Use of home pulse oximetry with daily short message service messages for monitoring outpatients with COVID-19: The patient's experience

Vaughan, Laura; Eggert, L.; Jonas, Andrea; Sung, Arthur; Singer, Sara J.

doi:10.1177/20552076211067651

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…This high level of patient acceptance has been previously reported by other studies who have described excellent patient satisfaction with virtual care during the COVID-19 pandemic. 2,[19][20][21][22][23] Aside from the near ubiquitous symptom of cough, dyspnoea was the symptom most frequently identified within the hypoxic group and thus patients reporting dyspnoea as a prominent symptom of their COVID-19 symptom profile should have access to home pulse oximetry. Conversely, cough in the absence of other respiratory symptoms was not a useful predictor of clinical deterioration, hypoxia and escalation to an ED.…”

Section: Discussionmentioning

confidence: 99%

Use of home pulse oximetry to enhance remote COVID-19 monitoring: Evaluating a single centre experience

France

Porter

Bennett

et al. 2022

Preprint

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Introduction Telehealth and remote monitoring of patients with mild COVID19 infection have developed rapidly in response to the pandemic. Many healthcare systems have embraced telehealth for remote clinical monitoring and pulse oximetry for enhanced monitoring. Methods The experience of a large healthcare centre's COVID Virtual Ward was reviewed retrospectively with a particular focus on evaluating the effectiveness, safety and utility of finger pulse oximetry within the home. Data from a 2 month period in early 2022 during a BA1 Omicron wave was retrospectively reviewed. 551 high risk patients were issued with pulse oximeters for monitoring oxygen saturations within their home. All patients received daily clinical review via telephone by a nurse or doctor. The group was highly vaccinated with only 6.4 percent of the cohort unvaccinated. Oximeters were promptly delivered via courier service across a vast geographical area. Results Pulse oximetry was well utilised by almost all patients. Only 2.7 percent of the cohort demonstrated resting oxygen saturations of less than 94 percent during their Virtual Ward admission. 91 percent of patients reporting dyspnoea were able to be safely managed without escalation to an emergency department due to reassuring clinical and oximetry assessment. Home oxygen saturations correlated well with saturations recorded within the ED, with no patients found to have lower saturations compared with home saturations. Discussion Within a high risk population experiencing COVID19 infection, pulse oximetry was a useful tool in clinical assessment, correlated well with hospital based pulse oximetry and allowed a substantial reduction in COVID19 related ED presentations.

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Section: Discussionmentioning

confidence: 99%

Use of home pulse oximetry to enhance remote COVID-19 monitoring: Evaluating a single centre experience

France

Porter

Bennett

et al. 2022

Preprint

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“…A study from the Netherlands, however, could not confirm a lower rate of nurse entries when continuous monitoring was made available to patients admitted to hospital with suspicion of COVID-19. 30 To relieve pressure on hospital beds, several initiatives tried to reduce the length of stay for patients with COVID-19 requiring hospital admission, either by allowing more comprehensive home monitoring and treatment in an effort to avoid or delay hospitalisation, 31 or by offering recovering patients earlier discharge from hospital with home monitoring of vital signs, home administration of low-flow supplemental oxygen (if needed) and daily telecontact with the care team. A small randomised trial by van Goor et al 32 confirmed that remote hospital care for recovering patients with COVID-19 is feasible, but the authors were unable to demonstrate an increase in hospital-free days in the 30 days following randomisation.…”

Section: Remote Patient Monitoring: Lessons Learnt During the Covid-1...mentioning

confidence: 99%

Value of improving patient safety: health economic considerations for rapid response systems–a rapid review of the literature and expert round table

et al. 2023

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ObjectivesFailure to rescue deteriorating patients in hospital is a well-researched topic. We aimed to explore the impact of safer care on health economic considerations for clinicians, providers and policymakers.DesignWe undertook a rapid review of the available literature and convened a round table of international specialists in the field including experts on health economics and value-based healthcare to better understand health economics of clinical deterioration and impact of systems to reduce failure to rescue.ResultsOnly a limited number of publications have examined the health economic impact of failure to rescue. Literature examining this topic lacked detail and we identified no publications on long-term cost outside the hospital following a deterioration event. The recent pandemic has added limited literature on prevention of deterioration in the patients’ home.Cost-effectiveness and cost-efficiency are dependent on broader system effects of adverse events. We suggest including the care needs beyond the hospital and loss of income of patients and/or their informal carers as well as sickness of healthcare staff exposed to serious adverse events in the analysis of adverse events. They are likely to have a larger health economic impact than the direct attributable cost of the hospital admission of the patient suffering the adverse event. Premorbid status of a patient is a major confounder for health economic considerations.ConclusionIn order to optimise health at the population level, we must limit long-term effects of adverse events through improvement of our ability to rapidly recognise and respond to acute illness and worsening chronic illness both in the home and the hospital.

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“…Community-based telemonitoring of symptoms scores, temperature, oximetry, and blood pressure supported by self-management information and/or remote monitoring proved to be a cost-effective alternative to hospitalisation. [15,16,18,[154][155][156][157][158] Although a rapid systematic review was unable to confirm safety due to lack of standardised reporting, [18] mixed-method evaluation of individual programmes concluded that they were reassuring to patients (especially the oximetry), [15,155,158] acceptable to clinicians, [15,154,158] able to detect signs of deterioration, [15,158,159] and a safe approach for selected high-risk patients with mild-to-moderate COVID-19. [15,16,18,[157][158][159] Economic analysis was limited to reporting resources used and the amount spent per patient monitored.…”

Section: Digital Innovation To Manage Covid-19 Infectionsmentioning

confidence: 99%

Telemedicine and virtual respiratory care in the era of COVID-19

Pinnock

Murphie²,

Vogiatzis

et al. 2022

ERJ Open Res

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The World Health Organization defines telemedicine as “an interaction between a health care provider and a patient when the two are separated by distance”. The COVID-19 pandemic has forced a dramatic shift to telephone and video consulting for follow up and routine ambulatory care for reasons of infection control. Short Message Service (“text”) messaging has proved a useful adjunct to remote consulting allowing transfer of photographs and documents. Maintaining non-communicable diseases care is a core component of pandemic preparedness and telemedicine has developed to enable (for example) remote monitoring of sleep apnoea, telemonitoring of chronic obstructive pulmonary disease, digital support for asthma self-management, remote delivery of pulmonary rehabilitation. There are multiple exemplars of telehealth instigated rapidly to provide care for people with COVID-19, to manage the spread of the pandemic, or to maintain safe routine diagnostic or treatment services.Despite many positive examples of equivalent functionality and safety, there remain questions about the impact of remote delivery of care on rapport and the longer-term impact on patient/professional relationships. Although telehealth has the potential to contribute to universal health coverage by providing cost-effective accessible care, there is a risk of increasing social health inequalities if the “digital divide” excludes those most in need of care. As we emerge from the pandemic, the balance of remote versus face-to-face consulting, and the specific role of digital health in different clinical and healthcare contexts will evolve. What is clear is that telemedicine in one form or another will be part of the “new norm”.

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Use of home pulse oximetry with daily short message service messages for monitoring outpatients with COVID-19: The patient's experience

Cited by 4 publications

References 5 publications

Use of home pulse oximetry to enhance remote COVID-19 monitoring: Evaluating a single centre experience

Use of home pulse oximetry to enhance remote COVID-19 monitoring: Evaluating a single centre experience

Value of improving patient safety: health economic considerations for rapid response systems–a rapid review of the literature and expert round table

Telemedicine and virtual respiratory care in the era of COVID-19

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