Journal article
Development and implementation of a Telenephrology dashboard for active surveillance of kidney disease: a quality improvement project
BMC nephrology, Vol.21(1), pp.424-424
10/06/2020
DOI: 10.1186/s12882-020-02077-0
PMCID: PMC7539521
PMID: 33023489
Abstract
Background Kidney disease accounts for more than 49 billion dollars in healthcare expenditures annually. Early detection and intervention may reduce the burden of disease. We describe a quality improvement project to develop a telenephrology dashboard that proactively monitors kidney disease. Methods One hundred eighty-four thousands Veterans within the Iowa City Veterans Affairs Health Care System were eligible for telenephrology consultation. The dashboard accessed the charts of 53,085 Veterans at risk for kidney disease. We utilized Lean-Six Sigma tools and principles and the Define-Measure-Analyze-Improve-Control Framework to develop and deploy a telenephrology dashboard in 4 community-based outpatient clinics (CBOCs). The primary measure was the number of days to complete consultation. Secondary measures included number of electronic consultations per month, distance and cost of Veteran travel saved, and number of steps for completion of consult. Results The data of 1384 Veterans at the 4 CBOCs were analyzed by the telenephrology dashboard, of which 459 generated telenephrology consults. The number of days to complete any type of consultation was unchanged (48.9 days in 2019, compared to 41.6 days in 2017). The average Veteran saved between $21.60 to $63.90 per trip to Iowa City. Between March 2019 and August 2019, there were 27.3 telenephrology consults per month. The number of steps needed to complete the consult request was decreased from 13 to 9. Conclusions Utilization of the telenephrology dashboard system contributed to an increase in consultations completed through electronic means without decreasing face-to-face consults. Electronic consults now outnumber traditional face-to-face consultations at our institution. Telenephrology consultation improved early detection and identification of kidney disease and saved time and costs for Veterans in travel, but did not decrease the average number of days to complete consultation requests.
Details
- Title: Subtitle
- Development and implementation of a Telenephrology dashboard for active surveillance of kidney disease: a quality improvement project
- Creators
- Melissa L. Swee - University of Iowa Hospitals and ClinicsM. Lee Sanders - University of Iowa Hospitals and ClinicsKantima Phisitkul - University of Iowa Hospitals and ClinicsGeorge Bailey - Iowa City VA Health Care SystemAngie Thumann - Iowa City VA Health Care SystemNikki Neuzil - Iowa City VA Health Care SystemBharat Kumar - University of Iowa Hospitals and ClinicsAmy M. J. O'Shea - University of Iowa Hospitals and ClinicsBradley S. Dixon - University of Iowa
- Resource Type
- Journal article
- Publication Details
- BMC nephrology, Vol.21(1), pp.424-424
- DOI
- 10.1186/s12882-020-02077-0
- PMID
- 33023489
- PMCID
- PMC7539521
- NLM abbreviation
- BMC Nephrol
- ISSN
- 1471-2369
- eISSN
- 1471-2369
- Publisher
- Springer Nature
- Number of pages
- 10
- Grant note
- Office of Rural Health, Veterans Affairs Health Care System
- Language
- English
- Date published
- 10/06/2020
- Academic Unit
- Nephrology; Immunology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984359691102771
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