Background: The VA National Transplant Program is challenged to provide timely kidney transplant evaluation for Veterans nationwide. Efforts to improve access have included implementing a centralized web-based submission system in March 2011 and promoting telehealth, which the Nashville VA Medical Center (VAMC) began utilizing in October 2013 for initial waitlist evaluations.

Objective: To evaluate the impact of telehealth on timeliness to initial kidney transplant waitlist evaluation at a VA transplant center.

Methods: Patients approved for waitlist evaluation at the Nashville VAMC from 01/09-10/15 were included. Monthly data were summarized as: number of applications, median days to initial evaluation, and % of initial evaluations that occurred within 30 and 60 days. Temporal trends were analyzed using non-parametric comparisons of medians between three eras: pre-web-based submission (PWB), web-based submission (WB), and web-based submission with telehealth (TWB).

Results: During the study period, 906 patients were approved. The number of applications per month did not vary between eras (p=0.571). The monthly median time to initial evaluation decreased significantly with the TWB era when compared to the WB and PWB eras (59 vs 260 and 116 days, respectively; p≤0.01). There were no differences in the monthly % of patients evaluated within 30 days between eras (p=0.521). TWB significantly increased the monthly % with appointments within 60 days compared to the WB and PWB eras (54% vs 8% and 0%, respectively; p<0.001).

Conclusion: Our transplant center has been able to markedly improve the timeliness to kidney transplant waitlist evaluation for Veterans with the addition of telehealth.

CITATION INFORMATION: Forbes R, Kummerow Broman K, Johnson T, Rybacki D, Hagemann M, Hannah-Gillis A, Feurer I, Hale D. Implementation of Telehealth Is Associated with Improved Timeliness of Kidney Transplant Waitlist Evaluation at a VA Center. Am J Transplant. 2016;16 (suppl 3).

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