Authors (including presenting author) :
Mo KC, Ng MW, Tse YW, Yam TF, Poon KH, Tsang HC, To YL
Affiliation :
Physiotherapy department, North District Hospital (NDH)
Introduction :
Since 2009, oximetry tele-monitoring has been used in NDH Respiratory Collaborative Care Team (RCCT) and providing reliable clinical information. In late 2022, a new model of wearable tele-monitoring sensor with secured cloud platform was introduced and it allows near-real time data retrieval. The enhanced model enables early result interpretations for efficient clinical decision-making and optimization of personalized care.
Objectives :
To outline the key functions of oximetry tele-monitoring for respiratory physiotherapy management in the community.
Methodology :
Physiotherapy records were reviewed and summarized retrospectively to describe the key functions of oximetry tele-monitoring in the community.
Result & Outcome :
Oximetry tele-monitoring services were delivered to 46 patients from November 2022 to October 2024. Two themes with three categories concerning multi-disciplinary respiratory patient management were identified.
Theme 1: Supporting respiratory care
Among non-invasive ventilation (NIV) users in the community, oximetry tele-monitoring was provided to 17.4% patients (n=8) to assess oxygen saturation (SpO2), pulse rate and predicted respiratory rate. Results were interpreted by physiotherapists, together with RCCT physicians and nurses remotely, which integrated with readings of transcutaneous carbon dioxide measurement (TcCO2) and parameters recorded by ventilator built-in software for assessing NIV efficacy and adjusting settings accordingly.
For oxygen therapy users in the community, oximetry tele-monitoring was provided to 67.4% patients (n=31) to collect vital data. Results were interpreted remotely by physiotherapists along with the six-minute walk test results. Oxygen therapy flow rate was then determined by activity analysis throughout the days in real life situation. Four patients (8.7%) were monitored during their portable oxygen concentrator trial. The data collected allows physiotherapists to explain the daily fluctuation in SpO2 to patients and caregivers, enhancing their knowledge and boosting oxygen therapy compliance.
Theme 2: Supporting COPD Self-Management
To manage exacerbation earlier, COPD self-management program was introduced in NDH for more than 15 years. Eligible patients are given crisis packs with adequate follow-up. Oximetry tele-monitoring was provided to 6.5% (n=3) patients to access if escalating level of care was needed. Patients were empowered to interpret oximeter readings and warnings, so that timely decision could be made by the respiratory team.
To conclude, oximetry tele-monitoring is a valuable tool for community respiratory physiotherapy management, it provides timely and relevant information essential for clinical decision-making. Its key functions include NIV and oxygen therapy titration, disease signs and symptoms monitoring, and supporting community COPD self-management.
