LHSC’s telehomecare for peritoneal dialysis patients a Canadian first

In January 2009, London Health Sciences Centre’s (LHSC) Peritoneal Dialysis Unit, in partnership with Baxter Corporation, began a ten month study to determine the feasibility and effectiveness of providing peritoneal home dialysis patients with touch screen technology and access to a health coach, all from the comfort of their home. Study results were analyzed and reported in March 2010, in honour of World Kidney Month.

LHSC’s provision of touch screen technology and health coaches marks a significant change in how care is generally provided by hospitals to peritoneal home dialysis patients and it is the first Canadian hospital to provide these important innovations for this group of patients.

Telehomecare gives patients a feeling of being cared for on a daily basis while also promoting their independence, empowerment and quality of life while on dialysis.

Through the program, a dialysis nurse from LHSC is able to connect with and care for a patient on home dialysis using a telemonitor system installed in the patient’s home when they start home dialysis.

By providing the tools by which patients can identify health concerns and see and speak with their health-care team, patients are able to identify any problems enabling the team to quickly intervene. This helps patients to avoid having to come to the emergency department or be admitted to hospital.

Patients were asked to enter health information, including blood pressure and blood sugar levels, fevers and infections, as well as other general health information, through touch screen technology and linking by computer screen to the peritoneal health-care team at LHSC.

Patient responses were analyzed through a software program and identified as: green – good results; yellow – questionable results; and red – unacceptable results.

Red results meant that the patient required telephone or video contact and if the health issue could not be resolved, the patient would be required to come to hospital.

The study found eight per cent fewer emergency department visits and seventy per cent fewer hospitalizations for the 26 patients involved in the study.

Patients reported positive comments regarding the touch screen technology and the health coach. As a result, the provision of touch screen technology and health coaches will be continued for an additional three to six months, per patient.

Chronic kidney disease (CKD) is growing in Canada. The Kidney Foundation of Canada estimates that two million Canadians have CKD or are at risk. As these rates continue to rise, the importance of early detection, prevention and cost-effective treatment options, including home dialysis therapies, is becoming increasingly important.

LHSC would like to thank Baxter Corporation for their generous support of the study.