053 Management of children requiring peritoneal dialysis (PD) at great ormond street hospital: introduction of a remote patient management (RPM) platform

Abstract

Background Prior to the introduction of an RPM platform, PD patients were reviewed at least monthly in outpatient clinics, with regular telephone support from the PD nurses. PD programme changes were mostly made in the clinic onto the patient‘s PRO card – a small memory card that uploaded the new PD programme onto their PD machine at home. The default drain alarm settings were used for all PD patients. To investigate the impact of the introduction of a web-based, RPM platform (SharesourceTM) on delivery of home PD services at Great Ormond Street Hospital, London. Methods A retrospective review of medical records of children receiving automated PD for ≥1 day was conducted over two 6 month time periods, pre and post-implementation of RPM. Data were collected on the number and type of programme changes made to individual patient‘s dialysis programmes and whether these changes occurred at the time of clinic or remotely to the patient at home. Results Following the implementation of RPM, the number of PD programme changes increased by 34%. A substantial proportion of these were related to adjusting the default drain alarm settings within the PD machine – the daily drain data now visible with RPM, enabled patient drain volumes to be optimised with confidence. Programme changes made at home increased by 73% per patient per month (0.11 to 0.19). A nurse-led telemedicine clinic was launched for specific patients using RPM, resulting in the number of PD hospital-based consultations falling by 20% per patient per month (1.2 to 1.0), with no adverse effect of patient safety. Conclusion Clinicians were able to execute a more personalised dialysis programme to patients with more timely adjustments; there was a shift towards greater virtual and remote care.