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Oximetry @home
The Oximetry service is designed to enable clinically vulnerable patients with Covid-19 who are isolating at home to measure their own oxygen levels and send data to local clinicians. The aim of the service is to both provide reassurance, and allow for early detection of deterioration so that the necessary steps can be taken.
The remote Oximetry @home service has received support from a number of BSW partners including hospitals, Medvivo and the West of England Academic Health Science Network.
How the service works
Patients who meet the eligibility criteria will be invited to join the service either by an SMS from their GP practice or a phone call. Patients are then given a pulse oximeter to measure their oxygen levels and their heart rate at home. They record this data and send it into a team of clinicians who will monitor oxygen levels and look for signs of deterioration.
If clinicians spot any early warning signs in terms of low blood oxygen levels, – which can lead to complications and poor outcomes, the patient can then be admitted to hospital where they can receive treatment.
What patients say
Patients who have used the Oximetry service have said that they have found it really reassuring because they had somebody contacting them on a regular basis, they knew that we were all talking to each other and that we could all see the same medical record, so it was really reassuring for both patients and their families to know that this service was here for them.
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Frequently asked questions
What is a pulse oximeter?
A pulse oximeter is a small medical device that is put on the tip of the finger, to check someone’s oxygen levels. Pulse oximeters measure blood oxygen levels by transmitting light through a finger – they are more accurate than smart watches or phones which make less accurate reading by reflecting light off the skin. By regularly monitoring oxygen levels, it can be easier to spot if COVID-19 symptoms are getting worse and whether people need to be admitted to hospital.
How do you use a pulse oximeter?
Below is a list of YouTube videos which show how to use the oximeter.
Watch in English:
Watch in Polish:
Watch in Hindi:
Watch in Punjabi:
Watch the video in a range of languages on the East Berkshire Primary Care YouTube channel.
Why is this service being recommended?
Patients most at risk of becoming very unwell from Covid-19 are best identified by oxygen levels. Because of this, the use of a pulse oximeter to monitor oxygen levels, including at home, is recommended for this group. This means that people are more likely to get the help they need as quickly as possible if their condition worsens.
Is everyone with a positive diagnosis of Covid-19 eligible?
This service is being designed to support those who are most likely to benefit, which are those people who are most at risk of becoming very unwell from Covid-19.
This includes people with Covid-19 who are symptomatic, and either aged 65 years or older or, under 65 years and at higher risk from Covid-19, or where clinical judgement applies considering individual risk factors such as pregnancy, learning disability, caring responsibilities and/or deprivation.
Who is eligible for the Oximetry @home service?
Patients are identified and contacted by clinicians if they are eligible for the Oximetry @home service.
Patients would have had a positive Covid-19 PCR test in the last seven days and are likely to fall into a clinically vulnerable category:
- are over 65 years old
- are over 16 years old and have a health condition like COPD, asthma or diabetes
- are pregnant
- are significantly overweight
- have an active malignancy (cancer)
- have a learning disability
What oximeters should people use? Can people use their own devices or smartwatches to monitor their oxygen saturation levels?
All oximeters for home use should be CE marked and must meet the international standard (ISO 80601-2-61:2017).
Some new devices such as smartwatches can measure blood oxygen levels, however, these devices are generally not medically accurate and therefore should not be used for monitoring oxygen levels of someone with Covid-19.
How will you ensure that patients have equality in access to oximeters and home monitoring?
Pulse oximetry has the potential to benefit those most at risk of Covid-19, therefore ensuring equality of access to the service from our most vulnerable patient groups is a priority.
Health professionals will tailor their support to patients based on their patient’s individual circumstances, following the principles of personalised care. This includes clinicians proactively seeking to onboard patients from all groups, acknowledging that language and health literacy may sometimes be a barrier to access.
Even where digital monitoring options are available, all patients will be offered an analogue (i.e. paper) alternative for monitoring to ensure that access to and usability of digital technology is not a barrier to accessing the service.
Tailored advice will be provided to patients and any carers of those patients to ensure that this process is equitable and safe for all.
The NHS Volunteer Responders programme may support distribution of oximeters as agreed locally and where appropriate.
Are oximeters less accurate for people with black or brown skin?
There has been recent media interest in the accuracy of pulse oximeters in people with darker skin.
The extent to which this effects Covid-19 patients is unknown and the Medicines and Healthcare products Regulatory Agency are not aware of any incidents where skin colour has had an adverse effect on the use of pulse oximeters.
NHS England and NHS Improvement have asked the National Institute for Health Research to undertake rapid research in this area and DHSC have announced an independent review of medical devices.
NHS advice remains that all patients should continue to use pulse oximeters, regardless of their skin colour, and record baseline oxygen saturation to compare subsequent changes in saturation readings.
Clinicians should also remain vigilant for other signs of deterioration and patients should seek help if any of their symptoms get worse.
What support and training is available for patients, carers, families to help use and interpret the oximeters?
A patient diary is available to download from the NHS website, which includes step-by-step, written instructions on using an oximeter and what to do in case of concerns.
This includes a paper version of a diary for monitoring but in some areas /for some patients where it is appropriate, an app may also be used.
Translated and easy read versions of the patient diary are available.
All patients, and/or their carers and family members, should be given information on the safe use and return of an oximeter, and if they have any concerns these should be discussed with the local clinical team.
How can I find out more about the Oximetry @home service?
If you have a positive PCR test result, you can contact 0300 111 2519 to find out more about monitoring your blood levels at home with a pulse oximeter. If you do not have a positive PCR test but are still interested in the service, please speak to your GP.
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