Tele-Nephrology: A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas

Marco A. Ladino, Joslyn Wiley, Ivonne H Schulman, Alberto J. Sabucedo, Desiree Garcia, Jose M. Cardona, Alejandro Valdes, Fernando Pedraza, Roberto J. Echeverri

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)650-654
Number of pages5
JournalTelemedicine and e-Health
Volume22
Issue number8
DOIs
StatePublished - Aug 1 2016

Fingerprint

Nephrology
Kidney Diseases
Patient Care
Blood Pressure
Chronic Renal Insufficiency
Veterans
Kidney
Videoconferencing
Bicarbonates
Electrolytes
Creatinine
Analysis of Variance
Potassium
Retrospective Studies
Delivery of Health Care

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 journalArticle

Ladino, MA, Wiley, J, Schulman, IH, Sabucedo, AJ, Garcia, D, Cardona, JM, Valdes, A, Pedraza, F & Echeverri, RJ 2016, 'Tele-Nephrology: A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas', Telemedicine and e-Health, vol. 22, no. 8, pp. 650-654. https://doi.org/10.1089/tmj.2015.0197
Ladino, Marco A. ; Wiley, Joslyn ; Schulman, Ivonne H ; Sabucedo, Alberto J. ; Garcia, Desiree ; Cardona, Jose M. ; Valdes, Alejandro ; Pedraza, Fernando ; Echeverri, Roberto J. / Tele-Nephrology : A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas. In: Telemedicine and e-Health. 2016 ; Vol. 22, No. 8. pp. 650-654.
@article{07ddc48820f04992ad7b1a5b39a2e493,
title = "Tele-Nephrology: A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas",
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.",
keywords = "care, CKD, electrolytes, hypertension, telenephrology",
author = "Ladino, {Marco A.} and Joslyn Wiley and Schulman, {Ivonne H} and Sabucedo, {Alberto J.} and Desiree Garcia and Cardona, {Jose M.} and Alejandro Valdes and Fernando Pedraza and Echeverri, {Roberto J.}",
year = "2016",
month = "8",
day = "1",
doi = "10.1089/tmj.2015.0197",
language = "English (US)",
volume = "22",
pages = "650--654",
journal = "Telemedicine and e-Health",
issn = "1530-5627",
publisher = "Mary Ann Liebert Inc.",
number = "8",

}

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 -