Telemedicine services for living kidney donation: A US survey of multidisciplinary providers

Abstract

Individuals considering living kidney donation face geographic, financial, and logistical challenges. Telemedicine can facilitate healthcare access/care coordination. Yet difficulties exist in telemedicine implementation and sustainability. We sought to examine centers' practices and providers' attitudes toward telemedicine to improve services for donors. We surveyed multidisciplinary providers from 194 active adult US living donor kidney transplant centers; 293 providers from 128 unique centers responded to the survey (center representation rate = 66.0%), reflecting 83.9% of practice by donor volume and 91.5% of US states/territories. Most centers (70.3%) plan to continue using telemedicine beyond the pandemic for donor evaluation/follow-up. Video was mostly used by nephrologists, surgeons, and psychiatrists/psychologists. Telephone and video were mostly used by social workers, while video or telephone was equally used by coordinators. Half of respondent nephrologists and surgeons were willing to accept a remote completion of physical exam; 68.3% of respondent psychiatrists/psychologists and social workers were willing to accept a remote completion of mental status exam. Providers strongly agreed that telemedicine was convenient for donors and would improve the likelihood of completing donor evaluation. However, providers (65.5%) perceived out-of-state licensing as a key policy/regulatory barrier. These findings help inform practice and underscore the instigation of policies to remove barriers using telemedicine to increase living kidney donation.

Keywords: access to health care; attitudes; health services; kidney transplantation; living donors; telehealth.

FIGURE 1

Flowchart representative of surveys eligible for inclusion

FIGURE 2

Mean response of multidisciplinary providers regarding their willingness to use telemedicine services for living kidney donation beyond the COVID‐19 pandemic. Overall, respondents were very willing to use telemedicine for counseling of potential donors (mean response [standard deviation]: 4.5 [0.8]) and post‐donation follow‐up care (mean response: 4.6 [0.7]). Respondents were somewhat willing to use telemedicine for the initial evaluation (mean response: 4.2 [1.2]) or psychiatric or psychological evaluation (mean response: 4.1 [1.1]). However, respondents were undecided whether they would use telemedicine to conduct a limited physical exam (mean response: 3.4 [1.3]). ILDA, independent living donor advocate. [Color figure can be viewed at wileyonlinelibrary.com]