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You are here: Home / COVID Oximetry@Home

COVID Oximetry@Home

The COVID Oximetry at Home template allows patient identification, assessment and management in line with the Oximetry@home SOP. 

This page hosts the guides for both EMIS and SystmOne and as with all CDRC Precision searches, they are free to access.


COVID Oximetry at home: SystemOne Guide

The steps below outline how to use the CDRC Precision COVID19 Oximetry at home guides for SystemOne:

Identification
  1. Search 

To identify patients use the following search DCS Quality > Infection 

COVID1g 
coviD1g 
coviD1g 
coviD1g 
coviD1g 
coviD1g1 00 Shieldina Rea 
- Home Oximet 1 
Consider Starlin Oxime Monitorin 
- Home Oximetry 2M Current register* 
- Home Oximetry 21 Current register without recall # 
- Home Oximetry 2 
3 Recall Due # 
- Home Oximetry 3 Ever Had Home Oximetry# 
ister#

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 

  1. 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 

Pulse Oximetry Monitoring OCS 
This patient is currently recording their Oxygen 
Saturation levels using a pulse oximeter 
Remote virtual care pulse oximetry montoring 
started (Y2a48) 
Recorded 27 Jan 2021

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. 

Template

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. 

Info For Patients Links 
Adult Primary Care Covid-19 Assessment Pathway 
Pulse rate 
Oxygen saturation 
Respiratory rate 
CAVPU score 
Covid Assessment - Follow up 
Symptoms ranked by severity predictiveness 
2 cg2% (or -4 less than usual) 02 g3-g4% (or 3-4 less than usual) 
Launch 
follow t 
Launci 
- fo//0'.v 
02 (or -1-2 less than usual) 
New confusion and NEWS 0-2 
onsider Need For Monitoring 
R 31 
ew confusion + NEWS -5 
onsidar urgent Admission 
Calculate NEVvS Score 
NB - you will need to close this 
template and open it again 
before clicking this button to 
calculate a NEWS Score 
RR 21-24 
HR g 1-130 
New confusion + NEWS 3-4 
Consider Admission 
Consider exertion oximetry 
(40 steps orl min sit to stand) 
Admission if: 
Clinical concern 
02 sats on exertion 
Covid Assessment- Follow up 
11 Jan 2021 1726 
Expand 
Entered by 
FORBES, Gareth (Dr) (General Medical Practitioner) 
Breathless 
ME gia 
e Fatigue 
Sputu m 
cough 
Nausea No miti ng 
Headache 
sore Throat 
Remote Oximetr 
Scheduled Task 
COW19 Assessment 
Patient's Overall Impression Better 
Breathlessness? 
Yes 
So breathless that unable to No 
speak more than a few words? 
Are you breathing harder or 
faster than usual when doing 
nothing at all? 
Are you so ill that youVe 
stopped doing all ofyour usual 
daily activities? 
Appointment Search Add Recall (Home Oximetry) 
NOT currently having home oximetry 
No Home Oximetry Recall Recorded

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 

12 
When to call for help 
use Preset Answer 
Patient/carer has PIL 
Yes

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

Follow up

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. 

Reports

These reports are available to support Oximetry @ home. 

coviD1g 
coviD1g 
COVID1g 
COVID1g 
COVID1g 
- Home Oximet 1 
Consider Starlin Oximet Monitorin 
- Home Oximetry 2M Current register* 
- Home Oximetry 21 Current register without recall # 
- Home Oximetry 2 
3 Recall Due # 
- Home Oximetry 3 Ever Had Home Oximetry#
1. Patients who might benefit from starting oximetry at home 
2.1 Patients currently having oximetry 
2.2 Patients currently having oximetry who don’t have a recall* 
2.3 Patients currently having oximetry whose recall is due* 
3 Patients who have ever had oximetry – for reporting to NHSE 

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

Patient information

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

Info For Patients Links 
Patient Information 
The patient information sheet to give to patient using home oximetry can be sent to 
the patient by sending this link 
https:/Www englandnhsukJcoronavirustwp-content/uploads/sites/52/2020/06/C04 
45-Remote-monitoring-in-primary-care-Annex-2-diarwpdf 
Or use the weblink below to print a copy 
Send SMS Message 
Patient Information - Weblink 
Send Email

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). 

Referral

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. 

Info For Patients 
Referral 
Referral to Home Oximetry 
Referral 
Links 
o 
Referral go remote virtual care pulse ox!metry mont!oring servic 
o 
Discharge from remote virtual care pulse oximetry montoring service 
Home Oximetry NUTH Referral Form

COVID Oximetry at home: for EMIS

The introduction of the Oximetry@Home specification and service allows for practices to manage patients at higher risk of complications, including silent hypoxia, following a COVID diagnosis.

5 Resources have been developed to support practices with managing the service

  • Searches to identify patients who may benefit from home oximetry monitoring
  • Searches to maintain the register of patients currently on the service
  • A protocol to add an alert to the “QOF” Alert Box that a patient is currently on the pathway (or due to complete the pathway)
  • A protocol to suggest a patient may be eligible to be put on the pathway, triggered by the addition of a COVID positive code into the record
  • A protocol intended to be attached to the F12 button that adds a quick code that a discussion has been had with a patient about the service and then launches the template.
  • A template to help manage patients on the Oximetry@Home pathway.

To access CDRC Precision COVID-19 vaccine recourses for EMIS, you must download the .ZIP file. You can do this using the button below:

Covid19 – Home Oximetry for EMISDownload
Importing the Searches: For All EMIS Practices
  • 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:
Importing and using the protocols

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.


Get in touch

If you have any questions regarding access, or the use of the CDRC Precision tools, please get in touch: contact-CDRC@ahsn-nenc.org.uk

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Oximetry@Home

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