Telemedicine system for home automated peritoneal dialysis.

We have developed a new telemedicine system to monitor elderly and handicapped patients that use an automated peritoneal dialysis (APD) system to perform continuous ambulatory peritoneal dialysis (CAPD) at home. The system has two parts: (1) a data collection and transport system, and (2) an interview system ("View Send" system). The former is assembled from the APD cycler, an automated blood-pressure recorder, and a scale. The latter is a combination of a digital camera, television, and set-top box (a kind of computer). The APD system contains recording and data transport junctions, a monitoring device, and a data tabulation function. All data collected by the APD system are sent directly in real time to the physician's office. Patients can easily use this telemedicine system to contact the medical staff at the Saitama Medical School CAPD center and to consult concerning their condition. Furthermore, the staff can directly change the CAPD schedule (dose and duration). Seven patients, including some who are older than 90 years or who are handicapped, have been using this telemedicine system for between 1 and 6 months (average: 3 months). From our recent experience, our tentative conclusions are that (1) elderly and handicapped patients benefit from this system by being able to maintain CAPD without major problems and accidents; (2) other problems are mainly due to simple mistakes such as accidentally pushing the on and off switches; (3) quality of life is improved for the patients.