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TELEHEALTH HELPS HOME DIALYSIS RATES Melbourne’s Western Health is running a trial of remote monitoring and video conferencing technology to improve the rates of home dialysis for patients with chronic kidney disease. Better known as the HUG trial, it aims to increase the amount of people dialysing at home, which is cheaper for health services and often more convenient for patients.
KATE MCDONALD Journalist: Pulse+IT kate.mcdonald@pulseitmagazine.com.au
The home therapy utilising telehealth guidance and monitoring (HUG) trial is the brainchild of the head of the nephrology unit at Western Health, Craig Nelson, and is based on similar projects conducted in the UK under its Whole System Demonstrator project. HUG project manager Catherine Blackmore told the Australian Centre for Health Innovation conference in Melbourne recently that the aim of the trial was to increase rates of home dialysis of Western Health patients from 15 per cent to the new benchmark set by the Victorian Department of Health of 30 to 35 per cent. “The rate [of home dialysis] does vary significantly if you look at different states,” Ms Blackmore says. “NSW has one of the highest instances of home dialysis at 38 per cent; Victoria has around 21 per cent but even in Victoria the rates from hospital to hospital vary significantly. “At Western Health, prior to HUG, our take up rates for home dialysis were 15 per cent. The Department of Health has set a KPI of 30 to 35 per cent of patients dialysing at home, so we have a lot of work to do to reach that.” The trial, which started officially in July 2013 with patient recruitment beginning
last April, is using a customised version of Tunstall’s ICP system to collect weight and blood pressure data for each patient. This is reviewed by a renal nurse every weekday, along with video conferencing capability so nurses can assist patients with correct needling and review exit sites for infection or inflammation. So popular has the project been that the nephrology unit’s dietitian is also conducting video conferences with patients in their own homes, remotely looking through their pantries and fridges and discussing foods with the patient, Ms Blackmore says.
Burden of dialysis The aim of the trial is not only to increase the amount of people dialysing at home – which is a far cheaper modality than centre-based dialysis, and is also more convenient for many patients – but also to reduce the number of people coming off home dialysis and returning to centrebased care. “In excess of 40 per cent stop dialysing at home because of social reasons,” Ms Blackmore says. “It’s often not really related to dialysis itself, but the burden of dialysis causing stress in so many aspects of their life. Often it is just too hard.”