Claudio Ronco, MD Dipartimento di Nefrologia, Dialisi & Trapianto Renale International Renal Research Institute Ospedale San Bortolo - Vicenza

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1 Claudio Ronco, MD Dipartimento di Nefrologia, Dialisi & Trapianto Renale International Renal Research Institute Ospedale San Bortolo - Vicenza

2 Four Areas where telemedicine can be useful in Nephrology Integrated inter-hospital networks Integrated in-hospital networks Home hemo- and peritoneal dialysis Wearable devices for dialysis and heart failure

3 Four Areas where telemedicine can be useful in Nephrology Integrated inter-hospital networks

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5 Vicenza Arzignano Asiago Schio Valdagno Bassano

6 ULSS

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10 The general concept of data collection Quality of Care PARAMETER INTERVENTION MEASURE ANALYSIS Patient Benefit

11 Computer Assisted Data Management Single session Single Patient History Center - Population Center - Population Center - Population Center - Population

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13 Continuous Quality Improvement Quality Assurance Programs Hardware Maintenance Statistical analyses Dialysis Billing Accountability Research Number of failures, number of hypotension or saline Clinical trials infusion, Uf Correlations off or Data Statistics pump speed Improvement of blood flow On line clearance Alarm or failures of electronics and hydraulics (blood flow, dialysate temperature, conductivity) DRG management and HD reimbursement Medical Director Acitivit

14 Server

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16 Clinical Data for a Kidney Transplant in real time

17 Clinical Data for acute dialysis in real time

18 Four Areas where telemedicine can be useful in Nephrology Integrated inter-hospital networks Integrated in-hospital networks

19 Nefrologia Intensive Care

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22 PRESCRIPTION WIZARD FINESTRA DI CONTROLLO POSTI LETTO

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26 INFORMATION TECNOLOGY FOR OBSERVATIONAL STUDIES Web Based data collection

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28 Four Areas where telemedicine can be useful in Nephrology Integrated inter-hospital networks Integrated in-hospital networks Home hemo- and peritoneal dialysis

29 In spite of modern technology..

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31 Home Hemodialysis

32 The largest PD program in Europe All patients treated with PD: a truly home-based therapy

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34 CAPD prescription

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36 PET data entry

37 PFT

38 Four Areas where telemedicine can be useful in Nephrology Integrated inter-hospital networks Integrated in-hospital networks Home hemo- and peritoneal dialysis Wearable devices for dialysis and heart failure

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46 SmartPD IMPROVED PATIENT FREEDOM: ONE BAG EXCHANGE BEFORE NIGHT, SECOND BAG EXCHANGE AT WAKE-UP + LOADING OF SmartPD BELT, ENHANCED EFFICIENCY IN CATABOLYTES REMOVAL FROM 4 BAGS PER DAY TO 2 BAGS PER DAY DAILY BATTERY OPERATED ADSORPTION SYSTEM

47 Palm Control Unit Necklace To the Catheter Belt Waterproof regeneration unit Fig 2

48 Shower Proof Disposable Kit Rechargeable Battery Front Top Side

49 Wireless Connection

50 A Wearable Continuously Functioning Artificial Nephron Design Concept

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52 Department of Nephrology,Dialysis and Transplantation International Renal Research Institute Vicenza - Italy World Conference on Portable, Wearable and Miniaturized Dialysis Systems Vicenza (Italy) October 1-2, 2010

53 Telemedicine It will never be a substitute for personal doctor care It may help to vevelop a dehospitalization strategy It may result useful in several areas of Nephrology In particular: for inter-hospital communications for in-hospital interdisciplinary care for home-based therapies It may become successfull if proven cost-effective

Wearable Artificial Kidney Juan Malvar Biomedical Engineering University of Rhode Island November 10, 2015

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