Although dialysis rates are similar in urban and rural areas, most remote rural counties in the United States lack in-county dialysis facilities. Of all the community hospitals in the country, only 38% are designated as rural hospitals, and it is estimated that two-thirds of rural hospitals do not offer acute dialysis due to a lack of dialysis and/or kidney specialists. A model telehealth program may help provide much-needed care to these regions, according to a study that will be presented at ASN Kidney Week 2016 November 15¬-20 at McCormick Place in Chicago, IL.
Charuhas Thakar, MD (University of Cincinnati) and his colleagues describe the development of a telemedicine program that partners a national dialysis provider with a rural hospital in Kentucky. Between January and April, they have treated more than a dozen patients (with >20 dialysis treatments) via the tele-nephrology program for conditions requiring medical, surgical, or critical care, and 67% of the patients were successfully treated and discharged from the rural hospital. The program now also provides 24/7 nephrology care other than dialysis to those patients with kidney and electrolyte disorders.
"This innovative patient-centered program plans to build a hub-and-spoke model for specialty care, and can be emulated nationally," said Dr. Thakar. "Models need to examine clinical effectiveness and efficiency of tele-medicine in nephrology in both acute and chronic settings to reduce the burden of travel to satellite dialysis units for providers, and thus make dialysis and renal care available in more proximity to patients."