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Abstract
As opposed to institutional and satellite dialysis, home dialysis is advocated as the preferred and cost-effective alternative to provide dialysis to a rising number of patients with end-stage kidney failure. Ongoing support to ensure success of a home dialysis program can be challenging because of limited nursing resources to visit patients who are often distributed over large geographical areas. Since patients on home haemodialysis (HHD) are reviewed much less frequently compared to those on institutional or satellite haemodialysis, we developed a telehealth information system, the Home Haemodialysis Remote Monitoring System (HHD-RMS), comprising of a mobile device application named 'My Home Hemo' app and a web portal for remote monitoring of patients' dialysis parameters. This study reports our findings from analysing the dialysis data from the app, collected and reviewed on 74 patients over 21 weeks. Using this data increased occasions of patient review by 270% as compared to the previous two years, with an average of 12 patients' dialysis data being remotely reviewed per week, resulting in 26 changes to dialysis prescriptions during the study period, and significant reduction in nursing and patient times associated with consultations and travel. Both patients and nursing staff reported high levels of satisfaction and ease of use. We conclude that this remote monitoring telehealth tool enabled nurses to remotely monitor dialysis parameters of patients on HHD, resulting in improved nursing efficiencies. The data allowed changes to be made to haemodialysis prescriptions and led to savings associated with patient and nursing time from the reduced need for travel. Anecdotally, the app also improved patient and staff satisfaction. This system has the potential for major health benefits to patients and cost savings to health services.
Keywords
Home haemodialysis, telehealth, mobile app, remote monitoring
Introduction
Home haemodiáysis (HHD) is the preferred haemodialysis modality for patients with end-stage renal failure as it is associated with better patient outcomes at lower health care costs (Lewicki etai., 2015), Western Renal Service (WRS) is one of the largest HHD programs in Australia that has experienced a 24% growth in patient numbers over the past three years. In October 2015, the service looked after 125 patients on HHD residing in 84 different suburbs which are spread across 9950 km2 between two local health districts in...