Who’s Keeping Watch? Continuous Monitoring From Hospital to Home, with Dr. James Mault

What changes for people with AFib when vital signs are watched continuously instead of a few times a day, especially in the vulnerable stretch after an ablation, a cardiac surgery, or a hospital stay? This week on AFibulous Life: Unlimited Conversation, Jim Kaveney sits down with Dr. James Mault, co-founder and executive chairman of BioIntelliSense, the company behind the BioButton, a coin-sized, FDA-cleared wearable that monitors vital signs from the hospital bed to the living room. Jim and Dr. Mault met at the AHA’s Pulse of Innovation webinar during AFib Awareness Month, and this conversation picks up where that one left off. Dr. Mault trained in general and cardiothoracic surgery at Duke, specialized in heart and lung transplantation and critical care, and has spent three decades building remote patient monitoring companies, including a stint as medical director of Microsoft’s Health Solutions Group and a company acquired by Qualcomm Life. His career-defining moment came early: his first lung transplant patient went home to North Dakota, 700 miles from anyone who had ever seen a lung transplant. Together they walk through the gap most patients never see. In the ICU, everything is measured continuously. On the general ward, it’s a manual check every four to eight hours. At home, it’s a list of instructions and good luck. Dr. Mault explains why stability is something measured over windows of time, not a single moment, and why trends often matter more than any one reading. They also dig into the “neglected vital sign,” respiratory rate. Dr. Mault cites published literature showing that most respiratory rates in the medical record are simply charted as 16 or 18, and explains why a rising breathing rate is one of the earliest signals of infection, pain, a struggling heart, or AFib. Pair it with heart rhythm, temperature, and body position, and the picture changes. Jim shares his own experience with older monitors that were shipped away and read weeks later, and the time his care team called him about a heart rate of 280 while he sat at his desk. The conversation also covers why FDA medical-grade wearables are not the same as consumer wearables, how “graduated” monitoring (a few weeks after discharge, then on-demand spot checks) may replace endless device-wearing, and Dr. Mault’s optimistic case for AI as the “autopilot” that helps every clinician make better decisions. Disclosure: Dr. Mault is a co-founder of BioIntelliSense, and this conversation discusses his company’s technology. In this episode: What years in the ICU taught Dr. Mault about continuous vs. snapshot monitoring The gap between the ICU, the general ward, and home Why respiratory rate is the “neglected vital sign” and what it can reveal Why multi-parameter context (rhythm, breathing, oxygen, body position) beats a single number Medical-grade vs. consumer wearables and why the difference matters Avoiding “technology fatigue” with short-term and on-demand monitoring The vision for annual at-home check-ups, and AI as a clinical “autopilot” Jim’s own experience with monitors that were read weeks too late Your heart doesn’t only matter at your appointments. This conversation is about the space in between. For educational purposes only. Always consult your physician or care team before making any changes to your AFib treatment or lifestyle.