Charkviani Mariam, Barreto Erin F, Pearson Kristina K, Amberg Brigid M, Amundson Rachel H, Bell Sarah J, Cleveland Eric J, Daniels Craig E, Kohler Christopher M, Leuenberger Angela M, Philpot Lindsey M, Ramirez David A, Reinschmidt Karen J, Zoghby Ziad, Kattah Andrea G
Division of Nephrology & Hypertension, Mayo Clinic, Rochester, MN, USA.
Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Can J Kidney Health Dis. 2023 Aug 11;10:20543581231192746. doi: 10.1177/20543581231192746. eCollection 2023.
Acute kidney injury (AKI) survivors have a dynamic posthospital course which warrants close monitoring. Remote patient monitoring (RPM) could be used to improve quality and efficiency of AKI survivor care.
The objective of this report was to describe the development and preliminary feasibility of an AKI RPM program launched in October 2021.
Academic medical center.
Patients enrolled in the AKI RPM program were those who experienced AKI during a hospitalization and underwent nephrology consultation.
MEASUREMENTS/METHODS: At enrollment, patients were provided with home monitoring technology and underwent weekly laboratory assessments. Nurses evaluated the data daily and adhered to prespecified protocols for management and escalation of care if needed.
Twenty patients were enrolled in AKI RPM in the first 5 months. Median duration of program participation was 36 (31, 40) days. Eight patients (40%) experienced an unplanned readmission, or an emergency department visit, half (N = 4) of which were attributed to AKI and related circumstances. Of the 9 postgraduation survey respondents, all were satisfied with the RPM program and 89% would recommend RPM to other patients with similar health conditions.
Acute kidney injury RPM was made possible by the existing infrastructure in our integrated health system and the robust resources available in the Mayo Clinic Center for Digital Health. Such infrastructure may not be universally available which could limit scale and generalizability of such a program.
Remote patient monitoring can offer a unique opportunity to bridge the care transition from hospital to home and increase access to quality care for the AKI survivors.
急性肾损伤(AKI)幸存者出院后的病程动态变化,需要密切监测。远程患者监测(RPM)可用于提高AKI幸存者护理的质量和效率。
本报告的目的是描述2021年10月启动的AKI RPM项目的开发情况及初步可行性。
学术医疗中心。
纳入AKI RPM项目的患者为住院期间发生AKI并接受肾病咨询的患者。
测量/方法:入组时,为患者提供家庭监测技术,并每周进行实验室评估。护士每天评估数据,如有需要,遵循预先指定的管理和护理升级方案。
前5个月有20名患者纳入AKI RPM项目。项目参与的中位时长为36(31,40)天。8名患者(40%)出现计划外再入院或急诊就诊,其中一半(N = 4)归因于AKI及相关情况。在9名毕业后续调查受访者中,所有人都对RPM项目满意,89%的人会向其他健康状况相似的患者推荐RPM。
急性肾损伤RPM项目得益于我们综合医疗系统的现有基础设施以及梅奥诊所数字健康中心的强大资源才得以实现。这种基础设施可能并非普遍可用,这可能会限制该项目的规模和推广性。
远程患者监测可为弥合从医院到家庭的护理过渡提供独特机会,并增加AKI幸存者获得优质护理的机会。