Telehealth in nephrology health care: a review

Background: Worldwide 80% of health care costs are being consumed by people with chronic disease. In Australia, chronic kidney disease (CKD) is estimated to cost $1 billion. With tighter fiscal control and a constantly expanding CKD population, multiple strategies are being investigated to provide more efficient models of care. Telehealth is one strategy which could provide significant efficiencies in relation to improved care, better disease management and reduced overall costs. Aim: To examine the peer-reviewed primary research exploring the use of telehealth in the context of renal health care. Method: The databases EBSCO (CINAHL, OVID and PRO REQUEST) and PubMed were searched for all research articles published in English from January 2000 to January 2012. Inclusion criteria were research findings and published in English. Exclusion criteria were discussion papers and literature reviews. Results: Ten articles met the inclusion criteria involving 3032 patients and four health care providers. Of those studies, eight were quantitative studies, one used qualitative methods and one adopted mixed methods. All of the research originated in North America and Europe. Renal health has used four types of telehealth: teleconferences, teleconsultation, telemonitoring and teledialysis. Telehealth applications have been successful in the remote care of CKD patients, in terms of patient outcomes and satisfaction. Conclusion: Telehealth applications based on information and communications technologies (ICT) are currently being successfully used throughout the world to treat and manage the care of CKD patients. Compared to other chronic disease specialities, the development of telehealth applications within the renal setting appears underutilised and under-researched.