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  4. Reduction in Resource Utilization

Reduction in Resource Utilization

Background

Peritoneal Dialysis (PD) at home
is both more convenient and
less costly than hemodialysis,
which requires 3, 4-hours visits
per week to the dialysis facility.

  • The RPM technology is a two-way
    connectivity platform that records treatment
    information and electronically transfers it
    daily through a secure online portal for
    a timely review by clinicians.
  • The technology also allows clinicians to
    change programs remotely.
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Objectives

Objectives

Conduct a simulated study to estimate
the potential impact of RPM on APD
patients’ use of healthcare resource and
costs in the US, Germany and Italy.

Determine if RPM allows for reduction
in costs of unscheduled visits and
complications.

Study Design

Study Design

Twelve APD Patient simulated profiles were developed by a group of nephrologists and nurses based on potential clinical scenarios.

  • Two versions of each profile were created to simulate healthcare resources use: one assuming use of RPM and one without.
  • Eleven APD teams estimated the resources that would be used in the "with RPM" scenario using an on-line survey.

Overview of Study

Tasks (By Whom)

  • Development of patient profiles without RPM & with RPM (Nephrologists & PD Nurses)
  • Estimation of resources avoided with RPM
    • Validation of without RPM scenarios and resources use (Nephrologists experienced in APD patient management [USA: 4, Germany: 2, Italy: 1])
    • Estimation of resources with RPM (Teams of 1 Nephrologist & 1 PD Nurse experienced in APD patient management [USA: 7, Germany: 3, Italy: 1])
    • Computation of difference without RPM / with RPM (Data Management Team)
  • Validation of resource avoided estimation (Teams of 1 Nephrologist & 1 PD Nurse experienced in APD patient management with RPM [UK: 2])
Study population
PopulationCharacteristics
Results

What have we seen so far?

Potential Reduction
in Resource Utilization

across the three countries ranged from 

​ 1-2 Hospitalizations

​ 2-5 Emergency Room Visits

​ 1-4 Home Visits

​ 4-8 Unplanned Clinic Visits

 

Total Potential
Cost Savings per year

across the three countries 

*  $23,364 USA

  $11,477 Germany

  $7,088 Italy

Conclusions reductions-in-resource-utilization

conclusions

Conclusions

 

In a simulated environment, RPM reduced healthcare system resource utilization and cost in APD patients with problems such as treatment adherence, fluid overload, volume depletion and low drain/unidentified alerts.

This study was conducted in a simulated environment which will require additional studies to confirm findings. Information derived from this study may not correlate with clinical outcomes

Makhija, D.et al. Remote Monitoring of Automated Peritoneal Dialysis Patients: Assessing Clinical and Economic Value. Telemedicine and e-Health, Vol. 24, No. 4, April 2018.

D. Makhija, J. Danek, T. Kudelka, and M. Gellens are employees of Baxter Healthcare Corporation. S. Laplante and J. Sloand were employees of Baxter Healthcare Corporation at the time of the study. K. McLeod is a consultant at Xcenda, funded by Baxter Healthcare Corporation to conduct the study. For all other authors, no competing financial interests exist.

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