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Kidney Week

Abstract: TH-OR088

Adoption of Home Remote Monitoring to Improve Outcomes in Peritoneal Dialysis (PD) Patients

Session Information

  • Home Dialysis
    November 07, 2019 | Location: 143, Walter E. Washington Convention Center
    Abstract Time: 04:30 PM - 04:42 PM

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Schreiber, Martin J., DaVita Inc, Denver, Colorado, United States
  • Gonzales, Mike, DaVita Inc, Denver, Colorado, United States
  • Roepe, Shannon, DaVita Inc, Denver, Colorado, United States
  • Cahill, Kevin, DaVita Inc, Denver, Colorado, United States
  • Van hout, Bram, DaVita Inc, Denver, Colorado, United States
  • Holly-Kestel, Jodi, DaVita Inc, Denver, Colorado, United States
  • Herzog, Patricia, DaVita Inc, Denver, Colorado, United States
  • Cassin, Michelle, DaVita Inc, Denver, Colorado, United States
Background

The use of virtual health technologies has the potential to transform care of end-stage renal disease patients, allowing ongoing biometric data capture and virtual in-home interactions between patients and the healthcare team. Tracking biometric data through home remote monitoring (HRM) platforms, especially for high-risk patients, can promote a more proactive approach to care management and may improve outcomes.

Methods

We examined the acceptance and utilization of HRM by high-risk PD patients of a large dialysis organization (LDO); patient risk status was determined using a predictive clinical algorithm in conjunction with care team clinical judgement. Each home dialysis facility's governing body approved the HRM protocol prior to use; patient consent and a physician's order was required to place a patient on the HRM protocol. Alerts were designed for all biometric values tracked (blood pressure, weight, temperature). Patients could also engage via an iPad in Daily Health Sessions, which included questions about symptoms as well as educational content designed to reinforce training concepts.

Results

Since April 2017, over 12,000 patients have used HRM and over 4700 patients were actively using the platform in May 2019; more than 1 million data points have been collected to date. Metrics tracked during implementation included: patient enrollment rate, consistency of patient data transmission, and speed of alert resolution by the care team. Adoption metrics were assessed by program, along with hospitalization rates and mean time on therapy.

Conclusion

HRM was shown to be feasible among high-risk PD patients of an LDO. Uncontrolled blood pressure, treatment weight > target weight, and an increase in positive answers to health questions could all be indicative of changes in patient health status that warrant action: use of HRM to track these metrics may help to drive action steps and improve outcomes. Areas of ongoing focus include improving adherence and adoption into clinic workflow, ensuring timely closure of HRM alerts, and consistency in targeting HRM to appropriate high-risk patients.

Funding

  • Commercial Support