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Kidney Week

Abstract: PO0853

Caring for Patients with Kidney Disease in the COVID-19 Era: The Kaiser Permanente Northern California Experience

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Zheng, Sijie, The Permanente Medical Groups, Oakland, California, United States
  • Poyan-Mehr, Ali, The Permanente Medical Groups, Oakland, California, United States
  • Pravoverov, Leonid, The Permanente Medical Groups, Oakland, California, United States
  • Belani, Sharina, The Permanente Medical Groups, Oakland, California, United States
Background

The COVID-19 pandemic has presented health care system in the United States with unprecedented challenges. Kaiser Permanente Northern California is an integrated health care system with 4.5 million members, who are cared for by The Permanente Medical Group (TPMG), a multiple specialty medical group of 10,000 physicians. Utilizing coordinated care, sophisticated Electric Medical Record system. KPNC Nephrology service line has developed several strategies to mitigate the effect of COVID-19, including rapidly increased video visit appointments for members with CKD.

Methods

After the “Shelter in place” order in March 2020, KP nephrologists started weekly virtual townhall meetings to coordinate care among 85 nephrologists in 19 hospitals covering patients with chronic kidney disease, receiving dialysis, and post kidney transplant. TPMG nephrologists have developed guidelines on: 1. Tier testing for Person Under Investigation (PUI) members; 2. Management of patients with Glomerulonephritis; 3. Post-kidney transplant care; 4. Expand advance care planning; 5. Converting direct patient visits to video visits; 6. Coordinating care with contracted dialysis providers for members on outpatient dialysis.

Results

The video visits have increased 780% from March to April and 1968% from March to May of 2020 (Figure). The top three diagnosis for video visits were: CKD3, CKD4, and post kidney transplant. Since April 8, 2020, average 0.038% of Dialysis patients were tested positive for COVID-19 and average 1.6% are PUI.

Conclusion

As an integrated health care system, KPNC has developed a systematic, collaborative and rapid crisis management of patients with CKD in COVID era. Further studies are needed to evaluate the long-term outcomes of these approaches.