Remote Patient Management for Home Dialysis Patients

Eric L. Wallace, Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Mitchell H. Rosner, Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA.
Mark Dominik Alscher, Department of Internal Medicine and Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany.
Claus Peter Schmitt, Center for Pediatric and Adolescent Medicine, Division of Pediatric Nephrology, University of Heidelberg, Heidelberg, Germany.
Arsh Jain, Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada, Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Institute for Clinical Evaluative Sciences, London, Ontario, Canada.
Francesca Tentori, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Catherine Firanek, Baxter Healthcare Inc, Deerfield, Illinois, USA.
Karen S. Rheuban, Department of Center for Telehealth, University of Virginia Health System, Charlottesville, Virginia, USA.
Jose Florez-Arango, Department of Biomedical Informatics, Texas A & M University, College Station, Texas, USA.
Vivekanand Jha, George Institute for Global Health, Syndey, New South Wales, Australia.
Marjorie Foo, Department of Renal Medicine, Duke-National University of Singapore Graduate Medical School, Singapore.
Koen de Blok, Department of Nephrology and Dialysis, Flevo Hospital, Almere, Flevoland, Netherlands.
Mark R. Marshall, Baxter Healthcare (Asia) Pte Ltd, Singapore.
Mauricio Sanabria, Baxter Healthcare Inc, Deerfield, Illinois, USA.
Timothy Kudelka, Baxter Healthcare Inc, Deerfield, Illinois, USA.
James A. Sloand, Baxter Healthcare Inc, Deerfield, Illinois, USA.

Document Type

Journal Article

Publication Date

11-1-2017

Journal

Kidney international reports

Volume

2

Issue

6

DOI

10.1016/j.ekir.2017.07.010

Keywords

end-stage kidney disease; home dialysis; patient monitoring; peritoneal dialysis; remote; telehealth

Abstract

Remote patient management (RPM) offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.

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