I’ve split this topic off from the one in the #open-forum as we were getting very ‘NZ’ in it
@shayne.hunter is away apparently - @jon_herries is holding the fort at Data & Digital at the NZ Ministry of Health. I rang him a few hours ago. He told me that they are aware of the NHS111 tool, and are working through the risks and benefits of having one here urgently.
Personally, as lovely as this is I think keeping things simple and advising people about when to seek medical attention is a better solution than determining if they have covid or not. Health navigator do this brilliantly already… be good to get a consumer perspective., @graeme.norton
It doesn’t work out if you have it or not - just guides you to what you should do (ie self-isolate, call your GP, call your hospital, etc) in various situations. I think that it hits your simple wish nicely. And Health Navigator isn’t that easy to navigate / digest for the average person.
The whole point of this tool (I think) is to prevent Healthline (111 in the UK), GPs, and Hospitals from being overwhelmed by the worried well or the slightly unwell and very infectious.
Yup I get that but it concentrates on covid rather than perhaps sepsis/not sepsis. So if you meet sepsis criteria it just tells you that you don’t have covid if you see what you mean. That’s not to say I don’t admire it I’m just not convinced in the current form that I would want to push it to my potential patients. Hope that makes better sense. I personally think healthnavigator is very simple and use it for patient advice all the time. It’s a great one stop shop 
Kia ora Ruth- Is this the healthnavigator you are referring to: https://www.healthnavigator.org.nz/apps/ If so, is there a particular tool you are recommending to patients at the moment, to self-triage need to seek medical care? I share your emphasize on needing to ensure people with non-Covid 19 serious illnesses, continue to seek medical attention when needed.
Agree Nathan. From GP practice perspective being able to embed this on our website would be invaluable in reducing calls to our triage nurses.
I think the simple 'yes/no’format is easier for a patient to parse than text on sites like health navigator. It is the ‘what to do’ that I’m interested in
Great that this looks like it is leading somewhere!
I am expecting the Ministry to provide further advice on a symptom checker for COVID-19. I’d like to see something next week. I think we need one option for people to use (accessible via multiple channels) and it will need to be COVID-19 only and be very clear that is the case. The criteria and underlying logic will need ongoing adjustment and clinical governance to keep it relevant and safe.
I think one of the issues with many checkers is they are decision tree based. One service I saw on a study tour last year use Bayesian logic. The research undertaken on the tool they provided (web based and mobile app) indicated that rate of successful diagnosis was very high.
@shayne.hunter it would be good if there was an ability to not just figure out if you may have covid but if you’re sick or not. That seems to be the bigger issue in our EDs anyway. @Janine from healthnavigator has been working on some great information for patients with the sepsis trust. Combo approach would be good.
Tena koutou
I was recently wondering about patient facing apps that measure pulse and oxygen Satan.
NZ Health Navigator has an app page which advises reasonable secure health apps to recommend to patients . Is there any of the pulse and oximetry apps this group would have sufficient confidence in that we could recommend to patients that might assist us as Triage Physcicians with at least some additional metrics that might seperate the chaff from the wheat in terms of those we might triage to be seen F2F.
I am suggesting a public and patient facing app that we could send out link on patient portal, SMS TXT2Remind or email for patients to download and have available to use when we phone To triage . A stable pulse and Sats even if not always robust May aid the decision tree process ??
Thanks
Grahame Jelley
I was curious about this today. There is a high demand for oximeters from pharmacies at the moment, eg from COPD patients etc. Many already have them. If accurate, it could be a really useful triage tool further down the track?
I think you are right. I used to be a skeptic but use them increasingly in my day to day practice. Shame phones aren’t up to it…
App Claims to Measure Oxygen Saturation With Only a Smartphone
## — There are apps making unjustifiable claims, exposing patients to unnecessary risk
My brief look at this suggests that the problem with apps is that they use visible light, not infrared. Fine for pulse detection but no O2 sat.
As long as the symptom checker is fit for purpose and lists the symptoms and avoids other outdated criteria, I believe they had issues with the NHS one;
https://www.nhs.uk/news/medical-practice/doctors-vastly-outperform-symptom-checker-apps/
I just found this app… anyone else using?
Looks like Orion are releasing a self-monitoring tool too @NathanK @shayne.hunter…
https://www.nzdoctor.co.nz/article/news/embattled-orion-health-offers-goodwill-covid-19-helping-hand?utm_source=NZ+Doctor+-+(Live+website)&utm_campaign=b2c4ee1878-Doctor%40Large+23+August_COPY_01&utm_medium=email&utm_term=0_01321a1cab-b2c4ee1878-61120769
Yes, they have approached some of us independently too. Everyone is jumping on this bandwagon; we are about to have COVID-19 risk calculator / tracker chaos. I just hope that out of this we can pull off connecting the data as we are about to see the whole proprietary data models + connectors vs open platform thing come to a head in this.
Nothing like confusing as many people as possible 
If I were in any kind of senior capacity in the health ministry of a nation state I would ask the local Facebook HQ team directly to make me a COVID19 chatbot for Messenger. I’ve seen these things developed in hours using the libraries and SDK. It’s a simple enough algorithm. The big 4 tech giants will be desperate to show off their social conscience (and not all will respond like Microsoft, seeing the oppo for a loss-leader on Teams)
Just out of interest these two respiratory wearables were mentioned in a WHO AI meeting
http://healthcareoriginals.com/solutions/#tophttp://healthcareoriginals.com/solutions/#top
https://stethome.com/https://stethome.com/
And not really related but just saw this
https://www.norwayhealthtech.com/news/decon-x-norways-first-self-disinfecting-hospital-room/
Hi Bronwen,
I think the difficulties are actually more about ‘perception’ than a reality. The app is tailored for self-assessment and minimises the questions, based on sound expert advice and a lot of wrangling to optimise the questions actually asked.
I do agree though that it would be better if the basis for the current questions was made more obvious - this is very fast moving and the expert guidance is changing daily - in some cases the app is possibly ahead of most professionals understanding - which just makes it more important that the journey from expert advice to app dialogue is traceable - partly to be able to defend any criticism but also to allow others working on similar projects to be able to replicate the fast moving guidance for slightly different care-settings.
Received this from Medtech
Also aware Orion Healthndue to release a similar tool
Hope this is useful
Grahame Jelley
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