From Days to Minutes: An Autonomous AI Agent Achieves Reliable Clinical Triage in Remote Patient Monitoring

• URL: http://arxiv.org/abs/2603.09052v1
• Date: Tue, 10 Mar 2026 00:50:54 GMT
• Title: From Days to Minutes: An Autonomous AI Agent Achieves Reliable Clinical Triage in Remote Patient Monitoring
• Abstract summary: Remote patient monitoring ( RPM) generates vast data, yet landmark trials (Tele-HF, BEAT-HF) failed because data volume overwhelmed clinical staff.<n>We developed Sentinel, an autonomous AI agent using Model Context Protocol (MCP) for contextual triage of RPM vitals.
• Score: 2.0918370570198763
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: Background: Remote patient monitoring (RPM) generates vast data, yet landmark trials (Tele-HF, BEAT-HF) failed because data volume overwhelmed clinical staff. While TIM-HF2 showed 24/7 physician-led monitoring reduces mortality by 30%, this model remains prohibitively expensive and unscalable. Methods: We developed Sentinel, an autonomous AI agent using Model Context Protocol (MCP) for contextual triage of RPM vitals via 21 clinical tools and multi-step reasoning. Evaluation included: (1) self-consistency (100 readings x 5 runs); (2) comparison against rule-based thresholds; and (3) validation against 6 clinicians (3 physicians, 3 NPs) using a connected matrix design. A leave-one-out (LOO) analysis compared the agent against individual clinicians; severe overtriage cases underwent independent physician adjudication. Results: Against a human majority-vote standard (N=467), the agent achieved 95.8% emergency sensitivity and 88.5% sensitivity for all actionable alerts (85.7% specificity). Four-level exact accuracy was 69.4% (quadratic-weighted kappa=0.778); 95.9% of classifications were within one severity level. In LOO analysis, the agent outperformed every clinician in emergency sensitivity (97.5% vs. 60.0% aggregate) and actionable sensitivity (90.9% vs. 69.5%). While disagreements skewed toward overtriage (22.5%), independent adjudication of severe gaps (>=2 levels) validated agent escalation in 88-94% of cases; consensus resolution validated 100%. The agent showed near-perfect self-consistency (kappa=0.850). Median cost was $0.34/triage. Conclusions: Sentinel triages RPM vitals with sensitivity exceeding individual clinicians. By automating systematic context synthesis, Sentinel addresses the core limitation of prior RPM trials, offering a scalable path toward the intensive monitoring shown to reduce mortality while maintaining a clinically defensible overtriage profile.

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