The nephrology field supports many patients with chronic kidney disease (CKD), renal failure, and other kidney disorders. These are complex conditions that typically correlate with comorbidities of diabetes, high blood pressure, and obesity. As a result, there is much to manage to ensure the best clinical outcomes. Monthly appointments usually won’t suffice in gathering vitals data to inform treatment plans. This specialty has become a significant adopter of remote care. The benefits of remote patient monitoring for nephrology extend care beyond the practice walls.
How does RPM support nephrology patients?
Remote patient monitoring provides an opportunity for nephrologists to gain insight into their patient’s daily vitals. These readings paint a more vivid picture of the day-to-day health of patients. They can include:
- Blood pressure: Monitoring this enables better management of hypertension and can be a key predictor in kidney disease progression.
- A1C: Many with CKD also have diabetes, and tracking their glucose is critical in managing the disease.
- Weight: When patients weigh on connected scales, physicians can trace any changes. It’s important for CKD patients because weight gain could indicate fluid buildup.
Even monthly visits to the clinic are not sufficient in understanding the patient’s management of their kidney diseases.
Research and data support these conclusions. CKD is very common in the U.S., affecting approximately 14% of the population. According to the Centers for Disease Control and Prevention (CDC), up to 90% of these people don’t even know they have it. When they do receive a proper diagnosis, it’s often a race to control and manage.
Implementing RPM for kidney disease has proven to have positive outcomes.
Some data points on this include:
- At-home blood pressure monitoring outperformed in-office for predicting kidney disease progression and improving blood pressure control.
- RPM blood pressure monitoring provides hypertension management for those with CKD and acts as an accurate predictor of organ damage.
- Peritoneal patients using RPM reduced hospitalization rate and days.
- RPM can improve outcomes for early-stage renal disease (ESRD) patients by strengthening the continuity of care by monitoring blood pressure, glucose, and weight.
Find more research on CKD and RPM in this resource guide.
Filling the gaps with RPM
RPM supports diagnoses, treatment compliance, improved outcomes, and greater physician visibility. It’s also an excellent gap filler in the area of kidney care to bridge:
- Poor care transition: Coordinating care for different stages of kidney disease can include many clinicians and systems. RPM vital data keeps all care team members in the know.
- Patient education disconnects: Kidney disease and its treatments are complex, and not all patients will have high health literacy. Regular two-way communication as part of RPM can improve this.
- Ineffective management of comorbidities: As noted, kidney disease patients have multiple health concerns, and RPM can monitor all of these.
Remote patient monitoring offers a new horizon for caring for nephrology patients, and it begins with easy-to-use connected devices
Connected devices and consistent vitals data for nephrology RPM
By using patient-friendly remote patient monitoring devices, care teams can track vitals. These data collectors are simple for patients to use, especially when they use cellular connectivity. These devices are ready to go out of the box with no extra steps.Patients take readings daily, and the devices sync those back to your RPM software.
Readings outside of a predefined threshold can initiate alerts, which clinical teams monitor. Regular information on vitals enables greater knowledge about the disease, and insights into it can lead to adjusted treatment plans.
Cellular connectivity is the most stable option for connected devices.
RPM devices can use cellular connectivity or Bluetooth, with the former being more reliable and requiring less work for patients. Bluetooth also needs “pairing” between devices and more complicated configurations. Cellular devices enable real-time data collection and transmission to your dashboard.
Users also don’t need smartphones or apps, which Bluetooth requires.
RPM device data collection: secure and compliant
With any type of healthcare data, there is always the concern of security and compliance. Vitals data transfer occurs via the internet and adheres to all security and compliance requirements relating to patient data. RPM devices used all have FDA (Food and Drug Administration) approval, which mandates security protocols as well as HIPAA compliance.
RPM devices for nephrology use
Nephrology specialists can recommend multiple devices to monitor the vitals of kidney condition patients, including:
- Blood pressure monitoring: Hypertension is a leading factor in kidney disease, witnessed in many stages of kidney disease. By monitoring daily blood pressure readings, care teams can track if patients stay within normal thresholds. Managing blood pressure is the leading way to control kidney disease, and RPM enables this.
- Blood glucose trackers: Glucose monitoring is critical in determining how efficiently the kidneys are working, especially for those on dialysis. These readings indicate the success of the treatment.
- Weight scales: Obesity is another component of kidney disease, and carrying extra weight is hard for those with these conditions. If weight management is part of the care plan, tracking the results with daily weigh-ins can support adherence.
The combination of these devices, a robust RPM platform, and clinical monitoring deliver substantial benefits for patients and care teams.
Remote patient monitoring benefits for nephrology
There is a clear connection between RPM and improved outcomes for those with kidney disease. The benefits of remote patient monitoring guide a proactive approach to treatment and management.
1. Increase the number of patients using peritoneal dialysis.
Peritoneal dialysis requires oversight since it doesn’t occur in clinic. It accounts for only 13.4% of dialysis in the U.S., which was a small increase driven by the pandemic. Yet, it has advantages for patients and the healthcare system over hemodialysis and is widely available.
Peritoneal dialysis can expand care options for those living in remote or rural communities experiencing healthcare deserts. It has a substantially lower cost and doesn’t require clinical teams.
For patients, having this alternative allows for greater freedom to travel, less medication, and fewer dietary restrictions. Overall, kidney function can improve, and many people have a higher quality of life with a “survival advantage” to end-stage kidney patients.
So, why is there such low utilization? First, there’s the challenge of non-adherence. A study determined this varied but could be as great as 53% for dialysis exchanges, 85% for medication, and 67% for diet/fluid restrictions.
