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Expanding the Reach of Telehealth to Kidney Disease

By Lily Mercer

Patients with kidney disease can gain tremendous benefits from telehealth. Telehealth solutions offer self management tools and enhanced communication between patients and clinicians. This level of enhanced care can help both patients and providers overcome barriers to healthcare for this patient population.

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Addressing The Limited Use Of Telehealth For Kidney Patients 

 

Telehealth is becoming increasingly prevalent in today’s healthcare landscape. Patients who suffer from a variety of chronic diseases have demonstrated substantial benefits from telehealth since its inception. However, adoption of telehealth among patients with renal disease has been slow.

 

To address the limited use of telehealth in this patient population, the Kidney Health Initiative launched a project to explore the current state of telehealth and its potential benefits in the care of patients with end stage renal disease (ESRD) in the United States. A paper was published in July 2017 outlining the Initiative’s conclusions.

 

To date, there are few clinical studies published on the role of telehealth in kidney disease. The authors of the Kidney Health Initiative paper call for an increased research focus on this patient population, as patients suffering from ESRD stand to gain many benefits from telehealth.

 

Telehealth's Role For Patients with ESRD 

 

Patients who receive dialysis treatments at home can increase their independence, while at the same time receiving necessary support from their care providers with telehealth. Additionally, telehealth has the potential to decrease healthcare costs associated with ESRD and home dialysis. Though not the focus of the paper, patients with chronic kidney disease and patients who receive kidney transplants are also likely to experience enhanced care with telehealth.

 

To facilitate a discussion on the use of telehealth with this patient population, the authors of the Kidney Health Initiative describe how telehealth presents care providers with several opportunities to augment care for patients with ESRD:

  • Caregivers can intervene early and modify the care plan when necessary
  • Telehealth improves access to care for patients burdened by travel or cost
  • Remote monitoring and video conferencing promotes patient independence at home

 

Telehealth also has the unique ability to increase acceptance and utilization of home-based dialysis care among patients with ESRD. Studies demonstrate that both patients and families prefer home dialysis, and data proves that home dialysis results in equivalent or improved outcomes compared to traditional dialysis. However, only a limited number of patients currently receive dialysis at home in the US. By facilitating patient-provider communication, telehealth can make both patients and caregivers more confident in the reliability of home dialysis therapy.

 

Establishing Communication Between Patient And Provider

 

By establishing a remote monitoring environment, telehealth can facilitate patient education opportunities for patients with ESRD. Video-conferencing allows care teams to monitor patients during self-care and simultaneously provide feedback to ensure that home dialysis therapies are performed correctly. Therefore, telehealth interventions have the potential to improve the success of home dialysis. Also of note, patients report satisfaction and acceptance of telehealth platforms with video-conferencing.

 

Another major advantage of telehealth is that it allows care providers to address issues before they result in more severe complications or re-hospitalization. Patients with ESRD can use telehealth platforms to send pictures or videos of their drain bags or catheter exit site, allowing caregivers to review for potential infection. Additionally, care providers can also monitor patient adherence to ensure that the plan of care is carried out properly.

 

These patient monitoring features have the added benefit of reducing costs associated with renal disease. By decreasing complication rates, telehealth can improve care efficiency and limit excess spending in the care of patients with ESRD.

 

Overcoming Telehealth Barriers

 

Though telehealth is a promising method of treatment in the management of patients with renal disease, it is expected that there will be barriers to implementation. Adjustments and changes in the status quo of patient care is often met with resistance. As telehealth is novel to much of this patient population, it is critical that care providers address barriers to implementation, such as upfront technological costs, EMR integration, and patient acceptance to technology.

 

Nevertheless, telehealth has great potential to enhance the care of patients with kidney disease. By increasing independence,improving outcomes, and reducing healthcare spending, telehealth can improve the experience of both the patient and provider. As more attention is directed toward this patient population, the benefits of telehealth for patients with kidney disease are sure to be realized.

 

References

 

Rosner MH, Lew SQ, Conway P, et al. Perspectives from the Kidney Health Initiative on Advancing Technologies to Facilitate Remote Monitoring of Patient Self-Care in RRT. Clin J Am Soc Nephrol. 2017 Jul 14.

 

Harrington DM, Myers L, Eisenman K, Bhise V, Nayak KS, Rosner MH: The use of a tablet computer platform to optimize the care of patients receiving peritoneal dialysis: A pilot study. Blood Purif 37: 311–315, 2014.

 

Lew SQ, Sikka N: Are patients prepared to use telemedicine in home peritoneal dialysis programs? Perit Dial Int 33: 714–715, 2013.

 

Tags: disease management, remote patient monitoring, communication, kidney disease, ESRD

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