Pulse oximeters secured for monitoring Covid patients at home

NEWS - eHealthNews.nz editor Rebecca McBeth

A national system for distributing pulse oximeters to Covid patients isolating at home is being developed and devices have already been secured, says the Ministry of Health.

The Ministry also intends to set up a digital service for collecting readings from the devices.

The government has revealed plans to eventually manage between 90-95 percent of Covid infections in the community using a mix of telehealth services and pulse oximeters that clip onto a person’s finger and measure oxygen saturation.

More than 100 people are already isolating at home, as part of an interim approach as the country transitions to a longer-term approach that will involve general practice and other community providers.

A Ministry spokesperson says pulse oximeters have been secured and will be managed centrally by the MoH. Distribution is currently administered through the clinical assessment teams in the Northern Region Health Coordination Centre (NRHCC).

“A national logistics structure is currently in design phase and the intent is to distribute the pulse oximeters, and other items of PPE, with instructions to those selected for self-isolation,” the spokesperson says.

At present, the readings are recorded through a telephone health check set up via the clinical response team at NRHCC.

“Our intent is to establish a digital, or virtual service, and provide wrap around support when and where required,” it says.

Jeff Lowe, chair of GPNZ, says the national pathway for Covid patients isolating at home is likely to grade them as mild, moderate or severe risk, but which of these groups will get a device is yet to be clarified.

Who will be in charge of monitoring patients also hasn’t been determined and will depend on the capacity of local general practices to perform daily health checks.

“The vast majority of GPs want to be involved and it’s important to leverage the long-term trusted relationships GPs have with patients, particularly those with long-term conditions,” he says.

People with mild to moderate Covid-19 will often deteriorate at about day 5-10 when they develop acute respiratory distress syndrome and monitoring oxygen saturation levels is key to detecting this.

This type of monitoring is already in use in the Covid response in the UK, New South Wales and Victoria and pulse oximeters are in demand globally.

Lowe says a base saturation level will need to be set for patients, with deterioration over a set percentage triggering a discussion with secondary care and transfer to secondary care if appropriate.

Monitoring temperature is also important and thermometers may also be acquired nationally.

He says issues will arise around digital literacy of patients and their ability to operate the device and report readings back to a clinician. Some patients may also be given a tablet computer and data to enable telehealth appointments with their general practice or clinician.

Overseas services suggest a need for around two pulse oximeters per thousand people to cover the population, but this will vary according to demographics and the number of vulnerable people within an area, he adds.

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