Remote monitoring of chronic kidney disease

Dr. Robert Lewis, a consultant nephrologist, from Wessex Kidney Centre Portsmouth, argues that patients are keen to embrace web-based remote monitoring, to support self-management of chronic kidney disease.

Despite the benefits, some clinicians have been hesitant to adopt the technology. He calls for a change in attitude and shares his insights into the implementation of virtual consultations.

In 2019, the NHS plan set the ambition for greater adoption of remote monitoring and virtual consultations in order to achieve a 33% reduction in outpatient attendance over five years.1 The authors of the NHS plan could not have foreseen the COVID-19 pandemic, which prompted an abrupt, unplanned reduction in clinic attendance driven by the need to reduce the risk to patients of COVID-19 exposure. Routine face-to-face consultations were largely replaced by telephone or video consultations scheduled at a given date and time using traditional clinic templates. This approach caused minimal disruption to existing administrative processes or staff working practices and thus provided a tolerable quick-fix to meet the needs of an emergency

Prior to the pandemic, there had been growing interest in the application of digital technologies to the management of chronic kidney disease (CKD). These systems have been shown to be useful for the remote transfer of data from patient to clinician2,3 or as a means of providing patient education.4 Computer-based software designed for remote management of CKD has been described,5 but its value in clinical practice remains unclear. The adoption of such technology into routine clinical practice has therefore been slow. 

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