While saving millions of dollars for the health-care system is important, improving quality of life for at-home dialysis patients is the utmost focus of a new study led by Department of Medicine professor Arsh Jain.
“Patients on in-home dialysis are not required to visit a clinic or hospital every day, and so experience more freedom,” said Jain, a Lawson Health Research Institute scientist. “The main reason patients leave in-home dialysis is because they feel isolated from their care team. With this new technology, patients and health professionals will be connected on a daily basis.”
Multiple funding bodies recently awarded Jain and his team $1.5 million, over three years, to improve in-home dialysis using eHealth technology.
Dialysis is the daily process used to remove waste from the blood when failing kidneys can no longer do so. While this can be done at home by the patient, they often choose to return to the clinical setting as a sense of disconnection from their care team grows.
Jain’s study will use a tele-home monitoring system to improve the patient experience. Beginning next month, research will give approximately 500 in-home dialysis patients across southwestern Ontario a mobile tablet with an application to track vital information on a daily basis, including weight, blood pressure and fluid amounts. The tablet will transmit this information instantly to the patient’s care team who can then determine if there are any concerns.
“In terms of quality of life, it’s better for people who do dialysis at home because they can travel, they can work,” Jain said. “But when they do it for a while, and if feelings of isolation builds over time, we have ways of helping with that. This idea here is not just to prevent the feelings of isolation, but give someone that same attention as if they were here in hospital. If we can give them attention, they will feel more comfortable at home and will want to stay home for longer.”
Patients who do at-home dialysis still go to hospital on a monthly basis for check-ups. However, with health professionals monitoring patients’ information on a daily basis, the care team can make proactive care decisions, rather than intervening at monthly appointments or, worse, when problems arise.
“When patients come back to the hospital, they get assessed. We are able to see their data at that point in time. Any problems that had happened in the last month or two, we wouldn’t have noticed until they came in,” Jain said. “Now we can intervene a little more quickly. Instead of you needing to come every month, we can even extend that out to two months, perhaps.”
The tablet and specially designed app helps patients manage their equipment inventory, delivers notifications from the patient’s care team and integrates two-way video and photo messaging. Jain’s three-year study hopes to reduce hospitalizations, infection rates and patient transfers from in-home dialysis to clinical-setting dialysis.
“This solution has the potential to improve the patient experience and create health system savings,” he said, adding he is thrilled to see health care embrace new technology for its patients. “There have been so many industries where technology has really improved efficiency. But in health care, that really hasn’t happened as of yet. This should be the field where it’s more important. The concept is simple – in-home dialysis is significantly less expensive than dialysis in a clinical setting. If we can improve the experience and comfort of these patients, it will have a big impact.”
Jain’s research is funded through the Canadian Institutes of Health Research (CIHR) eHealth Innovations Partnership Program, Baxter CEC (peer-reviewed grant), the Ontario Telemedicine Network with Canada Health Infoway, the Ontario Centres for Excellence and the Ontario Renal Network.