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Kidney Week

Abstract: SA-PO1108

Telenephrology Dashboard for Active Surveillance of Kidney Disease in Primary Care: A Quality Improvement Initiative

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Swee, Melissa L., University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • Dixon, Bradley S., Iowa City VA Medical Center, Iowa City, Iowa, United States
  • Sarrazin, Mary Vaughan, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • Shi, Qianyi, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • Griffin, Benjamin R., University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • Sambharia, Meenakshi, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • Yamada, Masaaki, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • Jalal, Diana I., University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
Background

Early detection and management of kidney disease are essential for optimal care and cost savings. We implemented a quality improvement project to develop a telenephrology dashboard for active surveillance of kidney disease in primary care clinics.

Methods

A multidisciplinary team collaborated to create a scalable and flexible dashboard system in the Iowa City Veterans Affairs healthcare system. Using iterative Plan-Do-Study-Act cycles and employing thematic analysis, nephrologists, primary care physicians, and case managers actively contributed to dashboard design. The Kano Model was utilized to prioritize features based on user needs. The project was initially piloted in four rural clinics, and subsequent cycles focused on refining parameters and enhancing efficiency as telenephrology was implemented in additional rural clinics.

Results

Findings from the semi-structured interviews revealed several important themes. Participants expressed appreciation for the potential of telenephrology to improve access to specialized nephrology care, particularly for Veterans living in remote areas. The convenience and reduced travel burden were highlighted as major advantages. However, concerns were raised regarding the coordination of care and potential increases in workload for primary care practitioners. Autonomy and the need for clear guidelines in integrating telenephrology into existing care processes were also discussed.

Conclusion

This qualitative study sheds light on the experiences and perspectives of key stakeholders involved in the implementation of telenephrology in the Iowa City Veterans Affairs Health Care System. The findings underscore the potential benefits of telenephrology in improving access to nephrology care for Veterans in remote areas. Addressing concerns related to care coordination, workload, and autonomy is crucial for successful adoption and integration of telenephrology. The insights gained from this study can inform future initiatives to optimize the implementation and utilization of telenephrology in similar healthcare settings.

Funding

  • Private Foundation Support