Table of Content
A new report by Alex Brill, former chief economist to the House Ways & Means Committee, reaffirms a GAO conclusion. Policy barriers—including partner requirements —keep too many from benefitting from home dialysis. The start of bundled payments for dialysis boosted PD, but reduced HHD growth in the US. The change is attributed to a higher profit margin for PD and low HHD training reimbursement. Dr. Eric Wallace’s first long distance patient, Ellen McGowan, couldn’t be happier about his new telemedicine program.
A Fresenius poster at the Annual Dialysis Conference looked at the frequency of bloodstream infections among home HD patients using the Buttonhole technique. The group instituted a best-practices approach to wash the access site before cannulating, scrub to remove scabs, and perform skin prep and cannulation while training. After almost 3 years, no patients on home HD in the study group had an access-related BSI.
Baxter Leaps Forward with Human Trial of On-demand PD Fluid
Dr. Dawn Wolfgram and her team looked at USRDS data and claims data to rule out people who had dementia when they started treatment, though doctors may have steered cognitively impaired patients away from a self-care option like PD. NxStage addresses myths about kidney disease prevalence and treatment, assuring people that there are, in fact, technological breakthroughs and that dialysis treatments can be done in the home. A GAO report finds that the need to fill excess capacity due to an excess of dialysis clinics built over the past 25 years—along with better profit margins for in-center patients—has led providers to de-emphasize home dialysis. 2948, the Medicare Telehealth Parity Act, would remove some barriers for home dialysis patients to use telemedicine connections and remote monitoring to connect with their nephrologists. The Dorset County Hospital is funding a project to give more people the chance to do home HD—since independence and even health can be impaired by in-center treatments.
A new 30- to 60-day online program, called Modality Choice, for patients with advanced CKD to learn end-stage renal disease treatment options is led by a “virtual clinical care team” of nurses and patient mentors. This activity has been designed to meet the educational needs of professionals involved in the care of patients with chronic kidney disease and end-stage kidney disease. These professionals are primarily nephrologists nephrology fellows, nephrology nurses, nurse practitioners, dietitians, pharmacists, program managers, administrators, social workers, and patient care technicians. Recognizing this, modality education must begin earlier in the disease course and be facilitated by timelier referral to nephrologists and better decision aids for patients.
March 3-6, 2023
Fresenius contracts with JMS to provide more dialysis choices to Japan’s aging population. Home treatments can better fit people’s lifestyles and improve their well-being. The 39th Annual Dialysis Conference 2019 brings together health professionals involved in established and developing dialysis programs. The only absolute clinical barrier to PD is the lack of a functioning peritoneal membrane.
Read the messages they give to patients in their newsletters on their home dialysis website. Dr. Karl Nolph, a pioneer in peritoneal dialysis, passed away in June, at age 77. Read the transcript of Dr. Dugan Maddux’s terrific interview with him on VoiceExpeditions.com. PD catheter placement practices are highly variable—but some are better than others. In a new study, 40 clinics from the US and Canada have taken a 29-item survey designed to identify factors in successful PD catheter placement and establish a framework for improvement. Read an interview with Dr. Marty Schreiber about his preferred sequence of ESRD options, causes of PD failure, future PD technology, best PD candidates, and thoughts about the Baxter solution shortage.
Annual Dialysis Conference
These individuals will have acute illnesses requiring acute-care and rehabilitation hospitalizations, as well as chronic conditions limiting physical and cognitive function. The lack of clinical expertise in many hospitals and the paucity of rehabilitation facilities, long-term acute-care hospitals, and nursing homes with the willingness or ability to care for PD patients limits PD as an option. Additionally, patients with greater comorbid conditions are more reliant on family support, potentially resulting in greater need for respite and assisted-PD options. Patients treated with both hemodialysis and peritoneal dialysis from the start had better outcomes than those who used just one or the other, found researchers from Japan who presented at the Annual Dialysis Conference.
With reimbursement lagging that of a typical evaluation and management clinic visit. The proposed ESRD Treatment Choices model expands the education benefit to chronic kidney disease stages 5 and 5D , with additional clinical staff, including dieticians and social workers, able to provide education. Currently, the average patient treated with PD is healthier than the average patient treated with HD. As PD expands, the PD population will include more individuals with greater comorbidity burden.
