With the number of COVID cases continuing to increase in the Fort HealthCare (FHC) service area, Madison Emergency Physicians (MEP), FHC’s partner for emergency services, encountered a challenge to continually monitor COVID-positive patients who did not require hospitalization. What patients need is a home pulse oximeter so that they can report readings by phone follow-up to ensure their condition is not deteriorating and home quarantine remains appropriate.   
The barrier for some low-income patients was the cost of a home pulse oximeter. MEP was aware that the equipment is not covered by insurance, even though it is medically necessary when prescribed by a physician. The cost at local retailers ranged $65 to $95. It did not make sense to send a COVID-positive patient to local retailer in search of equipment that might not be in stock. With so many devices on the market, ordering online for home delivery means the patient must be able to learn to use the equipment on their own.
FHC found a source to purchase home pulse oximeters for $27 each. At this price, FHC determined it a cost-effective strategy to prevent further trips to Emergency, reduce in-patient care unless the condition worsened, and reduce primary care clinic in-person exposure to COVID patients. Standardizing use of one model of home pulse oximeters allows emergency staff to train patients how to use the equipment and record readings. 
Fort Memorial Hospital Foundation is providing seed fund for 100 home pulse oximeters as a pilot for this solution. Patients are given a home pulse oximeter at no charge and trained to use it before being discharged to home from emergency care. Patients keep a log of their readings for review by their MEP or primary care provider in the days following diagnosis.
From the very first patient, this program is reducing barriers for care in the COVID environment. An older adult who tested positive for COVID-19 was stable for discharge from the emergency department. Although outpatient management was appropriate, it was important to be able to ensure his oxygen level remained normal. The patient was given a pulse oximeter and trained to use it. The patient reported their appreciation that the device was easy to use and that FHC was making it easier for them to recover at home.