Renal Telemedicine and Telehealth - Where Do We Stand?

Abstract

Chronic renal patients and patients with end stage renal disease are a distinctive patient group with a serious, chronic and irreversible health condition which is mainly treated at home. As such they are unique candidates for support via telehealth services. During the last 20 years, a number of ICT interventions have been deployed to support renal disease. This paper reviews current trends in home care telematics for patients on peritoneal dialysis and comments on certain design considerations that prohibit the widespread deployment of such services. Whenever pilot studies have been performed, these report user acceptance, increased quality of life and even better health outcomes. Interest in the area is expected to rise as the population with renal disease is increasing. Despite this, the extent of development and maturity in renal telehealth is rather limited, when compared to other telehealth applications. This paper argues that this low technology penetration is mainly due to the fact that current approaches are treatment- and disease-centric, do not integrate patient education and tools for overall disease management. Additionally current trenal telehealth services do not follow open, standard based software development principles and are inadequately evaluated. The paper concludes with specific proposals to alleviate these problems.