K BARRACLOUGH1,2, N ANDREW1, P HUGHES1,2
1Department of Nephrology, The Royal Melbourne Hospital (RMH), Parkville, VIC, Australia, , , 2University of Melbourne, Parkville, VIC, Australia, ,
Aim: To describe the experience of employing telehealth for routine follow-up of regional KTxRs.
Background: Kidney transplant recipients (KTxRs) require regular follow-up. For regional patients, this results in loss of time and costs travelling to a tertiary service. The utility of telehealth has been highly researched in some fields. However, only limited data exist regarding its use in KTxRs.
Methods: In 2016, the Royal Melbourne Hospital Renal Transplant Unit initiated a telehealth service for follow-up of regional KTxRs without access to local nephrology services. Initially, only those requiring frequent review early post-transplantation were considered. However, over time, all regional KTxRs were offered the opportunity. Generally, telehealth reviews were alternated with in-person reviews. Consultations were conducted via an audio webcam using a computer, tablet or phone. In some cases, the review was conducted in conjunction with the patient’s local general practitioner or nurse, while other patients connected directly from their home or workplace.
Results: To date, 230 telehealth reviews have been conducted for 45 regional patients. This has saved 189,005 kilometres in travel distance (equivalent to 4.7 trips around the circumference of the world); 2621 hours (109 days) of car travel time (equivalent to $28,880 petrol savings); and 57.6 tonnes C02 equivalents of greenhouse gas emissions (equivalent to planting 1229 seedling trees and growing them for 10 years). Informal patient feedback has been universally positive. No patients have opted to return to in-person reviews. No patient safety issues have been observed.
Conclusion: Telehealth follow up of KTxRs represents an innovative patient centred approach to care that leads to significant time, cost and environmental savings. Research formally surveying the patient experience and examining clinical outcomes is underway.
Katherine Barraclough is a Consultant Nephrologist at the Royal Melbourne Hospital in Melbourne. Her primary research interests include individualization of immunosuppression in kidney transplantation, Indigenous Australian renal health and disease and environmental sustainability within the health care system.