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Kidney Week

Abstract: PO0273

Telenephrology (TN) vs. Face-to-Face (F2F) Visits: A Comparison of Inpatient Nephrology Outcomes and Provider Perspectives

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Androga, Lagu A., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Ramar, Priya, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Amundson, Rachel H., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kattah, Andrea G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Thorsteinsdottir, Bjoerg, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Zoghby, Ziad, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Philpot, Lindsey M., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Albright, Robert C., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Clinical outcomes, patient, and provider perspectives on inpatient synchronous telenephrology care remain largely unstudied. In this retrospective study, we compared outcomes in patients who received inpatient synchronous TN plus F2F (cases) versus only F2F (controls) at two Mayo Clinic Health System (MCHS) community hospitals

Methods

Hospitalized adults who had nephrology consults from 3/1/2020 to 2/28/2021 were classified in several diagnoses groups. Logistic regression was used to assess 30-day mortality, readmissions, and hospital transfers. Penalized regression was used in the case of rare events. Negative binomial regression was fit to account for overdispersion in length of hospital stay data. Unadjusted and Adjusted odds ratio with 95% confidence intervals were calculated. We used structured surveys to evaluate the perspectives of non-nephrology hospital providers and tele-nephrologists

Results

A total of 850 patients were included. Mean age was 69 years, 59% were male and 93% white. Cases were more likely to get dialysis after a TN consult; OR: 1.80 (1.00, 3.22). Other outcomes were not statistically different (Table 1). Both non-nephrology hospital providers and tele-nephrologists reported the most frequent reasons for consults were AKI, ESRD, electrolytes, or acidosis. Tele-nephrologists preferred video consults (82%) to phone for communication. More than half (64%) of tele-nephrologists spent less time on TN compared to F2F consults. Non-nephrology hospital providers were very satisfied 10 (48%) and satisfied 6 (29%) with TN response time, and most felt TN was as safe as F2F (67%) and provided them enough information to make patient care decisions (76%)

Conclusion

Outcomes for in-hospital nephrology consults were similar between telenephrology plus face-to-face and face-to-face. Non-nephrology hospital providers and tele-nephrologists had favorable opinions for TN and most thought it is as safe as F2F consults