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Overcome the Technical Challenges of Telehealth for Nephrology


Sponsored by the Renal Physicians Association.

Not long ago, reimbursement rules severely limited how nephrology practitioners could treat patients via telemedicine. If they wanted to receive payment for their services, physicians could use the technology to treat only those dialysis patients who were at an “originating site,” such as a hospital or similar clinical setting. That all changed this past January when a pivotal portion of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017 went into effect, enabling providers to deliver telehealth services to dialysis patients in their homes.

The benefits of telemedicine for home dialysis are striking. The innovation could improve patient access, experience and outcomes, all while reducing provider burden and costs, and this potential was heightened in July 2019 when HHS announced substantial incentives for nephrologists to provide home dialysis care as part of sweeping changes in federal policy governing kidney care delivery. However, remaining technical challenges associated with the use of telehealth form a stiff barrier to entry for nephrologists and other clinicians.

To help solve this problem and foster meaningful conversation in other areas of kidney care, the medical professional society representing nephrology practitioners, Renal Physicians Association (RPA), has launched RPA Connect. Powered by Medstro, the digital platform brings together healthcare providers to learn, share and collaborate with their peers for discussions on practice management, coding and billing, clinical practice and much more — including the utilization of telehealth services.

“Many of us are still figuring out how to navigate the implementation of telemedicine to maximize access to home therapies for kidney patients,” says Harry Giles, MD, a nephrologist who practices in Alabama and sits on the Renal Physicians Association Board of Directors. “The RPA Connect’s platform is designed to be an easy-to-access source for online conversations on many topics, with the first being how to deploy and use telemedicine.

“I’m excited about using this new forum to cultivate and foster an online dialogue for all of us in the kidney community,” he says.

Challenges of Telemedicine for Home Dialysis

Although telehealth can prove critical for patients and providers in rural, suburban and even urban settings, the practice requires technological infrastructure. According to the Office of the National Coordinator for Health Information Technology, almost all telemedicine initiatives require four critical components, lest they suffer from dropped connections and decreased patient satisfaction:

  1. Broadband internet access
  2. Imaging technology or peripherals
  3. Technical support staff access
  4. Training for staff

For home dialysis telemedicine, however, the technical demand does not end here. For instance, physicians may find they require technologies that enable more detailed visual inspection. Further, healthcare providers must also consider the role of reimbursement and even clinician burnout.

But the technical challenges do not end with this list. What other roadblocks exist and how might nephrology practitioners overcome them?

Benefits of Telemedicine for Home Dialysis

It is critical that telemedicine services reach the homes of dialysis patients.

As Giles, the moderator of the first RPA Connect conversation, says, telehealth and home dialysis blend together to advance patient-centered care in ways previously unseen.

“As we offer this therapy to more of our patients, we can further our goals of less burdensome treatments by opening the door to telemedicine,” he adds. “The promise of this reducing the impact of the disease on the patient’s daily life.”

Advance the Conversation Among Nephrologists

Innovation and changing regulations rarely bring a step-by-step guide for proper implementation. Measurable success requires education and conversation among colleagues who are also navigating change, and this will only increase with HHS’ emphasis on increasing home dialysis utilization. The technical nature of telemedicine, specifically, mandates information sharing if home dialysis patients and providers are to reap the rewards of an evolving reimbursement system.

Have you encountered technical problems in launching a dialysis telemedicine program? Better yet, have you found solutions? Join RPA Connect’s conversation on telemedicine challenges today.

Image has been altered. Courtesy of Intel Free Press, Flickr.

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