare patients for surgery through evidence-based interventions. This preparatory process, known as prehabilitation, is designed to improve patients’ functional capacity, nutritional health and psychological readiness ahead of surgical procedures. Wearable devices and digital health applications support this goal by enabling the remote monitoring of physical activity, dietary habits and mental wellbeing. This allows patients to engage in supervised, home-based prehabilitation programmes and track their progress over time. Evidence has shown that such digital interventions are associated with increased levels of physical activity, improved walking distance and enhanced functional status prior to surgery. 

Must Read: Integrating Digital Biomarkers into Health Wearables 

In addition to enhancing physical preparation, digital biomarkers play an important role in monitoring symptom burden before surgery. Traditional clinic visits may not fully capture how illness affects a patient’s daily life. Wearable technologies, including smartphones and smartwatches, can gather continuous data on sleep quality, activity levels, screen time and symptoms such as pain and fatigue. This information provides a more detailed picture of the patient’s condition in the lead-up to surgery. It also allows for earlier recognition of concerning symptoms and the timely introduction of interventions to address them, helping both patients and clinicians better manage perioperative risk. 

Monitoring and Guiding Care in the Hospital 

Once the patient is admitted to the hospital, clinicians are responsible for managing individuals with varying degrees of complexity and acuity. Digital biomarker systems that incorporate artificial intelligence offer a practical solution for synthesising real-time health data and alerting healthcare teams when early signs of deterioration are detected. These systems can predict adverse outcomes, such as the need for intensive care unit admission, with a level of accuracy that may exceed clinical judgement. By sending alerts to clinicians about high-risk patients, these technologies contribute to more proactive and effective in-hospital management and may lead to improved patient survival. 

Intra-operatively, digital biomarkers offer valuable insights not only into patients’ physiological states but also into the condition of the surgical team. For instance, stress levels among perfusionists—the clinicians who operate heart-lung machines during cardiac surgery—can be assessed using wearable sensors that measure heart rate variability. Acute stress in such high-stakes environments has been linked to an increased risk of complications. Timely detection of heightened stress through digital monitoring may prompt the surgical team to adjust their approach, improving the safety of the operation. This application of digital biomarkers underlines their potential to enhance not only patient outcomes but also the performance and wellbeing of healthcare providers. 

Supporting Recovery at Home 

Following surgery, many patients continue their recovery at home, often transitioning from a highly monitored hospital setting to minimal oversight. During this vulnerable period, digital biomarkers enable ongoing monitoring of vital signs and other recovery metrics, bridging the gap in care. Wearable technologies can provide alerts when signs of deterioration emerge, allowing for early clinical intervention. This capability is especially important given that a significant proportion of post-operative complications occur after discharge. 

Moreover, patient-reported outcomes are increasingly regarded as key indicators of recovery quality. However, traditional methods of capturing this data are often unreliable or inconsistent. Digital biomarkers offer a practical alternative by allowing patients to continuously record data related to their recovery, such as levels of pain, physical activity and quality of sleep. This approach ensures that clinicians receive a more accurate and comprehensive picture of patient progress. Importantly, this can inform treatment decisions and support the timely adjustment of care plans. Studies have shown a strong correlation between digital biomarker data and patient-reported outcomes, confirming the validity of these tools in the post-operative context. 

Digital biomarkers, enabled by wearable and mobile technologies, are transforming perioperative care by enhancing pre-operative preparation, improving in-hospital safety and supporting post-operative recovery. They provide clinicians with real-time insights that support early intervention, better symptom management and more personalised care. However, their success depends on overcoming significant challenges, including the need for validated data across diverse populations, robust privacy protections and strategies to promote the uptake of new technologies in clinical practice. Through active engagement with stakeholders and adherence to established frameworks, digital biomarkers can be implemented safely and effectively. Their continued development and thoughtful integration into healthcare systems hold the potential to significantly improve outcomes for surgical patients at every stage of their journey. 

Source: npj Digital Medicine

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