Patient Snapshot and Treatment Summary provide a more detailed treatment information. Patient Snapshot provides a view of 7 or 30 days of information. Some information is presented graphically that allows for visual identification of trends that would not be apparent when reviewing a single treatment. Treatment Summary allows the clinician to review all of the details of a specific treatment. Review of the data may prompt communication with the patient, but the discussion can be focused on areas of concern identified through review of the treatment information. While Sharesource supports the clinician reviews, it is not intended to be a substitute for clinical practice, nor does it create decisions or treatment pathways.
If the clinician determines through their assessment that the patient’s therapy requires an adjustment, they can review the Device Settings for that patient and make the necessary modifications. The Device Settings feature allows clinicians to create a therapy for patients which can be transmitted to the cycler. Clinicians can program various therapy parameters, patient and system settings. Clinicians have the flexibility to create and maintain multiple device programs alongside the designated primary program. Device program templates allow clinicians to create generic templates which can be used as starting point to create the patient-specific device programs.
The patient’s cycler will communicate with Sharesource prior to their next treatment to check for any updates to their Device Settings. If there are updates, they will be provided to the cycler, the patient will be notified and asked to accept the updates which will then be available for their next treatment.
This cycle repeats with each treatment that the patient performs.
Reports provide the ability to view the selected set of data for offline view. Clinicians can generate reports by visiting reports tabs within the clinic portal. Clinicians can select the patient and date ranges to filter the data. Report format selection allows the clinician to download and save the data in PDF or spreadsheet format.
References
1Sharesource Connectivity Platform User Guide for Use with the Amia Automated PD System, E07-19-70-039D1, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, 2017.
2Sharesource Connectivity Platform User Guide for Use with the Homechoice Claria APD System, E07-19-73-157C1, Baxter Healthcare Corporation, One Baxter Parkway, Deerfield, 2017.
3Sharesource Connectivity Platform User Guide for Use with the Home PD System Kaguya, E07-19-78-321C1, Baxter Healthcare Corporation, One Baxter Parkway. Deerfield, 2017.
Andrew T. Gebhardt and Arvind Mishra
Baxter Healthcare Corporation
One Baxter Parkway
Deerfield, IL 60015 (USA)
E-Mail [email protected] and [email protected]
Information Communication Technology and Remote Monitoring
Ronco C, Crepaldi C, Rosner MH (eds): Remote Patient Management in Peritoneal Dialysis.
Contrib Nephrol. Basel, Karger, 2019, vol 197, pp 28–34 (DOI: 10.1159/000496315)
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Practical Aspects on Use of Sharesource in Remote Patient Management
Valérie Jotterand Drepper
Division of Nephrology, Geneva University Hospital, Geneva, Switzerland
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Abstract
Remote patient management (RPM) has been increasingly implemented in the care of chronic patients in the last decades with significant positive impact on clinical outcomes. Home-based dialysis therapies constitute an attractive alternative to in-center hemodialysis as they offer patients more flexibility and empowerment. Nonetheless, their remote nature and intrinsic problematic visibility to therapy-related issues occurring at home contribute to holding back both patients and nephrologists from adopting them. RPM has recently become available in automated peritoneal dialysis (APD) by means of a new cloud-based platform with a 2-way communication system (Sharesource), offering accurate daily monitoring of the therapy as well as ability to remotely alter the prescription. Its main documented advantage is the early identification of clinically relevant issues such as catheter dysfunction and non-adherence to prescribed PD therapy; its contribution to recognition of an imminent peritonitis has still to be evaluated. RPM is also of particular interest for patients with social, geographical or physical limitations in terms of travel reduction. Moreover, permanent access to data for PD teams may provide reassurance and alleviate anxiety generated by the remote nature of the method for both patients and nephrologists. Finally, RPM offers further advantages such as a more personalized APD prescription, tailored to patients’ needs, as well as improved clinical follow-up and a more proactive care. Long-term impacts of RPM in PD on patients’ outcomes, healthcare costs, and its potential influence on a greater take-up of the technique, notably through reinforced confidence for both patients and nephrologists through better visibility of the progress of the therapy, have still to be evaluated. Given the positive impact of PD on the preservation of residual renal function and association of the latter with better survival, any tool that may contribute to its broader use is most valuable.
© 2019 S. Karger AG, Basel
Telemedicine and remote patient management (RPM) have been of growing interest in the last decades, and have been implemented with a significant positive impact in the care of chronic patients in many medical fields, including cardiology, diabetology, neurology, and pneumology [1]. In nephrology, home-based dialysis therapies, offering patients more flexibility and empowerment in comparison to in-center hemodialysis, have increasingly been developed. Peritoneal dialysis (PD) has been recognized as a highly valuable method of renal replacement therapy (RRT) as it provides, in comparison to hemodialysis, a better preservation of residual renal function [2], which is associated in the literature with better survival [3]. However, global acceptance and use of PD remains low with only 11% of incident end-stage renal disease (ESRD) patients, compared to 85% for hemodialysis (the remaining 4% being pre-emptively transplanted), according to recent data [4]. Although reasons have not been clearly identified yet, clinicians’ lack of confidence about PD use because of problematic visibility to patient- and therapy-related issues, such as adherence to treatment and catheter dysfunction potentially hindering the smooth progress of therapy, as well as patients’ fear to be left alone at home are plausible explanations. In automated peritoneal dialysis (APD), an RPM cloud-based platform with a 2-way communication system such as Sharesource, offering accurate monitoring of the therapy and ability to remotely alter the prescription, could potentially help to overcome some of these reluctancies.
In Switzerland, RPM in APD, by means of the SHARESOURCE platform, was implemented for the first time in December 2015 in the care of a 23-year-old ESRD patient who required hospitalization for urgent start of RRT because of symptomatic uremia [5]. She was known for prior non-adherence to treatment and regularly missed medical visits. Upon her firm wish to do PD, a catheter was rapidly inserted and low-volumes PD started without complications. Upon returning home,