May 29, 2019
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New software can help identify high-risk patients otherwise lost to follow-up

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Mohamed Taher

Researchers at the Geisinger Medical Center in Danville, Pennsylvania, have developed a wait-list prioritization tool designed to identify high-risk patients with kidney disease who are overdue for a follow-up with a nephrologist.

According to study results presented at the National Kidney Foundation Spring Clinicals Meeting, the software, designed with Epic Systems Corp., prioritizes the scheduling of patients who are in the greatest need of care.

“For many patients with high-risk problems in the kidney, they're always overdue for a follow-up and we've lost them in the follow-up [because] the number of nephrologists is less than the load of the work,” study co-author Mohamed Taher, MD, PhD, of the Geisinger Medical Center, told Nephrology News & Issues. “We thought about developing a tool to prioritize higher-risk patients so we can give them the appointment very early and we can flag them [to note] that they have to be seen by the doctor [and] so the doctor [and staff] can know that they have to be seen ... ”

Researchers aggregated the data of patients who, within the last 3 years, were overdue for follow-up. Taher and his colleagues developed the prioritization tool by grouping patients within three high-risk factor categories:

  • eGFR category: less than 20, 20 to 29, 30 to 59, and greater than 60;
  • disposition: requested return fewer than 3 months, 3 to 6 months and more than 6 months; and
  • total days overdue.

“Then the system itself [can] highlight the patient by this criterion, so we can catch these 1,000 patients last year who were lost,” Taher said. “The doctor will decide, and the nurse and the scheduler, that this patient has to be seen as soon as possible.”

The goal for the development of this tool was to identify high-risk patients with kidney disease and to prevent progression to ESRD, by ensuring fewer patients are lost to follow-up. Due to the success of the tool, researchers believe this technology could be useful to other specialists, not only nephrologists.

“Even in our hospital, Geisinger, which is in central Pennsylvania, we decided that we will apply this tool, not only for nephrology, but other systems,” Taher said. “Even the respiratory systems, pulmonology [and] cardiology [systems], because they found that if we care for high-risk patients more, the rate of readmission, [of] course, will improve.” – by Kristine Houck, MA, ELS, and Scott Buzby

Reference:

Taher M, et al. Poster 275. Presented at: National Kidney Foundation Spring Clinicals Meeting; May 8-12, 2019; Boston.

Disclosure: Taher reports no relevant financial disclosures.