Telemedicine services for living kidney donation: A US survey of multidisciplinary providers

Abstract

Individuals considering living kidney donation face geographic, financial, and logistical challenges. Telemedicine can facilitate healthcare access/care coordination. Yet difficulties exist in telemedicine implementation and sustainability. We sought to examine centers' practices and providers' attitudes toward telemedicine to improve services for donors. We surveyed multidisciplinary providers from 194 active adult US living donor kidney transplant centers; 293 providers from 128 unique centers responded to the survey (center representation rate = 66.0%), reflecting 83.9% of practice by donor volume and 91.5% of US states/territories. Most centers (70.3%) plan to continue using telemedicine beyond the pandemic for donor evaluation/follow‐up. Video was mostly used by nephrologists, surgeons, and psychiatrists/psychologists. Telephone and video were mostly used by social workers, while video or telephone was equally used by coordinators. Half of respondent nephrologists and surgeons were willing to accept a remote completion of physical exam; 68.3% of respondent psychiatrists/psychologists and social workers were willing to accept a remote completion of mental status exam. Providers strongly agreed that telemedicine was convenient for donors and would improve the likelihood of completing donor evaluation. However, providers (65.5%) perceived out‐of‐state licensing as a key policy/regulatory barrier. These findings help inform practice and underscore the instigation of policies to remove barriers using telemedicine to increase living kidney donation.

Best practices during COVID-19 pandemic in solid organ transplant programs in Spain

“…Second face-to-face visit with the nephrologist for full anamnesis and inform donor and recipient on risks and benefits of donation and transplantation adapted to their personal history. A design of the study plan from that moment, if intention to donate is confirmed [ 10 ].…”

Revolucionando el sector salud: la inmersión de la telemedicina y su fortalecimiento a través del marketing

“…Asimismo, otro claro ejemplo de utilidad de la telemedicina en áreas de la medicina, tales como la nefrología, según Al Ammary et al (2022) se encontró heterogeneidad en la práctica actual de la telemedicina para la donación de riñón vivo en los Estados Unidos. Se halló que la telemedicina era principalmente utilizada por nefrólogos, cirujanos y psiquiatras/psicólogos para la evaluación y asesoramiento del donante, mientras que los trabajadores sociales utilizaban principalmente el teléfono y el video.…”

Changing landscape of living kidney donation and the role of telemedicine

“…Heterogeneity in telemedicine practice across U.S. transplant centers exists. In a national survey of multidisciplinary providers at adult living donor kidney transplant centers [37 ▪▪ ], 70% of 128 represented centers plan to continue using telemedicine services for donor evaluation and/or follow-up care beyond the pandemic, whereas only 28% of centers used telemedicine prior to the pandemic. Utilization of telemedicine modalities varies by provider role.…”

“…Although many providers across specialties are willing to use telemedicine beyond the pandemic [37 ▪▪ ], they need education and training about best practices for using telemedicine and performing a limited physical examination virtually. Providers also need to be empowered with staff and technology support and private space to provide high standards of care [43,57,58].…”