Physicians also have concerns over not having insights into the treatment as they would if it occurred on-site. They also worry about patient safety without oversight. RPM enables this visibility with regular monitoring and patient education. It can also improve treatment compliance.
Clinical studies have linked RPM with positive results for peritoneal dialysis patients. Some results included reductions in the rate of hospitalization, patient drop-out, technique failure, episodes of medication non-adherence, and time spent on therapy management.
2. Gather data seamlessly to drive better patient outcomes.
Remote patient monitoring is the key to complete visibility. Treating CKD patients is for a lifetime. The more information you have, the better decisions you can make about care plans. Remote monitoring creates a safety net for at-risk patients and expands care beyond the office visit. Make more informed decisions based on consistent vital readings that lead to a better quality of life for those with chronic kidney conditions.
3. Improve care coordination.
Kidney disease patients may have an expansive care team, and coordination and continuity of care are essential for the best outcomes. Since RPM readings sync to patient records, the data would be available to all stakeholders. These insights offer information on the key vitals that correspond to their conditions. This clarity would be unattainable if physicians have only the feedback from patients on their symptoms and health.
4. Act on critical vital readings immediately to intervene and mitigate emergency care.
Escalation workflows bring the patients who need immediate help directly to physicians with notifications. Optimize Health data concludes that 8% of patients monitored have a daily escalation for which additional clinical attention can replace emergency room visits.
Other data supports RPM’s ability to limit emergency department (ED) visits. One-quarter of healthcare organizations said RPM reduces ED instances and readmissions. A review of 91 studies on RPM and its impact on acute care concluded that 49% reported decreases in ED visits.
In the case of Kentucky Cardiology, RPM helped them keep patients out of the ED. Physicians were able to intervene more quickly to make medication adjustments. Another case study featuring Kidney Disease Consultants revealed similar results, as they experienced a 30% decrease in hospitalizations.
An escalation workflow works like this:
- Each patient has his or her own threshold for vitals.
- Clinical monitoring nurse teams track all patients, review readings, and contact patients to gather more information.
- If the readings are critical, the clinical team escalates that to attending clinicians.
- Physicians then deliver instructions to the patient, such as recommending they take medication, titrate dosage, or come to the office.
The immediate connection with patients through RPM helps keep them calm and focused with directives. Without this, they’d most likely head to the ED.
5. Reduce the costs in the entire healthcare system for kidney disease patients.
In 2021, 13.5% of Medicare fee-for-service (FFS) beneficiaries aged 66 years and older had a diagnosis of CKD. Yet, they accounted for about one-quarter of total Medicare FFS spending for this age group. Hospitalization expenditures grew, as did prescription drug costs. The CDC states that Medicare CKD costs were $87.2 billion, with an additional $37.3 billion for those with end-stage renal disease.
Could RPM shrink these numbers? It’s already proven to be a way to mitigate emergency care, which is the most expensive setting. Further, RPM’s ability to monitor those using peritoneal dialysis drives better health management. Plus, immediate inventions can eliminate many unnecessary hospitalizations.
It could be the difference between low- and high-risk outcomes. A study looked at the difference in expenditures for CKD patients at higher and lower risk of progression. Costs included hospital admissions, physician visits, and medication. Those at higher risk cost the health system $89,265 versus $48,374 for lower risk. A key component of lower risk would be using RPM to monitor vitals, intervene before emergency care is necessary, and make more data-driven decisions.
6. Understand the progress and effectiveness of treatments.
Since there are many stages of kidney disease, progression is a metric that nephrologists must take into consideration. Regular vital readings can track this reliably and provide indications of if a patient has moved to a new stage. It enables physicians to begin updating and reworking care plans to account for this progress.
It’s also a key indicator of treatment effectiveness, especially for peritoneal dialysis. It can also shed light on medications they are taking for hypertension or lowering A1C. Amassing all these data points helps nephrologists connect all the dots.
7. Boost patient engagement.
Research supports that RPM has an influence on patients being more involved in their care. Patient engagement is central to their well-being. Nephrology specialists who implement RPM can actively track vitals and increase touchpoints. Clinical monitoring teams can communicate daily with patients with reminders to take their readings and medication. For those on dialysis, it serves as another education channel, too.
Patients who have found it difficult to keep up with frequent follow-ups and complex treatment regimens now have easier ways to engage in their health.
8. Monitor multiple conditions.
Nephrology patients are more likely to have several conditions that impact their kidneys, including hypertension, obesity, and diabetes. By providing connected devices to monitor all those things, nephrologists have access to more data and can intervene immediately if any of these vitals spike. It’s a proactive approach to managing all the drivers of kidney disease.
9. Bolster telehealth effectiveness with RPM.
RPM greatly supports nephrology practices using telehealth to provide more equitable health access. The Centers for Medicare and Medicaid (CMS) allow telehealth and RPM reimbursement for CKD and ESRD. Using them together for diagnosing and managing kidney disease enables nephrologists to gain more knowledge of a patient’s progression and response to treatment. When they have telehealth visits, physicians already have an analysis of vitals to discuss with patients.
The benefits of remote patient monitoring for nephrology are life-changing.
With RPM as another tool for physicians, the results can be life-changing for you and your patients. You’re creating an ecosystem of data that improves patient outcomes and helps them manage their kidney condition with knowledge and empowerment. As a result, quality of life and expectancy can increase.
With a streamlined RPM program that includes robust software, cellular-connected devices, and clinical monitoring by licensed nurses, the possibilities for remote care are significant. Your practice doesn’t have to take on any new burdens with an RPM partner like Optimize Health.
In addition, we help with insurance eligibility verification, patient enrollment, and supply of RPM devices. Welcome to a world of simple and transformative RPM solutions to achieve all these benefits and more.
Get started by requesting a demo of our solution from our RPM experts.
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