Infectious Disease

The telemedicine platform allows the kidney transplant course of to proceed throughout a pandemic

December 30, 2020

2 min read

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Researchers at the Medical University of South Carolina have developed a telehealth platform that they believe is successful in ensuring the kidney transplant process continues during the COVID-19 pandemic.

“The outbreak of the COVID-19 pandemic brought about drastic and abrupt changes in health care in the United States.” Vinayak S. Rohan, MD, FACS, the Department of Transplant Surgery at the institution, and colleagues wrote. “In South Carolina, patient access to non-urgent care was severely restricted and the outpatient clinics traditionally used to assess kidney transplants were closed. Therefore, there was an urgent need to improvise a new COVID-19 compliant process for evaluating patients for possible kidney transplants. “

Telehealth

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As part of the virtual health platform, the researchers first examined the patients after reviewing the medical records and divided them into three risk stratification groups with the names red, green or yellow. Patients in the “red” group were those who were the least likely to have a transplant due to illness or who were likely to need additional testing, while patients in the “green” group were the ones who were likely to have a transplant and it would be little need additional testing. The “yellow” group consisted of patients who were already on a waiting list at another center and therefore would likely only need minimal testing. These patients were “accelerated” or accelerated by the virtual evaluation.

Virtual visits were then planned, followed by a visit to the clinic 2 weeks later.

“During this visit, the APP [advanced practice provider] arranges the test based on the patient’s preferences and documents the next step for the patient, which is forwarded to the coordinator via the electronic patient record, ”the researchers wrote. Once the additional test is completed, a personal visit to the patient is scheduled. The second visit is a personal appointment with the nephrologist or surgeon. This visit ensures the patient receives all necessary pre-transplant training and lists laboratories and regulatory records. The patient’s case will then be submitted to the selection committee the following week to determine if it is ready for listing. “

According to Rohan and colleagues, 1,258 patients completed an evaluation between April and September (247 were “paused” before a full evaluation was completed).

Of those who completed a full assessment, 152 were submitted to the selection committee and 113 were placed on the waiting list.

The results of a retrospective analysis indicated that the telehealth platform was able to effectively continue the transplant process. A 46% reduction was seen in patients in the active referral phase. In addition, more assessments were carried out within the virtual platform than before the pandemic (930 versus 880). This led to similar additions to the 2020 waiting list compared to the 2019 waiting list.

“Thanks to the platform, we can grant patients continuous access under the kidney transplant program even in the midst of a pandemic that has restricted access to the hospital,” said Rohan in a related press release. “We can also provide access to a kidney transplant for patients who have difficulty getting to the transplant center because of their place of residence or who have difficulties because of their socio-economic status.”

This way, Rohan said using virtual medicine can further speed up the transplant process even after the pandemic has ended.

“We have to continue this practice after CARES [Coronavirus Aid, Relief and Economic Security] The law is expiring and expanding care across state boundaries so that patients can continue to have access to medical care across all specialties, ”he said.

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