P1107CENTRALIZED CONTROL OF HEMODIALYSIS PROCEDURES AND CORRECTION OF CKD COMPLICATIONS WITH BI TOOLS

Abstract

Abstract Background and Aims Life expectancy of patients with terminal stage of chronic kidney disease depends on the quality of dialysis therapy and timely and adequate correction of dialysis complications. The goal of this work is to improve the treatment quality for dialysis patients in a setting of multi-facility hospital by employing of Business intelligence (BI) tools for centralized control of diagnostic and treatment process. Method We have created a system for centralized control of patients’ condition, using Microsoft Power BI platform. This system allows to analyze the process of hemodialysis procedure as well as treatment of hypertension, anemia and mineral bone disorder. The system generates various reports that may include parameters of a specific patient, single clinic, or multi-facility hospital for the period from arbitrary date to the day, previous to the report generation date. The effect of system usage was assessed on 288 patients from 30 hemodialysis facilities of “Nefrosovet” private organization, for the period of 6 month. Results Before deployment of the system, target value of Kt/V (1.4) was reached or exceeded in 49% of hemodialysis procedures, median duration of hemodialysis procedure was 227±18 minutes (mean total duration per week - 683 minutes). As the result of usage of centralized control and prescription correction system, target values of Kt/V was reached or exceeded in 65% of hemodialysis procedures, median duration of hemodialysis procedure increased to 238±11 minutes (mean total duration per week - 714 minutes). Before the start of the study, hypotensive episodes were registered in 34% of hemodialysis procedures, and hypertensive episodes were registered in 22% of hemodialysis procedures. As the result of centralized control of hemodialysis procedures, number of procedures with hypotensive episodes reduced to 28%, and number of procedures with hypertensive episodes reduced to 17%. Number of patients with blood hemoglobin value in target range of 100-120 g/l, increased from 1617 patients (56%) to 2051 patients (71%). Number of patients with blood ferritin value in target range of values, increased from 1013 patients (35%) to 1386 patients (48%). Number of patients with TSAT value in target range of values, increased from 873 patients (30%) to 1097 patients (38%). We have also noticed an increase in number of patients with target values of calcium and phosphorus metabolism parameters: calcium corrected for albumin – from 1992 (69%) to 2165 (75%) patients, phosphorus – from 693 (24%) to 982 (34%) patients, intact parathyroid hormone (iPTH) – from 635 (22%) to 837 (29%) patients. Conclusion The usage of BI based centralized patients’ condition control system allows to improve adequacy of dialysis therapy and quality of CKD complications correction in dialysis patients.