title: Telehealth in the Delivery of Home Dialysis Care: Catching up With Technology.
abstract: Geographic and socioeconomic barriers may pose a significant difficulty in delivering home dialysis care to remote underserved populations leading to low utilization rates and poor outcomes. Telehealth may serve as a solution to overcome geographic barriers in delivering home dialysis care. Although technologic advances in telehealth have progressed rapidly making it accessible and inexpensive, it has been underused by nephrologists. Components of a regular face-to-face visit that can be successfully accomplished remotely using telehealth techniques include physician-patient communication, physical examination, laboratory and treatment data monitoring, nursing and nutrition education. Regulatory and reimbursement-related policies continue to present barriers that need to be overcome in operationalizing telehealth and widespread adoption of telehealth solutions. Although more quality evidence is needed to study the impact of telehealth on home dialysis outcomes and uptake, telehealth holds the promise of increasing access to care, improving quality of life, and improving quality of care for current and would be home dialysis patients.
authors.affiliation: Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL; and Alabama Department of Public Health, Montgomery, AL.
authors.forename: Vinay N
authors.initials: VN
authors.lastname: Krishna
authors.affiliation: Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL; and Alabama Department of Public Health, Montgomery, AL.
authors.forename: Kamesha
authors.initials: K
authors.lastname: Managadi
authors.affiliation: Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL; and Alabama Department of Public Health, Montgomery, AL.
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.affiliation: Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL; and Alabama Department of Public Health, Montgomery, AL. Electronic address: ericlwallace@uab.edu.
authors.forename: Eric
authors.initials: E
authors.lastname: Wallace
mesh_terms: D003695:Delivery of Health Care; D006699:Home Care Services; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D010530:Peritoneal Dialysis / Q000379:methods*; D010808:Physical Examination; D012051:Reimbursement Mechanisms; D006435:Renal Dialysis; D017216:Telemedicine; D055986:Vital Signs
keywords: Home dialysis; Modalities education; Peritoneal dialysis; Quality of life; Telehealth