IntelliH as a Remote Patient Monitoring Solution for Home dialysis and Nephrology Practice

November 6, 2020, by Dr. Naveen Acharya, MD, FACC

Introduction:

IntelliH is a SaaS based platform with a focus on managing CHF, diabetic and post-operative patients. It provides a risk stratified dashboard for care coordinators on PC, MAC and Android tablets. The patient App on iOS and Android devices wirelessly collects physiological data and sends that to IntelliH’s for analysis. The IntelliH platform tracks care plan, analyze received vitals and generates alerts that are customized to individual patient. It prepares a comprehensive disease specific report for doctors to analyze across any longitudinal period. The IntelliH solution enables immersive collaboration with patients, care givers and care teams through rich telehealth videos as well as secure texts.

IntelliH for Home Dialysis and Nephrology Practices

Challenges for the adoption of home dialysis1:

  • Patients are apprehensive regarding how to perform home dialysis
  • Patients may be unsure of when to contact their providers if they perceive a problem
  • Physicians may fear their inability to monitor compliance with home dialysis

IntelliH addresses these concerns by:

  • Early identification of problems. Improves patient satisfaction, reduces costs while improving patient outcomes by avoiding ER visits and hospitalizations.
  • Improves engagement with physician providers with the aid of virtual visits, reducing time otherwise that would be spent in office or at-home visits or driving time; reduces attrition from home dialysis.
  • Has the ability to automate the collection of dialysis data with respect to vitals, weight and dialysis treatment parameters. This provides substantial time savings and improves efficiency. The close connection with the providers also reduces patients’ fear of mistakes in self-management.
  • Questionnaires can help address issues related to symptoms during dialysis versus other logistical questions.
  • Maybe used to monitor inventory supplies and eventually automate ordering thus minimizing missed treatments due to lack of supplies
  • Reduces time spent for data collection thereby increasing physician time spent with patients.

IntelliH for Remote Patient Monitoring in home Dialysis:

Factors to be Monitored2

Relevant IntelliH Function

Biometric Data: Weight, blood pressure, blood sugar, pulse oximetry, ECG

All obtainable via BLE sensor-based devices- weight scale, BP monitor, Glucometer, Pulse Oximeter (ECG sensor coming soon), with appropriate smart alerts

Uremic Symptom screen

Questionnaires can be provided to patients to assess for symptoms in advance

Medication usage

Medication compliance is tracked with our user-friendly system

Diet/Fluid intake habits

Our diet module tracks dietary parameters as well as fluid intake volumes

Dialysis specific parameters:

Exit site and effluent appearance

Ultrafiltration Volumes

Access Dysfunction

Virtual Video Visits help assess technical problems; the IntelliH system can be integrated with most electronic record systems to import relevant data

“Opportunities for remote patient management. The inner circle represents examples of individual patient monitoring variables. Moving outward, data can then be used to drive patient- and center-specific clinical care. Finally, in the outermost circle are the predicted health care−related outcome improvements. ECG, electrocardiography; f/u, follow-up; PD, peritoneal dialysis.”

Source: Remote Patient management for Home Dialysis Patients- Eric L. Wallace, Mitchell H. Rosner, […], and James A. Sloand https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733746/

IntelliH for General Nephrology Practice:

  • Blood pressure management: In office readings are often erroneous – IntelliH provides a gateway to continuous home monitoring of BP and assessment of compliance with medications.
  • Telehealth: IntelliH facilitates virtual visits for regular encounters with patients as well as care-coordination
  • Medication Reconciliation: CKD/ESRD patients are prescribed a large number of medications – IntelliH facilitates rapid reconciliation
  • Closer engagement with patients particularly rural populations: Better access to providers through the platform gives patients more reassurance particularly in remote settings
  • Multidisciplinary rounds: CKD/ESRD patients have complex management issues which can be better addressed with multiple care team members participating simultaneously in care coordination through the platform

Conclusions:

IntelliH provides essential Remote Patient Monitoring functions to better enable access to patients’ vitals data and engagement tools to aid advanced detection of potentially serious clinical problems. For the ESRD population, as the COVID pandemic forces the increasing adoption of home dialysis options, Remote Patient Monitoring via IntelliH provides patients and providers with greater assurance that the treatments are safe, and any technical or clinical problems are detected well in advance of an adverse outcome. Outpatient Care-coordination through IntelliH brings patients, particularly those located remotely, who often struggle to get appropriate specialty care, closer to their providers thereby improving satisfaction and clinical outcomes, which translates into improved quality metrics and higher bonuses from payors. To summarize, IntelliH is a virtual care platform that is highly comprehensive with detailed work-flows that provides essential Remote Patient Monitoring services and virtual care patient engagement tools, that extend the reach of a nephrology clinic to the patients’ homes, thereby enhancing the brand appeal of the practice and ensuring loyalty of patients to their providers.

References:

  • Wallace, Eric & Rosner, Mitchel & Alscher, Mark Dominik & Schmitt, Claus & Jain, Arsh & Tentori, Francesca & Firanek, Catherine & Rheuban, Karen & Florez-Arango, Jose Fernando & Jha, Vivekanand & Foo, Marjorie & Blok, Koen & Marshall, Mark & Sanabria, Mauricio & Kudelka, Timothy & Sloand, James. (2017). Remote Patient Management for Home Dialysis Patients. Kidney International Reports. 2. 10.1016/j.ekir.2017.07.010.
  • Ronco C, Crepaldi C, Rosner MH (eds): Remote Patient Management in Peritoneal Dialysis. Contrib Nephrol. Basel, Karger, 2019, vol 197, pp 124–132 (DOI: 10.1159/000496319). doi: 10.1159/000496319

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