Self-care and the Tablo dialysis machine

NN&I interviewed Leslie Trigg, CEO of Outset Medical, on the company’s new Tablo dialysis machine, which is aimed at clinics who want to develop the self-care option for patients. -by Mark Neumann

NN&I: What are Tablo’s key attributes?

Leslie Trigg: The Tablo technology is aimed at meaningfully improving the care experience for patients and lowering labor, infrastructure, and clinical costs for providers. In dialysis clinics, this comes in the form of in-center self care in which patients are able to set up and manage their Tablo treatments independently.

Three key Tablo technology innovations enable this approach: consumer product design simplicity, integrated water purification with dialysate production on demand, and wireless medical informatics.

NN&I: Why is the Tablo a good fit for in-center self-care?

Trigg: We’ve stayed very focused on minimizing the number of set up steps, eliminating memorization and mental math, and building a user experience to ensure it is accessible. In the clinic, that’s translated into Tablo training times measured in single-digit hours, not weeks, and fast set up times that allow for self-care to fit well into the clinic’s existing workflow.

NN&I: How have patients responded to in-center self-care?

Trigg: In our experience so far, generating patient enthusiasm about in-center self-care is the easiest part of the implementation process. The fascinating question is why patients are so interested. There are two words we hear most from patients answering this question: control and independence. I remember one patient who said, “No one cares more about me, than me.” Control is deeply valued by all of us at a very human level. It’s central to dignity, engagement, and a sense of self-worth we believe will translate into clinical cost reduction through a decrease in missed treatments, hospitalizations, and perhaps even mortality.

NN&I: Why pursue the in-center self-care approach with the Tablo?

Trigg: Home hemodialysis is a terrific option for some patients. However, for lots of people the current burdens outweigh the benefits, as evidenced by stagnant growth rates over the last few years. We view Tablo self-care as a way to offer more patients the benefits of home––independence and control––without the barriers to home (self-cannulation, needing to have a care partner, space in the home, and so forth). We see a clear opportunity to significantly increase patient ownership in ways that will also translate directly into cost reduction.

NN&I: When will Outset start rolling the Tablo out?

Trigg: Tablo is being sold commercially for in-center self-care in dialysis clinics in the U.S. Commercial introduction into the hospital environment for acute and extended care facilities will begin later this year.

NN&I: Will the company pursue FDA approval for home hemodialysis at some point?

Trigg: We continue to think that home hemodialysis offers benefits to patients and that Tablo has a lot to offer there in solving some of the key pain points that have prevented its growth to date. With most dialysis patients still treated in-center, and our ability to meaningfully change the economics within it for providers, our current commercial focus is on in-center self-care. We plan to follow that with in-hospital and extended care facility use given the operational support synergies between these three use environments. We have a home hemodialysis IDE trial cleared by the FDA and a plan to enroll that study and expand our labeled indication to include the use of Tablo in the home.