Abstract
The coronavirus disease 2019 (COVID-19) pandemic, technological advancements, regulatory waivers, and user acceptance have converged to boost telehealth activities. Due to the state of emergency, regulatory waivers in the United States have made it possible for providers to deliver and bill for services across state lines for new and established patients through Health Insurance Portability and Accountability Act (HIPAA)- and non–HIPAA-compliant platforms with home as the originating site and without geographic restrictions. Platforms have been developed or purchased to perform videoconferencing, and interdisciplinary dialysis teams have adapted to perform virtual visits. Telehealth experiences and challenges encountered by dialysis providers, clinicians, nurses, and patients have exposed health care disparities in areas such as access to care, bandwidth connectivity, availability of devices to perform telehealth, and socioeconomic and language barriers. Future directions in telehealth use, quality measures, and research in telehealth use need to be explored. Telehealth during the public health emergency has changed the practice of health care, with the post–COVID-19 world unlikely to resemble the prior era. The future impact of telehealth in patient care in the United States remains to be seen, especially in the context of the Advancing American Kidney Health Initiative.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 142-148 |
| Number of pages | 7 |
| Journal | American Journal of Kidney Diseases |
| Volume | 77 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2021 |
Funding
Susie Q. Lew, MD, Eric L. Wallace, MD, Vesh Srivatana, MD, Bradley A. Warady, MD, Suzanne Watnick, MD, Jayson Hood, RN, David L. White, BA, Vikram Aggarwal, MD, Caroline Wilkie, BA, Mihran V. Naljayan, MD, Mary Gellens, MD, Jeffrey Perl, MD, and Martin J. Schreiber, MD. The article was written without grant or pharmaceutical funding. Dr Gellens is an employee of Baxter Healthcare. Dr Naljayan has received speaking honoraria from DaVita Kidney Care and served on advisory boards for DaVita Kidney Care and Baxter Healthcare. Dr Perl has received speaking honoraria from AstraZeneca, Baxter Healthcare, DaVita Healthcare Partners, Fresenius Medical Care, Dialysis Clinics Inc, and Satellite Healthcare, and has served as a consultant for Baxter Healthcare, DaVita Healthcare Partners, Fresenius Medical Care, Otsuka Canada, and LiberDi. Dr Schreiber is Chief Medical Officer, Home Modalities, DaVita Kidney Care. Dr Warady is a Consultant for Bayer, Amgen, Akebia, AstraZeneca, GlaxoSmithKline and has received research support from Baxter Healthcare and honoraria from UpToDate. Ms Wilkie has received stipends from American Society of Nephrology, University of North Carolina, and the University of Pennsylvania. Mr White is an employee of the American Society of Nephrology. Dr Wallace has received honoraria and grants from Baxter Healthcare Corp, NxStage, and Davita Healthcare Partners; has received consulting fees and grants from Sanofi-Genzyme; is a consultant for Avrobio, Freeline Therapeutics, and Amicus; and is involved in clinical trials with Idorsia, Protalix, and Freeline Therapeutics. Dr Watnick is the Chief Medical Officer of Northwest Kidney Centers. The remaining authors declare that they have no relevant financial interests. We thank all the patients who shared their experiences and thoughts about telehealth and Kerry Leigh, BSN, RN, Project Specialist at the American Society of Nephrology, for administrative support. Received July 9, 2020. Evaluated by 2 external peer reviewers, with direct editorial input from an Associate Editor and a Deputy Editor. Accepted in revised form September 10, 2020.
Keywords
- Nephrology
- coronavirus disease 2019 (COVID-19)
- end-stage kidney disease (ESRD)
- home dialysis
- home hemodialysis (HHD)
- peritoneal dialysis (PD)
- public health emergency
- remote monitoring
- telehealth
- telemedicine
ASJC Scopus subject areas
- Nephrology
