PracticeUpdate Conference Series ISN WCN 2019

Follow-Up Telehealth Service Saves Significant Money, Time for Kidney Transplant Patients Environmental impact is also substantial, with the equivalent of 7.9 trips around the world avoided.

S ignificant time, cost and environmental savings have been found with the use of telehealth follow-up for patients who received a kidney transplant, according to new research. In response to a growing kidney transplant population, including many patients from rural and regional areas a long distance away, the Royal Melbourne Hospital in Melbourne, Victoria, began exploring alternative options to face-to-face appointments. “Seeing patients at our hospital for routine follow up imposes a time and cost significant burden on them and also on our service. It also leads to substantial travel-related emissions, which is a problem in the face of climate change,” Katherine Barraclough, MD, PhD, of the Royal Melbourne Hospital, told Elsevier’s PracticeUpdate . “All of these problems can potentially be addressed via using telehealth for consultations,” she noted. " Patients were overall very happy with the care they received via telehealth, with not one patient opting to return to face-to-face care. No patient safety issues were identified. " Dr. Katherine Barraclough

In 2016, the Kidney Transplant Unit at the Royal Melbourne Hospital, which performs more than 140 transplant operations each year, launched a follow-up telehealth service for transplant patients who did not have access to local nephrology services. In some cases, follow-up video consultations were conducted in conjunction with family doctors or nurses in the local community. In other cases, patients connected directly from their home, work or other location of choice. “We found that by using telehealth for patient review appoint- ments, we prevented patients travelling significant distances – equivalent to 7.9 trips around the world – which in turn saved them time and money. It also averted substantial greenhouse gas emissions,” said Dr. Barraclough, who is chair of the Victorian Nephrology Environmental Sustainability Special Interest Group and the Australian and New Zealand Society of Nephrology Green Nephrology Action Team. FromMay 11, 2016, to November 7, 2018, a total of 385 telehealth reviews were conducted involving 63 transplant patients. Over the course of the study, the number of reviews conducted via telehealth increased substantially from 172 in 2016 and 2017 to 213 in 2018. The majority of patients using the telehealth service were at least 50 years of age, but all age groups were represented in the study (8.9% = 18–30 years; 14.4% = 31–40 years; 21.1% = 41–50 years; 29.9% = 51–60 years; 19.2% = 61–70 years; 6.6% = 70+ years). In all, 30 patients were followed with the support of their local healthcare provider; the remainder joined video calls on their own. With respect to environmental considerations, the research team determined that, for kidney transplant patients in the study, the use of telehealth saved 314,292 km in travel distance, 5272 hours of car travel time, $42,876 in gasoline costs, and 78.8 tones of C0 2 equivalents in greenhouse gas emissions. “Patients were overall very happy with the care they received via telehealth, with not one patient opting to return to face- to-face care. No patient safety issues were identified,” said Dr. Barraclough. The research team is currently in the process of formally sur- veying patients to assess their experience and examine clinical outcomes. A formal survey of all patients at the Royal Melbourne Hospital who had used telehealth over the first 6 months of 2018 showed that 95% of respondents felt they had received the same standard of care as they would have in a face-to-face consultation. Approximately 85% indicated that the telehealth appointment had helped them better understand their condition. The use of telehealth for follow-up review could have wider application for patients, said Dr. Barraclough. “It holds enormous potential for improving access, saving time and costs, and reduc- ing the environmental impact of care delivery.

www.practiceupdate.com/c/82733

PRACTICEUPDATE CONFERENCE SERIES • WCN 2019 16