We provide new insights into the performance of camera-based heart and respiration rate extraction and evaluate its usability for replacing spot checks conducted in the general ward. A study was performed comprising of 36 ICU patients recorded for a total time of 699 h. The 5 beats/minute agreement between camera and ECG-based heart rate measurements was 81.5%, with a coverage of 81.9%, where the largest gap between measurements was 239 min. The challenges encountered in heart rate monitoring were limited visibility of the patient’s face and irregular heart rates, which led to poor agreement between camera- and ECG-based heart rate measurements. To prevent non-breathing motion from causing error in respiration rate extraction, we developed a metric which was used to detect non-breathing motion. The 3 breaths/minute agreement between the camera- and contact-based respiration rate measurements was 91.1%, with a coverage of 59.1%, where the largest gap between measurements was 114 min. Encountered challenges were the morphology of the respiration signal and irregular breathing. While a few challenges need to be overcome, the results show promise for the usability of camera-based heart and respiration rate monitoring as a replacement for spot checks of these vital parameters conducted in the general ward.