The adoption of artificial intelligence (AI) in healthcare is growing rapidly. Remote patient monitoring (RPM) is one of the common healthcare applications that assist doctors to monitor patients with chronic or acute illness at remote locations, elderly people in‐home care, and even hospitalized patients. The reliability of manual patient monitoring systems depends on staff time management which is dependent on their workload. Conventional patient monitoring involves invasive approaches which require skin contact to monitor health status. This study aims to do a comprehensive review of RPM systems including adopted advanced technologies, AI impact on RPM, challenges and trends in AI‐enabled RPM. This review explores the benefits and challenges of patient‐centric RPM architectures enabled with Internet of Things wearable devices and sensors using the cloud, fog, edge, and blockchain technologies. The role of AI in RPM ranges from physical activity classification to chronic disease monitoring and vital signs monitoring in emergency settings. This review results show that AI‐enabled RPM architectures have transformed healthcare monitoring applications because of their ability to detect early deterioration in patients' health, personalize individual patient health parameter monitoring using federated learning, and learn human behavior patterns using techniques such as reinforcement learning. This review discusses the challenges and trends to adopt AI to RPM systems and implementation issues. The future directions of AI in RPM applications are analyzed based on the challenges and trends.This article is categorized under: Application Areas > Health Care Technologies > Artificial Intelligence Technologies > Internet of Things

BACKGROUND: Peripheral intravenous catheter (PIVC) use in health care is common worldwide. Failure of PIVCs is also common, resulting in premature removal and replacement.OBJECTIVE: To investigate the characteristics, management practices, and outcomes of PIVCs internationally.DESIGN: Cross‐sectional study.SETTING/PATIENTS: Hospitalized patients from rural, regional, and metropolitan areas internationally.MEASUREMENTS: Hospital, device, and inserter characteristics were collected along with assessment of the catheter insertion site. PIVC use in different geographic regions was compared.RESULTS: We reviewed 40,620 PIVCs in 51 countries. PIVCs were used primarily for intravenous medication (n = 28,571, 70%) and predominantly inserted in general wards (n = 22,167, 55%). Two‐thirds of all devices were placed in non‐recommended sites such as the hand, wrist, or antecubital veins. Nurses inserted most PIVCs (n = 28,575, 71%); although there was wide regional variation (26% to 97%). The prevalence of idle PIVCs was 14% (n = 5,796). Overall, 10% (n = 4,204) of PIVCs were painful to the patient or otherwise symptomatic of phlebitis; a further 10% (n = 3,879) had signs of PIVC malfunction; and 21% of PIVC dressings were suboptimal (n = 8,507). Over one‐third of PIVCs (n = 14,787, 36%) had no documented daily site assessment and half (n = 19,768, 49%) had no documented date and time of insertion.CONCLUSIONS: In this study, we found that many PIVCs were placed in areas of flexion, were symptomatic or idle, had suboptimal dressings, or lacked adequate documentation. This suggests inconsistency between recommended management guidelines for PIVCs and current practice.

Background: We sought to identify the reasons for peripheral intravenous cannulae insertion in the emergency department (ED), and the first-time insertion success rate, along with patient and clinician factors influencing this phenomenon. Methods: A prospective cohort study of patients requiring peripheral cannulae insertion in a tertiary ED. Clinical and clinician data were obtained. Results: A total 734 peripheral intravenous cannula (PIVC) insertions were included in the study where 460 insertions were analysed. The first-time insertion success incidence was 86%. The antecubital fossa (ACF) site accounted for over 50% of insertions. Multivariate logistic regression modelling to predict first-time insertion success for patient factors found: age <40 versus 80+ years, emaciated versus normal patient size, having a visible or palpable vein/s, and ACF versus forearm insertion site to be statistically significant. Statistically significant clinician factors predicting success were: higher number of prior cannulation procedures performed, and increased clinician perception of the likelihood of a successful insertion. When patient and clinician factors were combined in a logistic regression model, emaciated versus normal, visible vein/s, ACF versus forearm site, higher number of prior PIVC procedures performed and increased clinician perceived likelihood of success were statistically associated with first-time insertion success. Conclusions: Peripheral intravenous cannulation insertion success could be improved if performed by clinicians with greater procedural experience and increased perception of the likelihood of success. Some patient factors predict cannulation success: ‘normal’ body weight, visible vein/s and cubital fossa placement; venepuncture may be a cheaper alternative for others if intravenous therapy is not imperative.

Objectives: This study aimed to identify the incidence of and factors associated with peripheral intravenous catheter/cannula (PIVC) first time insertion success (FTIS) in the emergency department (ED). Design: Prospective cohort study. Setting: Two tertiary EDs in Western Australia. Participants: 879 ED patients. Primary outcome: To identify factors affecting FTIS using univariate and multivariate logistic regression modelling. We created four models: patient factors only; clinician factors only; products and technology factors only and all factors model . We assessed each model’s performance using area under the receiver operating characteristic curve. Results: A total of 1201 PIVCs were inserted in 879 patients. The mean age was 60.3 (SD 22) years with slightly more females (52%). The FTIS rate was 73%, with 128 (15%) requiring a second attempt and 83 (9%) requiring three or more attempts. A small percentage (3%) had no recorded number of subsequent attempts. FTIS was related to the following patient factors: age (for a 1-year increase in age: OR 0.99, 95% CI 0.983 to 0.998; p=0.0097); and target vein palpability: (always palpable vs never palpable: OR 3.53 95% CI 1.64 to 7.60; only palpable with tourniquet vs never palpable: OR 2.20, 95% CI 1.06 to 4.57; p=0.0014). Clinician factors related to FTIS include: clinicians with greater confidence (p<0.0001) and insertion experience (301–1000 vs 1000 vs <301: OR 2.07, 95% CI 1.41 to 3.04; p=0.0011). The final all factors model combining patient factors; clinician factors and product and technology factors has greater discriminative ability than specific factors models. It has a sensitivity of 74.26%, specificity of 57.69%, positive predictive value of 82.87% and negative predictive value of 44.85%. Conclusion: A clinical decision, matching patients who have no palpable veins and are older, with clinicians with greater confidence and experience, will likely improve FTIS. Trialregistration number: ANZCTRN12615000588594; Results.