The above data in our Weather Info table are temperature predictions for the date of the medical event for Dallas, Usa. Dr Weiner receives salary support from Dialysis Clinic, Inc, paid to his institution, for his role as the Medical Director of Clinical Research and as a dialysis facility medical director. The other authors declare that they have no relevant financial interests. Additionally, there is no patient experience measure in PD, magnifying the financial importance of other measures for facilities that provide PD. Health insurance and the use of peritoneal dialysis in the United States.
The symposium is bringing together innovators, bioengineers, nephrologists, patients and more to discuss ways to transform dialysis. It's sure to be an interesting event -- lots of great speakers lined up. Beginning in 2019, telehealth has been approved for 2 of every 3 monthly clinic visits, using patients’ homes as originating sites. A home program at the Grand River Hospital in the Ontario Renal Network has more than 150 patients!
“Is the patient actually ready when we’re talking to him or her about home dialysis? ” Both patients and physicians need to be prepared, if we are to grow PD and home HD, noted Chan, Director of Nephrology at University Health Network in Toronto, in a presentation at the International Conference on Dialysis. Baxter has launched an FDA-approved clinical trial of system that will use a small device to blend filtered water with concentrate to make tap water into PD fluid. The safety and efficacy trial, which will run for 12 weeks, has enrolled its first patient, and will be used to support a New Drug Application to the FDA.
In the United States, 17% of incident PD patients transfer to HD within a year, and fewer than half the patients who start PD use this modality 2 years later. Home dialysis saves millions of kilometers of travel in BC and the Yukon. Just 1,000 Canadian patients doing home treatments saved that much time (20-35 years!) and gasoline. Black patients are 2.2 times less likely to be offered home treatments than white patients. Physician discrimination, lack of black nephrologists, and patient beliefs may be part of the reason.
Residual kidney function was stable, and patients were able to stay on the combined therapy for a decade. Better payment for home dialysis training and for PD under the bundle “made it more lucrative for clinics to suggest the in-home option to patients,“ doctors said, notes a new article about increased uptake of home dialysis in the US. Clinics are, of course, required to tell patients about all of their options and where to get them—regardless of how well each one pays.
This CE Activity provides 15.25 contact hours of continuing nursing education. The International Society for Hemodialysis will partner with Medical Education Resources for the provision of Physician Credit and Nursing Credit Hours. We offer exhibits at this conference because we think it is important for participants to be exposed to the products and services that make dialysis possible. The University of Missouri School of Medicine invites you to be a part of the Annual Dialysis Conference . This international conference has become the most important annual meeting in the world for all forms of dialysis.
Advocacy for Better Dialysis
Implementation of a hub and spoke model, pairing smaller and/or newer home dialysis programs with larger more sophisticated programs that offer education and mentoring, may help dialysis programs to grow and prosper. This pairing can be facilitated by traditional conferences and newer modalities such as telemedicine and training applications. Anticipating and understanding both patient and care partner burden is important for the development and implementation of patient- and care partner-centered support programs that can be deployed before a patient ceases home therapy. Finally, aligning Medicare reimbursement to support appropriate increased home dialysis uptake to prioritize both transplantation and home dialysis as the first-line treatments for kidney failure. Expanding treatment modalities available to patients with kidney failure is now a priority in the United States. Following this, the Centers for Medicare & Medicaid Services proposed the ESRD Treatment Choices model and described several voluntary models to incentivize kidney health, home dialysis, and kidney transplantation.
The Chronic Disease Research Group matched 4,450 NxStage users with people on PD between 2007 and 2010, based on 33 factors. Compared to those on PD, people who did daily home HD had a 13% lower risk of death from a heart problem and a 20% lower risk of death from infection. Disposal of dialysis waste is a challenge for many, but one PD consumer may find the police at his or her door. Boxes of PD solution, used bags, syringes, and other supplies were found illegally dumped in a landfill—with an address on the boxes. The American Medical Association and American Telemedicine Association are leading a charge for Medicare to recognize more telemedicine services.
No comments:
Post a Comment