Technology, Telehealth, and Nephrology: The Time Is Now

Jain, Gaurav; Ahmad, Masood; Wallace, Eric

doi:10.34067/kid.0002382020

Cited by 14 publications

(11 citation statements)

References 19 publications

(23 reference statements)

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“… 44 It can also help improve access for those with limited resources for travel and/or high disease burden and reduce barriers to the adequacy of disease management. 45 Although initial literature has shown comparable educational efficacy in medical school electives and clerkships, 46 , 47 it is unknown if telehealth can provide clinical experiences as effective as in-person interactions needed in graduate medical education. 48 Of the other new patient care approaches reported by fellows, the use of acute start peritoneal dialysis to manage patients with COVID-19 has also been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey

Pivert

Boyle

Halbach

et al. 2021

JASN

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BackgroundThe coronavirus disease 2019 (COVID-19) pandemic’s effects on nephrology fellows’ educational experiences, preparedness for practice, and emotional wellbeing are unknown.MethodsWe recruited current adult and pediatric fellows and 2020 graduates of nephrology training programs in the United States to participate in a survey measuring COVID-19’s effects on their training experiences and wellbeing.ResultsOf 1005 nephrology fellows-in-training and recent graduates, 425 participated (response rate 42%). Telehealth was widely adopted (90% for some or all outpatient nephrology consults), as was remote learning (76% of conferences were exclusively online). Most respondents (64%) did not have in-person consults on COVID-19 inpatients; these patients were managed by telehealth visits (27%), by in-person visits with the attending faculty without fellows (29%), or by another approach (9%). A majority of fellows (84%) and graduates (82%) said their training programs successfully sustained their education during the pandemic, and most fellows (86%) and graduates (90%) perceived themselves as prepared for unsupervised practice. Although 42% indicated the pandemic had negatively affected their overall quality of life and 33% reported a poorer work-life balance, only 15% of 412 respondents who completed the Resident Well-Being Index met its distress threshold. Risk for distress was increased among respondents who perceived the pandemic had impaired their knowledge base (odds ratio [OR], 3.04; 95% confidence interval [CI], 2.00 to 4.77) or negatively affected their quality of life (OR, 3.47; 95% CI, 2.29 to 5.46) or work-life balance (OR, 3.16; 95% CI, 2.18 to 4.71).ConclusionsDespite major shifts in education modalities and patient care protocols precipitated by the COVID-19 pandemic, participants perceived their education and preparation for practice to be minimally affected.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey

Pivert

Boyle

Halbach

et al. 2021

JASN

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“…The median distance traveled to attend the physical OPD (one way) was 113.5 (3-2249) km and 77.3% were dependent on public transport for reaching the OPD. The median number of outpatient visits per patient per year was five (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Nearly one-third (32.6%) of the patients stayed near the hospital premises for 4 or more days during each visit to get blood and imaging tests done and consult the nephrologist.…”

Section: Resultsmentioning

confidence: 99%

“…Nearly one-third (32.6%) of the patients stayed near the hospital premises for 4 or more days during each visit to get blood and imaging tests done and consult the nephrologist. Approximately twothirds (68.7%) of patients were accompanied by someone 5 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] during their hospital visits. Attendees incurred productivity loss due to missed work days in 54.7% of the cases.…”

Section: Resultsmentioning

confidence: 99%

Utility and patient acceptance of telemedicine in nephrology

et al. 2022

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Purpose There is an increasing burden of kidney diseases worldwide and access to specialist care is limited. Telemedicine, has been relatively less used in developing countries like India. The current study aims to assess the feasibility and acceptance of telenephrology services at our institute, a public hospital. Methods A total of 150 patients were selected by stratified random sampling from the list of attendees who had undergone both in-person outpatient consultation and telenephrology consultation. Patient's attitude towards, and knowledge and acceptance of telenephrology services were evaluated. ResultsThe average age of the study cohort was 42.52 ± 15.1 years. More than one-third (39.3%) of our patients belonged to the lower middle socioeconomic class. The median distance traveled to reach our outpatient clinic was 113.5 km (3-2249 km). Patients reported lost workdays in 54.7% cases. The majority (95%) of patients managed to consult through teleservices successfully. Ninety percent of the patients gave a satisfaction score of 4 (out of 5) or above for their teleconsultation experience. The most important perceived benefit of teleconsultation was the reduced risk of infection (40.6%) followed by economic benefits (32%). The major disadvantage (36%) was the absence of physical examination. A combination of physical and telenephrology services was the option preferred by 84% of the patients. Conclusion In developing countries like India, with the majority of the population residing outside major cities and with limited medical access, telenephrology has a huge potential to provide quality nephrology care to the remotest parts of the country.

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“…Clinicians remarked on the important role of expanded telemedicine care during the pandemic that has facilitated remote care of home dialysis patients, and as a result, efforts are needed to mitigate the digital divide affecting vulnerable patient populations. 53 , 54 …”

Section: Patient Empowerment and Educationmentioning

confidence: 99%

Expanding Utilization of Home Dialysis: An Action Agenda From the First International Home Dialysis Roundtable

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Technology, Telehealth, and Nephrology: The Time Is Now

Cited by 14 publications

References 19 publications

Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey

Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey

Utility and patient acceptance of telemedicine in nephrology

Expanding Utilization of Home Dialysis: An Action Agenda From the First International Home Dialysis Roundtable

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