The Future of Home Dialysis Through MHealth Support
e-Health ePoster Library. Huynh K. Jun 6, 2017; 167095; EP05.04
Kathy Huynh
Kathy Huynh
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Abstract
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Purpose/Objectives: Discuss the future of mHealth and eHealth support for patients going through Home-Hemodialysis (HHD) treatments, leveraging the experience of the world-renowned UHN Explore Home Dialysis Program. Data extracted from a global assessment of the barriers to HHD and Peritoneal Dialysis (PD) will be used to show the landscape of home dialysis programs and how mHealth and eHealth tools should be designed to support HD patients.

Methodology/Approach: Dialysis is an artificial process used to eliminate harmful metabolic waste, salts, and excess water from the blood of patients with kidney failure. There are two types of dialysis, peritoneal dialysis and hemodialysis. Peritoneal dialysis uses the inside lining of the patient’s abdominal cavity to filter the patient’s blood; while hemodialysis utilizes an artificial filter (dialyzer) that cleans the patient’s blood on an external machine (dialysis machine) outside the body, before returning the filtered blood back into the patient’s bloodstream. Unlike traditional hemodialysis that is performed by nurses in hospital settings, home dialysis treatments (HHD and PD) allow patients to perform their own dialysis independently in their homes, promoting better quality of life as it allows greater flexibility and convenience in the treatment and daily living.

Finding/Results: Barriers – Despite the benefits of home hemodialysis, several barriers still limit the successful implementation of this type of treatment for large patient populations. The most important barriers to self-care from a patient’s standpoint include patient education, remote patient support, and access to information about their treatment and equipment. Although systemic barriers also impact the deployment of HD, patient-perceived barriers are one of the main constraints to the wider deployment of HD. Needs – To successfully self-manage their care, patients need tools that will allow them to understand and take control over their treatment on a daily basis, as access to nurses and clinicians is limited. The utilization of eHealth and informatics can help by providing patients with easy access to information that will give them the ability to manage the common issues and maintenance of the machines on their own. Most of the patient-perceived barriers could be addressed if a combination of telehealth and educational platform was available to them. Potential tools – mHealth platform delivering access to training and FAQ about their treatment, remote technical support and training for their equipment, the ability to communicate with and seek medical advice from healthcare professionals remotely, and gaining access to their health information to monitor the changes and effectiveness of their treatment overtime. Examples of how these tools have been used to support patients with other chronic diseases will be explored.

Conclusion/Implication/Recommendations: Home dialysis has a strong positive effect on patients’ quality of life, but the perception that HD is risky and that patients and caregivers may not have the direct support of nurses can be a barrier to the wide deployment of the technology. mHealth and eHealth systems with the features outlined in this proposal could be used to support patients at home and ensure that they have the right level of oversight while getting accustomed to the technology.

140 Character Summary: Discuss some of the user-perceived barriers towards the deployment of home dialysis technology and how mHealth tools can be designed to support these patients.
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