Telehealth in Peritoneal Dialysis: Review of Patient Management

Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telemedicine is the use of electronic communications for the exchange of medical information from one site to another to improve a patient's clinical health status.Several studies show that, by providing better patient oversight and communication, telehealth in PD enhances patient care, outcomes, quality of care, and satisfaction. Associated benefits include increased patient retention to home dialysis, reduced use of hospital services, and reduced costs of care.The sustainability of telehealth had been limited by reimbursement and regulatory restrictions. The Centers for Medicare and Medicaid Services (CMS) limited services related to end-stage renal disease by providing reimbursement for telehealth only in rural areas or counties outside of a metropolitan statistical area. Moreover, the dialysis facility and the patient's home were not approved as originating sites. However, effective January 1, 2019, those restrictions will be lifted. Telehealth will require that home dialysis patients be established with 3 initial face-to-face monthly clinical assessments without the use of telehealth; after those initial 3 months, a face-to-face visit at least once every 3 consecutive months will be required. Claims can be submitted using designated Current Procedural Terminology codes and modifiers.The actual extension of telehealth to home dialysis patients will depend on the details of forthcoming CMS regulations.