Kidney disease prevention, therapy requires innovation

Traditional Chinese medicine believes that the kidneys are the root of Qi. They hold the basic life force, have much to do with how long a person lives and, when weak, make us vulnerable to myriad illnesses. The diets and lifestyles of the modern day present unprecedented, formidable challenges to renal health. Innovative prevention and treatment of kidney failure is of paramount importance to both quality of life and the global cost of health care.

My brother-in-law, Vincent Garvey, an Irish inventor with no background in health care, came to Hawaii several months ago asking questions about how dialysis works and what might make it better. The next thing I knew he was written up in the Lancet, Britain’s pre-eminent medical journal, for a breakthrough invention in home dialysis, particularly relevant to Third World patients with renal failure. He won the Affordable Dialysis Prize for his work.

Worldwide, over 2.5 million people are on dialysis with an additional two- to threefold more without access to care who would likely benefit from treatment. With annual costs of dialysis in the U.S. approaching $100,000, it is simply not affordable for much of the developing world. While kidney failure is an incurable condition, with dialysis, lives can be extended. Unfortunately without access to dialysis, people die.

Garvey developed a system for inexpensive home dialysis that brings together a water purifier with a care station that combines sterile water with dialysis powder run by a renewable power source using a photovoltaic solar panel.

Innovation in prevention of kidney disease is equally important.

Victoria Page is the executive vice president of Health Innovations at the National Kidney Foundation of Hawaii. Her group has transformed primary care physician offices, by providing workflow redesign, disseminating pertinent information, and improving patient outcomes.

Health Innovations has helped with the transformation to patient-centered, value-based care.

Current services provided by the Kidney Foundation’s Health Innovations division include:

>> Practice readiness assessment

>> Data-driven change management using electronic health records and other databases

>> Workflow redesign for increased access to patients

>> Development of team-based care

>> Care management and care coordination where physicians can refer patients for help understanding and maintaining care plans

>> Electronic health record/registry/dashboard training for population health

>> Quality improvement capacity building with incentive qualification

The National Kidney Foundation of Hawaii works with local insurers and government agencies to understand incentive programs and assist providers getting paid for these programs.

Page and Dr. Zoya Zaki, Quality Improvement Coach at the Kidney Foundation, have been instrumental in helping physicians adapt to Hawaii Medical Service Association’s Health Payment Transformation Initiative now in its pilot phase. The reimbursement model for primary care providers is changing from fee-for-service to a fixed fee per member each month.

Zaki understands the nuances of the health care environment and is able to anticipate physician’s questions and concerns as they work to maintain clinical practice in the face of ever increasing, multivaried requirements.

In its wisdom, the National Kidney Foundation of Hawaii, Health Innovations Division understands that the best way to prevent renal failure is to proactively support physicians to adapt to the dynamic changes in the health care environment.

For those patient who eventually find themselves in need of dialysis, Garvey, has made an epic contribution to millions of lives by inventing an inexpensive, safe and versatile dialysis system for patients to treat at home. As traditional Chinese doctors have known for millennia, the kidneys are the root of life. These modern innovations show great promise.