Changes in vital signs are an important indicator of physiological decline and provide opportunities for early recognition and intervention. The collected vital signs data can be evaluated using several approaches such as the Early warning score (EWS) approach to predict the risk level of patients. By exploring the Internet of things (IoT), vital signs monitoring solutions are automated based on various medical devices and sensors. However, there is a lack of efficient tools that enable an adaptative monitoring depending on the patient situations. This article explores the IoT technologies to provide an EWS system in smart hospital situation. The proposed solution presents an adaptative configuration of the vital signs monitoring process depending on the patient’s health status variation and the medical staff decisions. Also, an intelligent notification mechanism that reduces the delay of the medical staff intervention in the case of risk detection is proposed.