Telehealth Helps MUSC Improve Kidney Transplant Screening Process

A telehealth platform has helped the Medical University of South Carolina screen patients for kidney transplants during the coronavirus pandemic – in some cases improving on the process that was in place before COVID-19 hit.

Between April and September, MUSC saw almost 1,150 candidates for kidney transplant in a three-tiered system that used connected health platforms in place of some in-person visits. Of that group, 176 transplants were performed, 930 candidates were screened on a doxy.me virtual care platform and 282 were placed on a wait list.

During the same time period in 2019, the hospital conducted 177 transplants, screened 880 of the 1,639 candidate patients and put another 308 on a waiting list.

Those involved with the program say the telehealth platform enabled them to increase the number of evaluations and reduce the number of patients in the referral phase by almost 50 percent – all while reducing travel costs and time for patients, improving provider workloads and reducing the risk of COVID-19 infection.

“Because of the platform, we can give continuous access to patients in the kidney transplantation program even in the midst of a pandemic that has restricted access to the hospital,” Vinayak Rohan, MD, FACS, an assistant professor of surgery at MUSC and author of a study published in December in the Journal of the American College of Surgeons, said in a press release. “We can provide access to kidney transplantation even for patients who have difficulty getting to the transplant center because of where they live or who have difficulties due to their socioeconomic status."

The telehealth program offers a model for other health systems looking to improve the transplant screening process, both during and after the ongoing public health emergency.

At MUSC – one of two National Telehealth Centers of Excellence – a team from the hospital’s division of transplant surgery developed a virtual kidney transplant evaluation, then divided patients into three categories. Those in the red group were unlikely to qualify as transplant candidates because of age or underlying medical conditions, as well as those who would need more tests; those in the green group were likely candidates with little or no need for further testing and were placed on the wait list; and those in the yellow group were already on a wait list for a transplant (“fast track” patients) and other prime candidates for transplants.

With the virtual platform in place, patients were screened according to their status – yellow first, followed by green and red. In-person visits were then scheduled for those who required more tests.

The program was aided by the CARES Act, passed in March, which expanded Medicare coverage for telehealth services.

Rohan said the virtual care platform could be adapted for other specialties, though it would require permanent changes in telehealth regulations.

"We need to continue this practice in the future, even after the CARES Act expires, and expand care across state lines so that patients can continue having access to medical care across all specialties," he said.