Patients on in-center hemodialysis may adapt to telehealth, but concerns remain
Key takeaways:
- Patients were able to adapt to virtual visits by gaining familiarity and confidence.
- Some patients expressed concern about the lack of a personal touch.
Some patients on in-center hemodialysis were able to successfully adapt to telehealth during the COVID-19 pandemic, but more research is needed on communication and privacy, data show.
“As clinicians and policymakers consider the future role of telemedicine for in-center hemodialysis, it is important to understand patient experiences,” Trenton M. Haltom, PhD, of the Baylor College of Medicine in Houston, wrote with colleagues. “This is particularly true for underserved populations (eg, older, less educated, unemployed, persons of color, rurally located, etc.) who comprise a disproportionately higher share of patients receiving hemodialysis and who may experience unique challenges with the use of telemedicine.”
To explore perspectives on the use of telehealth, researchers performed a qualitative study of 32 adults from underserved populations (defined as older, less educated, unemployed and communities of color) who had nephrology visits remotely during the COVID-19 pandemic.
Researchers used convenience sampling to recruit participants by distributing flyers to local physicians and dialysis facility nursing staff to share with patients. Upon finalizing the cohort, investigators conducted semi-structured interviews covering patients’ experiences, processes, benefits, challenges and views on the future of telehealth with hemodialysis.
Findings identified several common themes among the cohort.
Positive perspectives included the following:
- Adapting to telehealth. Patients were able to adapt to virtual visits by gaining familiarity, confidence, beating technical difficulties and relying on staff for help.
- Ensuring availability of the physician. Respondents valued immediate response to urgent needs for peace of mind and enhanced attention from physicians.
- Safeguarding against infection. Telehealth also helped limit exposure to COVID-19.
The remaining three revealed areas that need attention:
- Straining communication and physical interactions. Patients expressed concerns about the lack of a personal touch, limited physical exams and the that they may be unable to reapproach physicians about forgotten issues.
- Maintaining privacy. Safeguarding privacy during appointments, such as the volume of the conversation during visits, was also a concern among patients.
- Supporting confidence in telehealth. Patients underlined the need for established rapport with physicians, clinical stability of health and the option for in-person visits when needed to support their certainty in telehealth.
“In summary, in our study of primarily Black and Hispanic participants receiving in-center hemodialysis in a major metropolitan area, many participants adapted to telemedicine visits by their nephrologists in the context of the COVID-19 pandemic and observed its benefits,” the researchers wrote. “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.”
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