Online Consultation in Nephrological Care - An Online-Survey Among Nephrologists (Preprint)

Abstract

In the midst of COVID-19, where health systems are severely overloaded, and arriving at hospitals and clinics poses risks for chronic condition patients, the need for telemedicine rises. This study examines readiness and potential barriers for telemedicine adoption among a specific sector of physicians. Chronic kidney disease (CKD) is a growing medical and economic problem worldwide. Digital strategies provide opportunities for more effective and efficient CKD management, especially when clinic-treated dialysis patients require treatment at the hospital, and when general practitioners consult nephrologists.

This study aimed to identify both the current status and the needs, expectations and concerns of nephrologists in the context of digitization, which is a necessary step toward adoption of telemedicine, even partially.

N=128 members of a professional nephrologists’ association participated in an online survey, conducted through “Lime Survey”. Members were contacted by the association via email. Participation was voluntary and anonymous.

Nephrology consultation between departments and organizations, occurs mostly by phone. Online consultation, and patient-management software would facilitate coordination reducing data-procurement efforts. However, nephrologists expressed concerns, e.g. that they would issue improper recommendations if they did not examine the patient in person, at the clinic. On a more procedural note, the survey showed that almost all nephrologists (more than 90%) are currently unable to discern clear remuneration regulations. Nephrologists need more health policy support and framework conditions for the technical implementation of digitization. Currently, the nephrologists are mainly typing input manually to enter information into the practice management system – they are not using more advanced, time-saving means, such as voice-to-text data transfer. The vast majority of respondents use Internet-related information sources several times a day, mostly to search for diagnostic and therapeutic standards.

Nephrologists are ambivalent about digitization. They perceive improved coordination between different departments as an opportunity but have doubts about the feasibility of integration into everyday practice. To allow for broader adoption of digitization practices, training, resources, and systems’ support are required. This can save patients’ and doctors’ time, reduce medical errors, and improve care.