Moving Health Care Home: Insights We’ve Learned in Kidney Care

The pandemic sparked new energy around moving health care into the home. From prescription drugs to hospital services and long-term care, investment is pouring into new companies with promising business models that could make home health care work at scale.

While this is a fresh take for many health care companies, it isn’t new in kidney care. The kidney care community has been helping people with kidney failure—some of the most medically complex, at-risk patients—administer their dialysis treatments directly in their own homes for more than 40 years.

When I published my first piece on home dialysis in 1982 while training at Cleveland Clinic, there were fewer than 5,000 patients treating their kidney failure at home. Since 2002, DaVita alone has helped approximately 445,000 dialysis patients treat at home—more than any other kidney care provider*.

Increasing access to home dialysis has always been a priority for DaVita, but I’ve never been more optimistic about the future than I am now. Today, our home program is growing at five times the rate of our in-center dialysis program. Yet our aspirations to increase access to home dialysis is about more than hitting certain targets; it represents a true belief in transforming patients’ lives by managing their condition in their homes, which can give them more time back to do the things they love.

To others in health care coming into this space, we offer three fundamental lessons we’ve learned from helping our patients treat at home.

Know your patients and their environment

Understanding our patients’ health care needs and goals is essential to increasing home care access and implementation. First, we must identify barriers potentially preventing patients from engaging in home care. DaVita has established an enhanced modality education process to educate our patients, which also provides comfort and peace of mind when considering home care.

Assessing the physical home environment is also crucial to understanding the big picture and helps shape shared decision-making and care planning. Conducting initial home visits helps ensure the home care setting is safe for each individual patient. For example, during our initial home visits, we identify a clean area for conducting dialysis treatments and storage space for necessary supplies.

This helps open a dialogue with patients and their care partners about what it takes to be successful, and our goal is always to provide a “can do it” approach.

Commit to patient experience

Cultivating a memorable and positive care experience is important when we move care into the home. While the experience should reflect the feeling your company’s brand is striving to create, success will ultimately come from creating a platform that makes it easy for your patients to engage. To do that, you must understand your patients’ needs and barriers in relation to your offering. It’s also vital to check in with patients to hear their ongoing feedback. From here, you’ll derive insights to help improve the experience and elevate your home care program, which ultimately can help strengthen adoption and retention.

Remember, the whole concept of home care is that care is brought to the patient; thus, the patient should be at the center of your home care program.

Deepen connectivity with smart technology

Providing creative and connected technology solutions helps to deepen bonds between patients and their care teams while facilitating the exchange of key health information needed to improve clinical outcomes. This can also be a powerful way to expand access in rural areas and underserved regions, as clinicians can stay attuned to patients’ physical and mental health through remote monitoring and two-way messaging.

Additionally, smart technology can foster community. Patients with kidney failure who treat at home often seek to bond with others. Connecting with fellow patients can help improve mental health by reducing isolation and nurturing connections. At DaVita, we use our multiparty, interdisciplinary DaVita Care Connect® telehealth platform as a space to host virtual support groups for home dialysis patients, offering support from our social workers and a space to share experiences.

Dr. Marty Schreiber is the Chief Medical Officer for Home Modalities and Pediatrics at DaVita Kidney Care

*Service provider and modality selection are choices made exclusively between the patient and nephrologist.

The editorial staff had no role in this post's creation.