In-center hemodialysis unit patient experience with telehealth

To the Editor Centers for Medicare and Medicaid Services (CMS) issued a series of telehealth waivers in 2020 that lifted geographic restrictions and expanded originating sites to include the home and dialysis units. For the first time, all nephrology practitioners in the United States could conduct in-center hemodialysis patient visits through telehealth. We evaluated patient experiences with the use of telehealth by their nephrologist in hemodialysis. Hemodialysis patients from 2 units located in the District of Columbia completed a survey in July/August 2021 regarding the use of telehealth with their nephrologists during the COVID-19 pandemic. Telehealth was conducted while patients were receiving treatment in the dialysis unit, and the clinicians were in their home, office, or hospital. The nephrologist determined whether a telehealth visit occurred. During telehealth visits, renal dietitians facilitated videoconferencing by bringing to the chair-side a laptop or tablet installed with a Health Insurance Portability and Accountability Act (HIPAA) compliant video platform. According to the telepresenters, each session approximated 10 min, with a range of 5–60 min. The survey, with a response rate of 75%, reported 94 patients using telehealth while 54 patients did not. A p value of <0.05 was used to identify differences between patients who did and did not report receiving dialysis care via telehealth. Patient demographic characteristics, time on dialysis, education level, primary language, and risk factors of COVID-19 exposure and/or infection did not differ by the receipt of care via telehealth (Table S1). Using a Likert scale ranging from 1 to 10 (10 = extremely satisfied), patients reported an average telehealth satisfaction score of 8.0, with 42% of patients indicating the highest satisfaction rating and 74% indicating a score of 7 or higher (Figure 1). More than 90% of patients reported spending enough time with their physician during their virtual visits and most patients did not report concerns regarding internet security (85%), privacy (85%), or technical issues (92%).