Patient Perspectives on Using Telemedicine During In-Center Hemodialysis: A Qualitative Study

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dc.citation.articleNumber100848en_US
dc.citation.issueNumber7en_US
dc.citation.journalTitleKidney Medicineen_US
dc.citation.volumeNumber6en_US
dc.contributor.authorHaltom, Trenton M.en_US
dc.contributor.authorLew, Susie Q.en_US
dc.contributor.authorWinkelmayer, Wolfgang C.en_US
dc.contributor.authorChertow, Glenn M.en_US
dc.contributor.authorJaure, Allisonen_US
dc.contributor.authorErickson, Kevin F.en_US
dc.contributor.orgBaker Institute for Public Policyen_US
dc.date.accessioned2024-08-29T21:11:42Zen_US
dc.date.available2024-08-29T21:11:42Zen_US
dc.date.issued2024en_US
dc.description.abstractRationale & Objective In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the United States federal government expanded originating telemedicine sites to include outpatient dialysis units. For the first time, nephrology practitioners across the United States could replace face-to-face visits with telemedicine for patients receiving in-center hemodialysis. This study describes patients’ perspectives on the use of telemedicine during in-center hemodialysis. Study Design A qualitative study. Setting & Participants Thirty-two patients from underserved populations (older, less educated, unemployed, persons of color) receiving in-center hemodialysis who used telemedicine with their nephrologist during the COVID-19 pandemic. Analytical Approach Telephone semistructured interviews were conducted in English or Spanish. Transcripts were thematically analyzed. Results We identified 6 themes with subthemes: adapting to telemedicine (gaining familiarity and confidence, overcoming and resolving technical difficulties, and relying on staff for communication); ensuring availability of the physician (enabling an immediate response to urgent medical needs, providing peace of mind, addressing patient needs adequately, and enhanced attention and contact from physicians); safeguarding against infection (limiting COVID-19 exposures and decreasing use); straining communication and physical interactions (loss of personalized touch, limited physical examination, and unable to reapproach physicians about forgotten issues); maintaining privacy (enhancing privacy and projecting voice enables others to hear); and supporting confidence in telemedicine (requiring established rapport with physicians, clinical stabilty of health, and ability to have in-person visits when necessary). Limitations Interviews were conducted later in the pandemic when some nephrology care providers were using telemedicine infrequently. Conclusions Patients receiving in-center hemodialysis adapted to telemedicine visits by their nephrologists in the context of the COVID-19 pandemic and observed its benefits. However, further considerations regarding communication, privacy, and physical assessments are necessary. Integrating telemedicine into future in-center hemodialysis care using a hybrid approach could potentially build trust, optimize communication, and augment care. Plain-Language Summary This study describes patients’ perspectives on the use of telemedicine while receiving in-center hemodialysis during the coronavirus disease 2019 (COVID-19) pandemic. Data are derived from semistructured interviews with thirty-two patients from underserved populations (older, less educated, unemployed, persons of color). We identified 6 major themes including adapting to telemedicine, ensuring availability of the physicians, safeguarding against infection, straining communication and physical interactions, maintaining privacy, and supporting confidence in telemedicine. These findings suggest that patients receiving in-center hemodialysis adapted to telemedicine visits by their nephrologists in the context of the COVID-19 pandemic and observed its benefits. However, further considerations regarding communication, privacy, and physical assessments are necessary. Integrating telemedicine into future in-center hemodialysis care using a hybrid approach could potentially build trust, optimize communication, and augment care.en_US
dc.identifier.citationHaltom, T. M., Lew, S. Q., Winkelmayer, W. C., Chertow, G. M., Jaure, A., & Erickson, K. F. (2024). Patient Perspectives on Using Telemedicine During In-Center Hemodialysis: A Qualitative Study. Kidney Medicine, 6(7), 100848. https://doi.org/10.1016/j.xkme.2024.100848en_US
dc.identifier.digital1-s2-0-S2590059524000591-mainen_US
dc.identifier.doihttps://doi.org/10.1016/j.xkme.2024.100848en_US
dc.identifier.urihttps://hdl.handle.net/1911/117712en_US
dc.language.isoengen_US
dc.publisherElsevieren_US
dc.rightsExcept where otherwise noted, this work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives (CC BY-NC-ND) license.  Permission to reuse, publish, or reproduce the work beyond the terms of the license or beyond the bounds of fair use or other exemptions to copyright law must be obtained from the copyright holder.en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en_US
dc.titlePatient Perspectives on Using Telemedicine During In-Center Hemodialysis: A Qualitative Studyen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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