A key principle of telemonitoring in response to COVID-19, is that it has to be simple enough that it maximises the proportion of people who can use it, and can be deployed with minimal training given the risks of prolonging face-to-face contact.
People with COVID-19 are at risk of relatively sudden deterioration in the first two weeks of the illness. Morag Hearty, National Strategic Lead, Home and Mobile Health Monitoring, Scottish Government, working with clinical partners, have developed a telemonitoring system for following up people with COVID-19 at risk of deterioration.
Suspected COVID-19 patients attending an assessment centre, who are to be discharged home will be enrolled in the telemonitoring system, given a pack with equipment, and information on its use. Either later that day or the following day they will receive a call from the monitoring service to explain the system and resolve any queries.
Patients are given a written self-management plan and advised that telemonitoring is just an aid and that any significant symptom or oximetry deterioration at any time should prompt an immediate contact for advice.
Patients will be asked to record their temperature and pulse oximetry readings twice daily, with pulse oximetry at both rest (after 20 minutes seated) and after walking on the flat for one minute.Â
The Scottish system to be initially implemented will use commercially available pulse oximeters, and thermometers and is based on an SMS based text service (Florence) which will work with any mobile phone, and which is configured for secure data delivery to NHS systems.
Patients will be texted reminders to complete symptom diaries and temperature/pulse oximetry, and text data back to a central server which collates a report for the clinical team.
Contacts
- Morag Hearty, Home & Mobile Health Monitoring Lead, Scottish Government TEC programme/ TEC Programme Manager NHS Lanarkshire email: nss.tec@nhs.net
- Brian McKinstry, Professor Emeritus Primary Care eHealth, The University of Edinburgh & Honorary Professor of Medicine University of St Andrews. Contact @brianmckinstry or email: Brian.McKinstry@ed.ac.uk