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 Nov 7;12(11):1900-1909. doi: 10.2215/CJN.12781216. Epub 2017 Jul 14.

Abstract

Telehealth and remote monitoring of a patient's health status has become more commonplace in the last decade and has been applied to conditions such as heart failure, diabetes mellitus, hypertension, and chronic obstructive pulmonary disease. Conversely, uptake of these technologies to help engender and support home RRTs has lagged. Although studies have looked at the role of telehealth in RRT, they are small and single-centered, and both outcome and cost-effectiveness data are needed to inform future decision making. Furthermore, alignment of payer and government (federal and state) regulations with telehealth procedures is needed along with a better understanding of the viewpoints of the various stakeholders in this process (patients, caregivers, clinicians, payers, dialysis organizations, and government regulators). Despite these barriers, telehealth has great potential to increase the acceptance of home dialysis, and improve outcomes and patient satisfaction while potentially decreasing costs. The Kidney Health Initiative convened a multidisciplinary workgroup to examine the current state of telehealth use in home RRTs as well as outline potential benefits and drawbacks, impediments to implementation, and key unanswered questions.

Keywords: Caregivers; Cost-Benefit Analysis; Dialysis; Government; Health Status; Hemodialysis, Home; Humans; Patient Satisfaction; Pulmonary Disease, Chronic Obstructive; Self Care; Telemedicine; diabetes mellitus; heart failure; hypertension; monitoring; renal dialysis.

Publication types

  • Review

MeSH terms

  • Cost Savings
  • Hemodialysis, Home
  • Humans
  • Insurance, Health, Reimbursement
  • Kidney Failure, Chronic / economics
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Monitoring, Physiologic / instrumentation
  • Monitoring, Physiologic / methods*
  • Patient Acceptance of Health Care
  • Peritoneal Dialysis
  • Self Care*
  • Telemedicine* / legislation & jurisprudence