Abstract
Background: The Miami VA Healthcare System serves veterans in three South Florida counties: Miami-Dade, Broward, and Monroe, with an estimated veteran population of 175,000. To overcome geographical barriers and facilitate the access to nephrology clinics, we implemented provider-patient tele-nephrology using secured videoconferencing. Methods: A retrospective and descriptive study design was used to evaluate the effect of the tele-nephrology clinic intervention. Multiple clinical indicators were included in the analysis: blood pressure (BP) control, stabilization of the renal function, and electrolyte/metabolic control. One hundred one patients who were evaluated in the clinic between 2013 and 2015 were included in the analysis, and the indicators were collected retrospectively. Results: One hundred one patients were included in the analysis, with 95% of patients being male (n = 96) and 5% female (n = 5). The mean age was 65.5 years. Fifty patients had chronic kidney disease (CKD) stage III (49.5%), 14 patients had CKD stage IV (13%), and 8 patients had CKD stage II (7.9%). A one-way analysis of variance between subjects was conducted and showed that the effect of the tele-nephrology clinic intervention on reducing BP was statistically significant (systolic BP less than 140 p value <0.0001). Renal function stabilized but the creatinine changes over time were not statistically significant (p value: 0.50). Potassium showed a significant improvement in this sample (p value: 0.0076). Phosphorous and bicarbonate did not show a statistically significant improvement (p value 0.79 and 0.91, respectively). Conclusion: With the tele-nephrology clinic intervention, we were able to effectively improve BP and stabilize renal function in patients with kidney disease who reside in underserved areas.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 650-654 |
| Number of pages | 5 |
| Journal | Telemedicine and e-Health |
| Volume | 22 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2016 |
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Keywords
- care
- CKD
- electrolytes
- hypertension
- telenephrology
ASJC Scopus subject areas
- Medicine(all)
- Health Informatics
- Health Information Management
Cite this
Tele-Nephrology : A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas. / Ladino, Marco A.; Wiley, Joslyn; Schulman, Ivonne H; Sabucedo, Alberto J.; Garcia, Desiree; Cardona, Jose M.; Valdes, Alejandro; Pedraza, Fernando; Echeverri, Roberto J.
In: Telemedicine and e-Health, Vol. 22, No. 8, 01.08.2016, p. 650-654.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Tele-Nephrology
T2 - A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas
AU - Ladino, Marco A.
AU - Wiley, Joslyn
AU - Schulman, Ivonne H
AU - Sabucedo, Alberto J.
AU - Garcia, Desiree
AU - Cardona, Jose M.
AU - Valdes, Alejandro
AU - Pedraza, Fernando
AU - Echeverri, Roberto J.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: The Miami VA Healthcare System serves veterans in three South Florida counties: Miami-Dade, Broward, and Monroe, with an estimated veteran population of 175,000. To overcome geographical barriers and facilitate the access to nephrology clinics, we implemented provider-patient tele-nephrology using secured videoconferencing. Methods: A retrospective and descriptive study design was used to evaluate the effect of the tele-nephrology clinic intervention. Multiple clinical indicators were included in the analysis: blood pressure (BP) control, stabilization of the renal function, and electrolyte/metabolic control. One hundred one patients who were evaluated in the clinic between 2013 and 2015 were included in the analysis, and the indicators were collected retrospectively. Results: One hundred one patients were included in the analysis, with 95% of patients being male (n = 96) and 5% female (n = 5). The mean age was 65.5 years. Fifty patients had chronic kidney disease (CKD) stage III (49.5%), 14 patients had CKD stage IV (13%), and 8 patients had CKD stage II (7.9%). A one-way analysis of variance between subjects was conducted and showed that the effect of the tele-nephrology clinic intervention on reducing BP was statistically significant (systolic BP less than 140 p value <0.0001). Renal function stabilized but the creatinine changes over time were not statistically significant (p value: 0.50). Potassium showed a significant improvement in this sample (p value: 0.0076). Phosphorous and bicarbonate did not show a statistically significant improvement (p value 0.79 and 0.91, respectively). Conclusion: With the tele-nephrology clinic intervention, we were able to effectively improve BP and stabilize renal function in patients with kidney disease who reside in underserved areas.
AB - Background: The Miami VA Healthcare System serves veterans in three South Florida counties: Miami-Dade, Broward, and Monroe, with an estimated veteran population of 175,000. To overcome geographical barriers and facilitate the access to nephrology clinics, we implemented provider-patient tele-nephrology using secured videoconferencing. Methods: A retrospective and descriptive study design was used to evaluate the effect of the tele-nephrology clinic intervention. Multiple clinical indicators were included in the analysis: blood pressure (BP) control, stabilization of the renal function, and electrolyte/metabolic control. One hundred one patients who were evaluated in the clinic between 2013 and 2015 were included in the analysis, and the indicators were collected retrospectively. Results: One hundred one patients were included in the analysis, with 95% of patients being male (n = 96) and 5% female (n = 5). The mean age was 65.5 years. Fifty patients had chronic kidney disease (CKD) stage III (49.5%), 14 patients had CKD stage IV (13%), and 8 patients had CKD stage II (7.9%). A one-way analysis of variance between subjects was conducted and showed that the effect of the tele-nephrology clinic intervention on reducing BP was statistically significant (systolic BP less than 140 p value <0.0001). Renal function stabilized but the creatinine changes over time were not statistically significant (p value: 0.50). Potassium showed a significant improvement in this sample (p value: 0.0076). Phosphorous and bicarbonate did not show a statistically significant improvement (p value 0.79 and 0.91, respectively). Conclusion: With the tele-nephrology clinic intervention, we were able to effectively improve BP and stabilize renal function in patients with kidney disease who reside in underserved areas.
KW - care
KW - CKD
KW - electrolytes
KW - hypertension
KW - telenephrology
UR - http://www.scopus.com/inward/record.url?scp=84981342165&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84981342165&partnerID=8YFLogxK
U2 - 10.1089/tmj.2015.0197
DO - 10.1089/tmj.2015.0197
M3 - Article
C2 - 26974738
AN - SCOPUS:84981342165
VL - 22
SP - 650
EP - 654
JO - Telemedicine and e-Health
JF - Telemedicine and e-Health
SN - 1530-5627
IS - 8
ER -