Telemedicine technology and applications for home hemodialysis

Home hemodialysis (HD) for the treatment of patients with end-stage renal d isease (ESRD) was first put into practice about 30 years ago. In this paper we describe the application of telematics monitoring services (TMS) for su pporting patients who need home or satellite HD (SHD). For the clinical tri als two modified HD machines were located in the renal unit and a central c ontrol station (UNIX workstation with multimedia PC-terminal) was located i n another room of the hospital. Bi-directional communication between modifi ed HD machines and central control station was managed via ISDN (Integrated Services Digital Network) links. Using these HD-machines 150 HD sessions were performed in nine patients ove r a period of five months. This system enabled on-line remote supervision o f the HD machine-related functions (air in the blood, leak of blood, low co nductivity etc.) and the clinical condition of patients through measurement of blood pressure (BP), pulse rate, PO, (pulse oxymetry) and electrocardio gram (ECG) from the central control station (CCS). The user checked the typ e of alarm/warning, its appearance on HD machines and multimedia terminal u nits (MTU), the action of the protective system and the appearance of consu ltative messages from CCS on the remote terminal unit RTU. According to the data collected, the disturbances of HD machine function were visible and a udible in the CCS and the user messages were always observed on the RTU. No unusual dialysis-associated complications were observed all data and alarm s/warnings were transmitted correctly and patients had adequate HD treatmen t.