UPDATE ON HOW TELEHEALTH REVOLUTIONISED RENAL HEALTHCARE DELIVERY IN WAIKATO HOSPITAL, NEW ZEALAND

E TAN 1,2, T JENNINGS 2. K RABINDRANATH 1,2

1Regional Renal Unit, Waikato Hospital, Hamilton, New Zealand), 2Whakatane Hospital, Bay of Plenty DHB, New Zealand

Aim: To describe how telehealth impacted on renal healthcare delivery

Background: The Waikato renal unit uses the hub-and-spoke model to cover vast catchment areas. Both staff and patients regularly travel huge distances for clinics, meetings and education. This is time-consuming, expensive and unsustainable. With an ever-growing renal service, innovative and cost-effective solutions are necessary.

Methods: Telehealth was phased-in gradually, using secure, encrypted electronic platforms: Cisco-Jabber (facilitates virtual hospital-to-hospital video clinics, with outreach nurse acting as physician’s proxy in examining patients) and SmartHealth (HealthTap: facilitates video consultations with patients at home). These expanded to monthly results review, telephone clinics, virtual dialysis ward rounds, impromptu consults and urgent patient-family meetings. The whole renal department rapidly adopted telehealth (dietitians, transplant co-ordinators, pre-dialysis nurses, social workers and dialysis technicians) for many activities (consults, education, departmental meetings, virtual home visits, home assessments and problem-solving). Feedback questionnaires were also sent out.

Results: There were huge time-savings and cost-savings, with minimal carbon footprint impact; Cisco-Jabber increased outreach clinic capacity whilst SmartHealth allowed home consultations. Travel was reduced, including unnecessary physical home visits. The video facility flexibly enabled impromptu consultations, meetings (including palliative end-of-life discussions with dialysis patients) and problem-solving (particularly with dialysis equipment malfunction). Another unexpected benefit is the clinical upskilling of satellite-based nurses. Patient and staff feedback was excellent.

Conclusions: Renal telehealth is phenomenally successful and has revolutionised renal healthcare delivery. Improved access to physicians reduced satellite units’ vulnerability. Telehealth improved patient care (improved all-round communications led to better care continuity) and improved work efficiency and environment for staff.

Discussion: Future plans include increasing virtual renal outpatients to 30%. New technological advancements include: mobile Cisco-Jabber, electronic prescribing and electronic pathology-investigations ordering.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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