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Initial implementation of a web-based consultation process for patients with chronic kidney disease
Nynke D Scherpbier-de Haan1, Vincent A van Gelder, Chris Van Weel
1Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. n.scherpbier@elg.umcn.nl
Annals of Family Medicine
|March 20, 2013
Summary
Telenephrology, a web-based system, significantly reduces unnecessary in-person referrals for chronic kidney disease patients. This technology enhances primary care by providing remote specialist support, improving healthcare efficiency.
Area of Science:
- Nephrology
- Digital Health
- Health Services Research
Background:
- Chronic kidney disease (CKD) management often involves specialist referrals.
- Primary care physicians (PCPs) may benefit from remote specialist support for CKD patients.
- Telenephrology offers a potential solution for efficient CKD care coordination.
Purpose of the Study:
- To assess the potential of telenephrology to reduce in-person referrals from family physicians to nephrologists.
- To evaluate the usability and effectiveness of a web-based consultation system for CKD management.
Main Methods:
- An observational, prospective study analyzed telenephrology consultations in the Netherlands.
- Data from 28 family practices and 5 nephrology departments (May 2009-August 2011) were examined.
- Primary outcome: difference between intended and requested referrals; Secondary outcomes: system usability and response time.
Main Results:
- Telenephrology reduced intended referrals from 35.3% to 13.9% (P <.001).
- Nephrologists deemed referral necessary for only 10 of 79 patients initially managed in primary care.
- System usability was high: <10 minutes per consultation, 1.6-day response time.
Conclusions:
- Web-based telenephrology systems are usable and can significantly decrease referral rates.
- Telenephrology facilitates effective primary care management of CKD patients with remote nephrologist support.
- This approach optimizes health facility utilization and patient care delivery.
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