How Nephrology is keeping up with technology
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Conceived before I came to Nephrology Administrative hurdles First visit September 2014
How in the World? COW/TOW Presenter takes in front of each dialysis chair Review BPs, weights, meds, issues Visit Examine
Blood pressures and weights are given by presenter (to save time) Heavily rely on presenter More difficult to hear
Weekly visits Monitor more closely Intervene early
Doubled Sheridan dialysis patient visits & doubled Nephrology telemed visits Reimbursement based on # of visits/mo 1 visit $364 / pt 2-3 visits $504 / pt 4 visits $625 / pt
Privacy Patient perception Patients in chair, limits exam Initially - organization, something new (RN) Scheduling
CE 64 yo female w/ ESRD 9/17/14 dx w/ calciphylaxis as inpatient, started on sodium thiosulfate Discharge 9/20/14 First telemed 9/24/14 10/15/14 worsening pain, lesions, overall health. Spoke with PCP Dr. Hunter 11/6/14 admitted with progression, started on Pamidronate D/C 12/04/14 Telemed 12/8/14 12/15/14 comfort care
LP 66yo gentleman w/ ESRD due to atherosclerosis 11/17/14
LH
Trained in Baltimore, MD. (12,406 sq miles) Montana 147,000, Wyoming 97,818 How can you use telemedicine or other technologies to better serve your patients? Just because no one has done it doesn’t mean it can’t be done!