Improving safety and efficiency in care: multi-stakeholders’ perceptions associated with a peritoneal dialysis virtual care solution

Abstract

BackgroundAlthough there is a growing body of literature on the outcomes and impacts of remote home management with peritoneal dialysis (PD) patients, less is understood how this virtual care solution impacts the quality and efficiency of the healthcare system care. In this context, a study was undertaken to understand the perceptions of patients and their caregivers, healthcare providers, health system decision makers, and vendors associated with a remote monitoring and tracking solution aimed at enhancing the outcomes and experiences of chronic kidney disease (CKD) patients receiving PD at home.MethodsA qualitative design using semi-structured interviews with 25 stakeholders was used in this study. Narrative data were analyzed by a thematic analysis approach.ResultsThe following two themes emerged from the data: (1) leveraging data to monitor and intervene to keep patients safe and (2) increasing efficiencies and having control over supplies.DiscussionOur study findings elucidated the ability of patients (and in some cases, caregivers) to monitor and trend their data and order and track directly on-line their dialysis supplies were key to their active participation in managing their CKD and keeping them safe at home. Their active participation and functionality of the virtual care solution also led to enhanced efficiencies (eg, process faster, easier, convenient, time savings) for both patients and healthcare providers.ConclusionThe virtual care solution showed promising signs of a patient-centric approach and may serve as a blueprint for other virtual care solutions for chronic disease management.

Benefits and Challenges of Remote Patient Monitoring as Perceived by Health Care Practitioners: A Systematic Review

“…Jeffs et al 20 found that health care practitioners believe that the eQConnect software, 23 which monitors peritoneal dialysis treatment and health status in patients with chronic kidney disease, can increase efficiency and safety for their patients, although with certain drawbacks. Through an open-ended survey, Craven et al 19 gathered information on the potential of remote monitoring in patients with epilepsy, multiple sclerosis, and depression.…”

“… 10,14,15,20,21 Patient studies echo the practitioner perceptions, showing that telemedicine does establish confidence in patients 26–29 and reduce emergency or unnecessary in-person visits. 30 Jeffs et al 20 noted that health care practitioners were able to see the supply usage data of patients with chronic kidney disease and address deficiencies in their self-management, further improving the patient’s ability to self-manage.…”

“… 18 Additionally, these technologies can also provide alerts prompting patients to contact the clinic if there are any abnormalities with their health status. 20 The technologies also alert health changes on the practitioner end to create an appointment or prompt a phone call from a clinician. 19 …”

“… 10 In a survey done by Engler et al, 39 they found the main reason patients did not use monitoring technology was due to their high cost. However, Jeffs et al 20 found that RPM can result in overall cost savings for the patient due to consistent tracking of self-management supplies, minimizing overuse, and reducing the need for clinic visits. Additionally, the decreased need for emergency in-person visits will also be cost saving.…”