Kidney Week

Abstract: FR-PO0048

Effect of Telemedicine on Nephrology Clinic Use in Correctional Clinic

Session Information

• Artificial Intelligence: Clinical Prediction, Decision Support, and Digital Kidney Care
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Artificial Intelligence, Digital Health, and Data Science

• 300 Artificial Intelligence, Digital Health, and Data Science

Authors

• Ewing, Elise Catherine, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States

Elise Catherine Ewing, MD

• Monga, Divya, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States

Divya Monga, MD

• Israni, Ajay K., The University of Texas Medical Branch at Galveston, Galveston, Texas, United States

Ajay K. Israni, MD, MS

• Ojo, Olugbenga Babatunde, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States

Olugbenga Babatunde Ojo, MD, MBA

• Onyeaghala, Guillaume Chinedu, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States

Guillaume Chinedu Onyeaghala, PhD, MPH

Background

As of 2022, the United States had ~1.9 million adults incarcerated. These individuals have disproportionately high rates of chronic kidney disease and related comorbidities, yet frequently encounter barriers to specialty care due to transportation limitations, staffing shortages, and security constraints. We evaluated the use of our protocol for referral to our telemedicine clinic from prisons across East Texas and its association with clinic utilization in this population.

Methods

A retrospective analysis was conducted over 19 months (September 2024 – March 2026) at Texas Department of Criminal Justice (TDCJ) nephrology clinics served by the University of Texas Medical Branch. Clinics are held once weekly as 4-hour sessions. In June 2025, one session per month transitioned to telemedicine, then expanding to two telemedicine sessions per month in March 2026. The study period was divided into pre-intervention (September 2024–May 2025), and post-intervention (June 2025–March 2026). Outcomes included visit completion and no-show rates by modality. Comparisons were performed using the Mann-Whitney U test. This study was deemed as exempt by UTMB IRB.

Results

A total of 758 visits were completed. During the post-intervention period, telemedicine accounted for 31.2% of completed visits. Telemedicine no-show rates were lower than face-to-face (F2F) clinics in most months, often below 20%, and reached 0% in one month. The mean no-show rates were significantly lower for telemedicine compared to F2F visits (25.0% vs. 62.8%; p<0.01) (Figure 1), with patients less likely to miss telemedicine appointments (relative risk 0.398). Overall visit completion rates improved significantly in the post-intervention period compared to pre-intervention (53.1% vs. 32.9%; p<0.05), representing a 1.61-fold increase in likelihood of visit completion with telemedicine.

Conclusion

Our telemedicine protocol in TDCJ nephrology clinics was associated with lower no-show rates and improved visit completion.