Author: David V. White


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In recent years, the healthcare industry has seen a surge in the use of telehealth services, and nephrology is no exception. Remote nephrology, or tele-nephrology, involves the use of telecommunication technologies to provide nephrology services to patients who are not physically present in the same location as their healthcare provider (e-visits).

This emergence has similarities to that of hospitalists 25 years ago. Hospitalists were specialists who provided care for patients in the hospital setting, allowing primary care physicians to focus on outpatient care.  At first, primary care was skeptical about coordinating care with the inpatient specialist but more access, coordination with the primary care physician, and responsiveness to inpatient testing and results resulted in creating a new gold standard of care.

Remote Nephrology is a growing trend and an increasingly popular approach to providing specialized care to patients who live in rural or underserved areas or supporting busy nephrology practices due to increasing patient demand and decreasing nephrologist supply.  Access to specialists for inpatient consults and acute program coordinate can elevate the services provided by hospitals and their hospitalists teams.

A significant number of patients with chronic kidney disease in the United States live more than an hour away from the nearest nephrology clinic. This can make it difficult for patients to receive regular care, which can lead to a decline in their health and an increased risk of hospitalization. Remote nephrology provides a solution to this problem by allowing patients to receive care from a specialist without having to travel long distances.

One of the main benefits of remote nephrology is improved access to specialized care (keeping care local).  Patients who live in rural or underserved areas may not have access to a nephrologist in their local community. By providing care remotely, hospitals can work with nephrologists trained in remote care to reach patients who would otherwise have limited access to specialized care. This can lead to improved patient outcomes, reduced hospitalizations, new revenue streams, and enhanced patient satisfaction.  Another significant benefit of remote nephrology is the potential for cost savings. Chronic kidney disease is a costly condition, and the annual cost of treatment for end-stage renal disease in the United States is estimated to be over $50 billion (Medicare was over $49B in 2018). By providing remote care, nephrologists can reduce the need for costly hospitalizations, costly transportation (approximately $3 Billion per Year – not to mention uncomfortable and a significant time investment for patients) and improve the efficiency of care delivery. 

Despite the many benefits of remote nephrology, there are also challenges associated with its adoption. Technology, high speed internet, secure communication and trained workforce are the most cited challenges associated with e-visits; however, advances over the last several years in equipment design and advances with technology vendors/partners has alleviated most, if not, all these concerns.  

Working with companies like TeleNeph, LLC out of Denver, Colorado can help minimize the stress, cost, and time to successfully operationalize a quality program. Ron Kubit, TeleNeph CEO states, “working with rural hospitals in the development of the tele-nephrology program has been a win / win for the hospital, the community, the patients, and their caregivers.  We have heard from our hospital clients that the transportation issues are very burdensome on the patient and their families”.

Remote nephrology is an emerging field that has the potential to revolutionize the management of kidney disease and improve access to specialized care for patients across the country. Like hospitalists 25 years ago, remote nephrologists are specialized providers who can improve patient outcomes and enhance the efficiency of care delivery. While there are challenges to its adoption, remote nephrology is an exciting development that has the potential to transform the way nephrology services are delivered.