Abstract
Enhancing Access to Nephrology Care: Development of a Telenephrology Dashboard via Human-Centered Design: FR-PO1103
Journal of the American Society of Nephrology, Vol.35(10S)
10/2024
DOI: 10.1681/ASN.2024jyh321g6
Abstract
Background:
Chronic kidney disease (CKD) is common and associated with high rates of morbidity and mortality. Despite evidence that early referral to nephrology improves outcomes, it is estimated that less than half of patients with CKD see a nephrologist. We aimed to improve access to nephrology care by developing a user-friendly Telenephrology dashboard for the 40,000 Veterans receiving care through the Iowa City Veterans Affairs Health Care System.
Methods:
The development process adhered to the human-centered design framework, encompassing five phases: (1) Empathize, (2) Define, (3) Ideate, (4) Prototype, and (5) Test. We interviewed patients’ and providers’ regarding perceptions of structural barriers and facilitators for the Telenephrology program, using the Consolidated Framework for Implementation Research (CFIR) as a guide. Data from these interviews were analyzed using directed content analysis. Then, a rapid ideation workshop was convened to generate creative solutions that balance technical requirements with the needs of clinicians and patients.
Results:
The iterative design process identified three critical needs: (1) clarity in visualizing data, (2) accuracy of information, and (3) balancing standardization with individualization. The final Telenephrology Dashboard developed through the rapid ideation workshop included: (1) a graph of kidney function over time, (2) tables synthesizing lab data, (3) options to drill down events to specific times, (4) customization of views, and (5) integration of kidney disease progression models. Since the inception of the Telenephrology program in 2018, clinic productivity has increased and wait times have decreased.
Key facilitators identified in interviews included increased access to specialist care and convenience for providers and Veterans. Perceived barriers included: concerns of decreased autonomy and increased workload for primary care providers, added complexity, and lack of sustainability.
Conclusion:
Telenephrology increases nephrology access and convenience. Nevertheless, future challenges include concerns around primary care autonomy, workload, and system complexity. Ongoing research is needed to validate the impact of Telenephrology on patient outcomes and physician satisfaction and effectiveness.
Details
- Title: Subtitle
- Enhancing Access to Nephrology Care: Development of a Telenephrology Dashboard via Human-Centered Design: FR-PO1103
- Creators
- Melissa L. Swee - Iowa City VA Health Care SystemDiana I. Jalal - University of IowaM. Lee Sanders - Iowa City VA Health Care SystemMary Vaughan Sarrazin - University of IowaAngie R. Thumann - Iowa City VA Health Care SystemKantima Phisitkul - Iowa City VA Health Care SystemMasaaki Yamada - University of IowaHeather Reisinger - Iowa City VA Health Care SystemBradley S. Dixon - Iowa City VA Health Care System
- Resource Type
- Abstract
- Publication Details
- Journal of the American Society of Nephrology, Vol.35(10S)
- Publisher
- AMER SOC NEPHROLOGY
- DOI
- 10.1681/ASN.2024jyh321g6
- ISSN
- 1046-6673
- eISSN
- 1533-3450
- Grant note
- NIDDK
NIDDK Support, Private Foundation Support
- Language
- English
- Date published
- 10/2024
- Academic Unit
- General Internal Medicine; Internal Medicine; Health Management and Policy; Nephrology; Center for Social Science Innovation
- Record Identifier
- 9984738878402771
Metrics
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