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. 2017 Jul 29;2(6):1009-1017.
doi: 10.1016/j.ekir.2017.07.010. eCollection 2017 Nov.

Remote Patient Management for Home Dialysis Patients

Eric L Wallace  1 , Mitchell H Rosner  2 , Mark Dominik Alscher  3 , Claus Peter Schmitt  4 , Arsh Jain  5 , Francesca Tentori  6 , Catherine Firanek  7 , Karen S Rheuban  8 , Jose Florez-Arango  9   10 , Vivekanand Jha  11 , Marjorie Foo  12 , Koen de Blok  13 , Mark R Marshall  14   15 , Mauricio Sanabria  7   16 , Timothy Kudelka  7 , James A Sloand  7
Affiliations

Remote Patient Management for Home Dialysis Patients

Eric L Wallace et al. Kidney Int Rep. .

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.

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

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Figures

Figure 1
Figure 1
Opportunities for remote patient management. The inner circle represents examples of individual patient monitoring variables. Moving outward, data can then be used to drive patient- and center-specific clinical care. Finally, in the outermost circle are the predicted health care−related outcome improvements. ECG, electrocardiography; f/u, follow-up; PD, peritoneal dialysis.
Figure 2
Figure 2
Schematic representation of remote patient monitoring (RPM) program implementation. A remote patient monitoring program begins with the selection of the parameters to be monitored (right-hand side of the diagram). After training of the patient and nurses on remote patient monitoring tools, data are collected and clinical decisions are rendered on these data to effect outcomes. Maintenance of the RPM program is of the utmost importance and requires, at a minimum, continued surveillance of response times, patient adherence, and outcomes (indicated by red arrows) in order to be successful.
See this image and copyright information in PMC

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