WEARABLE BIOSENSORS IN REMOTE CHRONIC DISEASE MONITORING: A STRUCTURED REVIEW OF IMPLEMENTATION BARRIERS AND HEALTH EQUITY IMPLICATIONS

Abstract

Background Clinical-grade wearable biosensors offer significant potential for tracking chronic diseases outside the hospital. However, while the hardware itself is highly accurate, the medical field still struggles with the logistical reality of deploying these tools. The structural barriers preventing widespread clinical use, and the ways these hurdles impact overall health equity, lack rigorous synthesis in the current literature. Objective Moving beyond pure hardware accuracy, this analysis maps the practical realities of continuous patient surveillance. It specifically investigates the institutional workflow bottlenecks, hardware usability hurdles, and underlying economic disparities that dictate how monitoring programs actually function for populations managing heart failure, diabetes, or COPD. Methodology Peer-reviewed literature spanning 2018 to 2026 was extracted from PubMed/MEDLINE and Google Scholar. The inclusion criteria deliberately filtered out purely technical validation studies. Instead, the analysis targeted data documenting the logistical friction, long-term adherence failures, and unequal access surrounding continuous glucose monitors, ambulatory cardiac patches, and multi-parameter tracking devices. Results The synthesized data show that severe workflow friction and poor electronic health record interoperability actively block hospital networks from scaling these programs. On the patient side, a distinct "compliance paradox" emerges. High initial motivation frequently collapses into device abandonment, usually triggered by physical skin irritation, convoluted software interfaces, and low technical literacy. The literature also exposes a severe digital divide. A patient's income bracket, geographic location, and advanced age strictly gatekeep their ability to access continuous medical monitoring. Conclusion Healthcare networks cannot rely solely on precise hardware to improve chronic disease management. Deploying continuous monitors successfully requires a fundamental shift toward repairing broken clinical workflows and addressing systemic exclusion. Without structural interventions targeting financial and technical accessibility, digital health initiatives will simply reinforce existing medical inequalities.