Gianpaolo Amici1, Daniela D'Angela2, Antonina Lo Cicero3, Dino Romanini3, Francesca K Martino4, Federico Spandonaro2. 1. Nephrology and Dialysis Unit, Hospitals of San Daniele del Friuli and Tolmezzo, ASUFC Friuli Venezia Giulia, Udine, Italy. gianpaolo.amici@aulss4.veneto.it. 2. Facoltà di Economia, Università di Roma "Tor Vergata" and C.R.E.A. Sanità, Roma, Italy. 3. Nephrology and Dialysis Unit, Hospitals of San Daniele del Friuli and Tolmezzo, ASUFC Friuli Venezia Giulia, Udine, Italy. 4. Nephrology, Dialysis and Kidney Transplantation Center, San Bortolo Hospital, Vicenza and International Renal Research Institute, Vicenza, Italy.
Abstract
PURPOSE: Follow-up of automated peritoneal dialysis (APD) has been improved by data transmission by cellular modem and internet cloud. With the new remote patient monitoring (RPM) technology, clinical control and prescription of dialysis are performed by software (Baxter Claria-Sharesource), which allows the center to access home operational data. The objective of this pilot study was to determine the impact of RPM compared to traditional technology, in clinical, organizational, social, and economic terms in a single center. METHODS: We studied 21 prevalent APD patients aged 69 ± 13 years, on dialysis for a median of 9 months, for a period of 6 months with the traditional technology and 6 months with the new technology. A relevant portion of patients lived in mountainous or hilly areas. RESULTS: Our study shows more proactive calls from the center to patients after the consultation of RPM software, reduction of calls from patients and caregivers, early detection of clinical problems, a significant reduction of unscheduled visits, and a not significant reduction of hospitalizations. The analysis also highlighted how the RPM system lead to relevant economic savings, which for the health system have been calculated € 335 (mean per patient-month). With the social costs represented by the waste of time of the patient and the caregiver, we calculated € 685 (mean per patient-month). CONCLUSION: In our pilot report, the RPM system allowed the accurate assessment of daily APD sessions to suggest significative organizational and economic advantages, and both patients and healthcare providers reported good subjective experiences in terms of safety and quality of follow-up.
PURPOSE: Follow-up of automated peritoneal dialysis (APD) has been improved by data transmission by cellular modem and internet cloud. With the new remote patient monitoring (RPM) technology, clinical control and prescription of dialysis are performed by software (Baxter Claria-Sharesource), which allows the center to access home operational data. The objective of this pilot study was to determine the impact of RPM compared to traditional technology, in clinical, organizational, social, and economic terms in a single center. METHODS: We studied 21 prevalent APD patients aged 69 ± 13 years, on dialysis for a median of 9 months, for a period of 6 months with the traditional technology and 6 months with the new technology. A relevant portion of patients lived in mountainous or hilly areas. RESULTS: Our study shows more proactive calls from the center to patients after the consultation of RPM software, reduction of calls from patients and caregivers, early detection of clinical problems, a significant reduction of unscheduled visits, and a not significant reduction of hospitalizations. The analysis also highlighted how the RPM system lead to relevant economic savings, which for the health system have been calculated € 335 (mean per patient-month). With the social costs represented by the waste of time of the patient and the caregiver, we calculated € 685 (mean per patient-month). CONCLUSION: In our pilot report, the RPM system allowed the accurate assessment of daily APD sessions to suggest significative organizational and economic advantages, and both patients and healthcare providers reported good subjective experiences in terms of safety and quality of follow-up.
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Authors: Eric L Wallace; Mitchell H Rosner; Mark Dominik Alscher; Claus Peter Schmitt; Arsh Jain; Francesca Tentori; Catherine Firanek; Karen S Rheuban; Jose Florez-Arango; Vivekanand Jha; Marjorie Foo; Koen de Blok; Mark R Marshall; Mauricio Sanabria; Timothy Kudelka; James A Sloand Journal: Kidney Int Rep Date: 2017-07-29