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Behind the Expansion of Home Dialysis, Rigorous Training and Texting

   July 12, 2016

More training and the use of timely communication are helping home dialysis patients overcome some of the workflow problems they face there.

Home-based kidney dialysis remains a relative rarity, with only one in ten U.S. patients able to receive peritoneal dialysis and hemodialysis at home, according to national averages.

But driven by the staggering cost of outpatient dialysis treatments and improvements in home dialysis technology, one chain of dialysis clinics has been able to double that average. And it aims to double it again through an innovative program involving feedback from patients as well as nephrologists and payers.

The costs paid by Medicare tell the tale: While dialysis patients represent less than 1% of the Medicare population, they also represent 6% to 7% of the total cost of Medicare.

Satellite Healthcare, based in San Jose, CA achieved its doubling through its Wellbound Centers, which are dedicated to peritoneal dialysis and hemodialysis and include a training room or space to instruct patients how to perform home dialysis. It serves 7,000 patients in six states.

For two days in June, Satellite brought patients from its service area to San Jose, CA to brainstorm new technology and workflows in an effort to double its home dialysis rate again to 40%.

"There's absolutely a feeling in the nephrology community that we can bring the benefits of home therapies to a greater number of patients," says Graham Abra, MD, medical director at Wellbound San Jose. He is also a practicing nephrologist at Stanford Medicine and clinical assistant professor at Stanford Medical School.

Less Travel, Better Quality of Life

A major benefit of home dialysis is eliminating the travel time required for patients to get to and from dialysis clinics. "They have clinical benefits, in that these therapies in general often lower the number of blood pressure medications and phosphorous-binding medications that patients need to take," Abra says.


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Scott Mace is the former senior technology editor for HealthLeaders Media. He is now the senior editor, custom content at H3.Group.

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