COVID Oximetry @home and Virtual Wards
Detecting the early signs of deterioration
Detecting the early signs of deterioration in patients with confirmed or suspected COVID-19 is a significant challenge for health and social care teams. People at risk can be identified by reduced oxygen saturation levels and the ability to recognise this is vital.
Health Innovation Manchester (HInM), through its Greater Manchester and Eastern Cheshire Patient Safety Collaborative, is commissioned by NHS England and Improvement through the Managing Deterioration Safety Improvement programme to support the use of pulse oximeters in the local health and care system, as part of the national COVID Oximetry @home and virtual ward/home monitoring models.
COVID Oximetry @home
COVID Oximetry @home uses pulse oximeters for patients at risk to safely self-monitor their condition at home, providing an opportunity to detect problems early and ensure assessment and prompt specialist care, if required. Patients record their oxygen saturation levels, through a pulse oximeter, and record them in a patient diary before reporting their readings to a clinical team over the telephone. As an alternative, patients can also use an app to enter their readings and these can be seen by the home monitoring clinical team on a secure internet platform. Early experiences of implementing this approach across England have been linked to reduced mortality, hospital length of stay, and the number of patients requiring intensive care admission and ventilation.
In Greater Manchester, all localities have now rolled out a COVID Oximetry @home programme. This has been supported by HInM and Greater Manchester and Eastern Cheshire Patient Safety Collaborative through the creation of a learning networks and signposting to key resources such as webinars, e-learning and operating protocols. The PSC are also supporting GM localities to visualise data about their services in order to identify opportunities for improvement.
COVID Virtual Wards
The COVID virtual ward model is hospital-led initiative and supports early and safe discharge from hospital (step down care) for COVID patients. For patients who have required hospital assessment or a stay in hospital, home monitoring means they can be discharged safely with ongoing hospital supervision while at home. It has already been implemented in some parts of the country where it is having an impact in reducing emergency admission and enabling earlier discharge, including in Greater Manchester. This builds on the COVID Oximetry @home model. HInM and GMECPSC are continuing to support this work through learning networks.
Greater Manchester COVID Oximetry @home virtual wards digital platform
The Greater Manchester system has worked together to rapidly develop a COVID-19 home monitoring digital platform for patients on a COVID Oximetry @home programme or virtual ward. The platform records the health status, including pulse oximeter readings, for patients being supported on the virtual ward. The platform includes an app which will enable patients to directly input their pulse oximetry readings. The digital platform also creates a dashboard report which can be used to manage and monitor the group of citizens in a local area. Clinical teams can also send tailored advice to patients using the app. The app has been developed by tech company Graphnet, which specialises in developing health and care IT solutions.
COVID Oximetry @home is part of a range of NHS initiatives providing better connected, more personalised care in people’s homes, including care homes. It is being supported at a national level by the AHSN Network https://www.ahsnnetwork.com/covid-oximetry
If you are involved with setting up a local Oximetry @home service and need support please contact firstname.lastname@example.org.
What does this mean for patients?
How to home monitor
General advice for anyone experiencing the symptoms of COVID-19 is available on the NHS website.
This leaflet is for patients with suspected coronavirus who have not been admitted to hospital and will be isolating at home. Read the leaflet
This leaflet is for patients to help explain how to use a pulse oximeter to check you are OK. Read the leaflet
Health Education England has produced this animation which explains how to use pulse oximeters at home and keep a COVID-19 diary.
Useful patient resources
How to use Pulse Oximeter Patient Videos (in English and other languages)