Currently submitted to: JMIR mHealth and uHealth
Date Submitted: Sep 14, 2026
Open Peer Review Period: Sep 15, 2026 - Nov 10, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of a Closed-Loop Proactive Health Management Model Integrating Smart Wearables and a Health Cloud Platform: A Real-World Intervention Study
ABSTRACT
Background:
Chronic noncommunicable diseases are leading causes of mortality and disability in China.
Objective:
This study evaluated a closed-loop proactive health management model integrating smart wearables, a cloud platform, and graded community health services for older adults.
Methods:
A total of 120 community-dwelling older adults were recruited. Smart rings continuously monitored heart rate, SpO2, and sleep. The study included a 5-day baseline observation phase and an 85-day intervention phase. During intervention, a three-tier “cloud platform - health manager - family physician” model was implemented. The platform detected abnormal physiological changes in real time and generated work orders. Health managers addressed routine abnormalities using standardized procedures and escalated complex or high-risk cases to family physicians. All dispositions were fed back to the platform to close the loop. Baseline temporal patterns and sex differences were analyzed, and pre-post changes were compared.
Results:
Baseline data showed that heart rate deviations (>100 bmp or <60 bmp) and hypoxemia (SpO2 < 95%) were time dependent, clustering at night and peaking around 04:00. Men had more daytime tachycardic events, whereas women had a higher risk of nocturnal hypoxemia. Women had better overall sleep quality, although high sleep scores (> 90) were less common. During the 90-day intervention, compared with baseline, the proportion of daytime heart rate >100 bmp events during the intervention period increased (suggesting increased physical activity), while the proportion of nighttime blood oxygen <95% events decreased significantly, and the proportion of sleep scores <60 points declined substantially.
Conclusions:
A closed-loop wearable-enabled health management model can promote daytime activity, reduce nocturnal hypoxemia, and improve sleep quality in older adults, offering a feasible digital approach for integrated medical and elderly-care services. Clinical Trial: null
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