Oximetry at home
By Kerry Sharp
Case Studies 7 April 2021

Inhealthcare is supporting the expansion of a breakthrough programme for the remote monitoring of people with confirmed or suspected Covid. The company, a market leader in digital health technologies, is helping to deploy Oximetry @ Home service across southern England, making it widely available to patients in primary and community care settings.

The NHS has recommended the rapid roll-out of the pathway to help clinicians identify early signs of deterioration and intervene to improve patient outcomes. It says those most at risk of poor outcomes are best identified by oxygen levels and advises the use of oximetry to monitor and identify ‘silent hypoxia’ among Covid patients at home.

The battle for lives:
Dr Matt Inada-Kim, the national clinical lead for deterioration at NHS England, has said the pathway will save lives, reduce intensive care admissions and cut the length of hospital stays. “The battle for lives will be won in the community, not the hospital,” he said.

Chris Harris, a retired IT consultant from Hampshire, was added to the service after testing positive for Covid. His self testing at home alerted doctors to a fall in oxygen levels and he was taken to hospital for treatment. Mr Harris told the BBC: “I got there before my condition worsened. I was ahead of the game. It was a lifesaver.

Early interventions:
Bryn Sage, chief executive of Inhealthcare, said: “Remote monitoring empowers patients to take control over their health and enables clinicians to intervene early when necessary and provide necessary treatment. This simple and effective technology has truly come of age during the pandemic and can quickly and easily be applied to most long-term health conditions.”

How the service works:
Patients use a pulse oximeter to monitor their oxygen saturation levels and report these readings alongside other vital signs on a regular basis to healthcare teams. Inhealthcare helps staff and patients to monitor symptoms while minimising face-to-face contact and allowing individuals to recover safely at home. Staff view patient readings on a web-based dashboard and can see who might need intervention, supervision or support or has not submitted their reports.

Inhealthcare provides local and regional reports for clinicians, demonstrating the number of patients on the service and their progress through the pathway. To date, more than 2,200 people have benefited from the service.

Digitally inclusive:
Patients have a choice of communication channels and submit their readings via a link sent by email, SMS
text message or automated telephone call, making the service fully inclusive. Staff can also input readings manually if patients would prefer to speak with another person on the telephone.

Readings are stored safely and securely within NHS-approved cloud storage providers and accessible only to relevant staff. Patient records are updated via integration with the EMIS and SystmOne GP systems, showing progress and the amount of time spent on the virtual ward.

Pathway highlights:
Patient presents at GP with confirmed or suspected Covid
If patient meets criteria for service and provides consent GP makes referral and provides oximeter if needed
Inhealthcare registers patient on pathway
Patient enters vital signs readings into Inhealthcare platform
Patient prompted for readings at regular intervals by chosen method for 10-14 days
Inhealthcare sends patient data to clinical systems
Clinicians monitor responses through platform
Patient escalated or discharged.

Key software features:
Staff use the Inhealthcare Toolkit to tailor the pathway to fit their local STP/ICS model
Patients choose from a range of inclusive and intuitive communication channels
Sends SNOMED codes to EMIS and SystmOne clinical systems
Links directly to NHS Spine, simplifying registration for NHS staff
Connects to secondary care electronic patient record systems
Pathway adaptable for monitoring long-term conditions.

What’s next?
Inhealthcare has rolled out the service across Hampshire, the Isle of Wight, Dorset and is soon to go live
in Buckinghamshire, Surrey and Sussex. More locations will follow, including Bristol, North Somerset and South Gloucestershire.

In summary:
Dr Matt Inada-Kim of NHS England told the BBC: “Prevention is nearly always better than the cure. While ventilators are really important for treating people who are seriously unwell with Covid, a simple intervention like an oximeter is probably just as important because by getting to patients as early as possible we can hopefully prevent severe deterioration and potentially their future need for a ventilator and intensive care admission.”

About Inhealthcare:
Yorkshire-based Inhealthcare is a market leader in digital health and remote patient monitoring and
supports more than 440 NHS customer organisations across England, Scotland and Northern Ireland.

More than one million people have used the company’s services, which allows for the digitally enabled remote care of people living with both long and short-term health conditions and the delivery of large-scale healthcare transformation programmes.

The platform and its associated patient and clinician-facing applications are registered with the Medicines and Healthcare products Regulatory Agency as a Medical Device.

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