COVID Oximetry@Home

1. Search 

To identify patients use the following search DCS Quality > Infection 

This identifies patients over 65 or on the shielded patient list with a positive covid diagnosis in the last 3 weeks who do not have any of the oximetry codes in the last 3 weeks (including oximetry declined, not appropriate). 

This search could be set to run automatically and send a daily task to a nominated individual or group, see Automated Reporting 

2. Popup Alert 

A protocol is available that will deliver a popup message on record opening for patients in the search above.  You will need to activate this protocol by emailing NECSU.CDRC@nhs.net 

Once a patient has started, home oximetry the following patient status alert will be displayed at the top of the screen 

Clicking this icon will open the oximetry at home template.  There is also a similar TPP system-wide icon which you may wish to disable to prevent duplication. 

The template can be reached from the main Covid19 template menu, by adding it to one of your own templates or toolbars or by typing ‘oximetry’ or ‘covid’ into the search box at the bottom left of the S1 screen. 

The home screen of the template allows recording of the key information provided by the patient/carer at each contact along with guidance on how to interpret the findings. 

There is a link to a NEWS score calculator but this might be difficult to calculate remotely without a blood pressure or respiratory rate.  These readings would be possible if using a video consultation and the patient has a sphygmomanometer.  If the pulse, oxygen saturation, respiratory rate and CAVPU score are entered on this template, it will need to be closed and opened again to use the NEWS calculator.  Alternatively use the Calculate NEWS Score button and enter all the vital signs into the calculator. 

The Covid Assessment – Follow Up  button opens a questionnaire of standardised questions to assesses progress and disease severity and to allow recording of the advice given to the patient.  The latest copy of these questions is shown in the central panel.  The standard advice for the patient about when to seek help is included in a preset 

If needed, this can be amended to suit individual patient circumstances, or an entirely different set of instructions can be given. 

The template allows 3 different mechanisms for follow up. 

1. Scheduled task – will send a task to a nominated person or group at the interval determined by the assessing clinician 
2. Appointment – allows clinician to book the next contact 
3. Recall system – allows addition of a specific recall* 

*For option 3 a recall type with the name Home Oximetry will need to be added locally. 

These reports are available to support Oximetry @ home. 

* only needed for practices which decide to use a recall system 

The second page of the template have a link to the patient information leaflet. 

This can be printed at the practice via the weblink or the weblink can be sent to the patient via SMS text or email.  (The latter two options may need local setup to ensure that text messaging is enabled from your S1 unit and that email messages are set to be sent from the unit generic email account rather than from personal accounts). 

For areas where oximetry is being provided out of the practice, the third tab allows recording of the referral into and discharge from a third party service.  A link to a pre-populated NUTH referral form is available. 

• Copy the “COVID19 Home oximetry reports” to the desktop
• Navigate to the reporting module
• Create a new folder entitled Oximetry at Home
• Click on the “Import” button
  

• In the box that pops-up,click on the ellipsis icon to navigate to the oximetry report found on the desktop
  

• This will then import both searches together
• Within the folder, the relevant searches are:
  

For Practices With CDRC /CBC Resource Publisher Agreement Activated

The templates and protocols are included in resource publisher.

The oximetry@home template is shared in the active form. To use, simply run the template from within a consultation.

The following protocols need to be activated:

• Covid oximetry at home alert
• COVID oximetry@Home at risk group
• COVD oximetry at home contact

Currently these are hosted within the NGCCG resources folder. Within Resource Publisher, click on Protocols and templates à Shared Folders à CBC Health Ltd à NGCCG Protocols. Right click over each protocol and set status to active.

For Practices Without CDRC / CBC Resource Publisher Agreement Activated

The template and protocols need to be imported. Firstly export them from the Zip Folder on to the desktop.

Within Resource Publisher click on protocols and templates. Either open or create an appropriate folder, and click on Import. Navigate to the desktop and import each in turn.

Once imported, right click over the template / protocol and set status to active.

It is important that the Triggers are correctly set:

1. For the COVID oximetry at home alert, set the protocol to always run when a consultation is added and always run when the patient recorded is loaded
2. For the COVID Oximetry@home at risk group to always run when a code is added. Set the codes that activate the protocol to include all codes below:
   
   

The COVID oximetry at home protocol is best used by attaching it to the F12 protocol launcher.