A home health monitoring service which provides home-based monitoring of patients with COVID-19 is expanding to include those who require oxygen therapy but who are otherwise safe to go home.
“This expansion of the original program is ensuring patients get the right care in the right place while freeing up much-needed beds for other very sick people,” said Amy Reid, a Primary Health Care manager for the Regina area.
Two COVID-19 units at the Regina General Hospital began piloting the change to the Home Health Monitoring Program on April 15.
“The service affords a safe discharge for clients who still need to be monitored while supporting acute care as it experiences a surge in the number of high acuity COVID-19 clients,” said Reid.
Clients must meet criteria to be considered. They need to be over the age of 16, stable on oxygen and requiring no more than three litres of oxygen per minute or stable and weaning from oxygen for 24 hours or more. Clients cannot have other acute, unstable medical conditions and must be deemed safe for discharge, agreeable to the support and able to manage independently at home.
Once a client has been identified for this service, the unit calls an acute care respiratory therapist who provides the client with an oxygen monitor, instructions on use as well as information about the Home Health Oxygen Monitoring Program. The client also receives a visit from a home oxygen company representative who provides them with a tank to take home and then meets them at home to complete the set-up.
A pre-printed order form is completed by the client’s hospital unit, and then shared with Primary Health Care which results in an intermediate care service provider visiting the client at home the day of discharge.
The provider completes an assessment and enrolls the client in the oxygen monitoring program, available through an app on the client’s phone or computer, and teaches them how to use it.
Every day, the client goes into the app and answers a series of questions about their health and well-being.
“There are questions about whether the client is having breathing difficulties, chest pain, experiencing confusion, what their temperature is, medications and etcetera. The client records their vitals, such as oxygen saturation and heart rate. If the client is isolating, and if they have concerns about meeting their family’s basic needs, the Health Network will connect clients to other services. Do they have enough food? Medications? Stable housing?” Reid explained.
The intermediate care provider monitors the client daily through the app. Depending on the client’s responses, the provider may determine the client needs a follow-up visit, help from other community services or an in-person consultation with a physician.
After regular business hours, both community providers and physicians through the Doctors Assisting Seniors and Homes (DASH) program are available to address clients’ urgent concerns.
“Services are truly wrapped around the client,” said Reid. “It’s a perfect partnership because you have acute care connected with primary health care and that team within primary health care connecting all of the multi-disciplinary supports for the client. I think that’s great.
“This is really the model of primary health care service,” added Reid, noting that as of April 21, eight clients were participating in the service.
Michelle Mula, SHA’s executive director of Digital Health and Chief for the SHA-EOC, said the number of services that support remote patient monitoring and virtual clinical consultations, of which the Home Health Monitoring Program is one example, has grown significantly in the past year.
“We are seeing many patient and health system benefits including reduced transmission, reducing ER visits and emergent situations due to regular monitoring, and reducing capacity pressures on ER and hospital services. Through innovative programs and providers such as this one, we’ve had close to 4,000 patients monitored using home health monitoring and over 400,000 virtual clinical consultations using PexIP (a virtual care consultation platform).”
Saskatchewan has signed a bi-literal agreement with Health Canada which will enable the province to continue expanding virtual program options.
Shane Hill is among the registered therapists working in acute care who provides COVID-positive patients on oxygen with instruction about the monitoring program before they leave the hospital.