Implementation of an automated system for monitoring adherence to hemodialysis treatment: A report of seven years of experience

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• 作者：Riccardo Bellazzi^a ; ^{riccardo.bellazzi@unipv.it} ; Lucia Sacchi^a ; Ezio Caffi^a ; Amedeo de Vincenzi^b ; Maurizio Nai^b ; Francesco Manicone^a ; Cristiana Larizza^a ; Roberto Bellazzi^b
• 关键词：Hemodialysis ; Quality assessment ; Failure to adhere ; Data mining ; IT solutions ; Telemedicine
• 刊名：International Journal of Medical Informatics
• 出版年：2012
• 期刊代码：133_13865056
• 类别：med
• 出版时间：May, 2012
• 卷：81
• 期：5
• 页码：320-331
• 文件大小：687 K

摘要

Objective

In this paper we present the clinical deployment and evaluation of a computerized system, EMOSTAT, aimed at improving the quality of hemodialysis sessions. EMOSTAT automatically imports data from the hemodialysis monitoring software tools and analyzes the delivered treatment looking at six clinically relevant parameters. Failures-to-adhere (FtAs) to the planned treatment are detected and reported to the care-givers.

Methods

EMOSTAT has been used for more than seven years in the management of a dialysis service located in Mede, Italy. A total of 72 patients were monitored and 21 251 dialyses were collected. Data analysis is performed on the periods 2002-2005 and 2005-2008, corresponding to two different software releases.

Results

The system had been exploited into everyday clinical practice for the entire considered period. The number of FtAs significantly decreased along the first period: the bulk blood flow FtAs decreased after the introduction of the system. Hemodialysis sessions lasted longer in the second period. Co-occurring FtAs, highlighting the presence of complex FtAs patterns, were also detected.

Conclusions

EMOSTAT provides an effective way to re-focus the attention of the dialysis department on the treatment plan and on its implementation. The automatic data collection and the design philosophy of EMOSTAT allowed the routine use of the system.