Category 2 Winner Daniel Marsh

Open Dialysis Chair App

In the course of living life, it is typical for humans to experience periodic delays affecting our ability to make scheduled appointments, necessitating these appointments be rescheduled. When this occurs to an in-center hemodialysis patient, the end result is frequently a missed dialysis treatment, potentially leading to an avoidable hospitalization, or in the worst case, even death. Currently 90% of our country's Medicare dialysis population are treated with in-center hemodialysis, making this a significant problem affecting the morbidity and mortality for most dialysis patients. I propose that Medicare develop an "Open Chair" app for smart phones that would allow patients to see open time slots for dialysis treatments in regional Medicare-participating clinics that are available for them to schedule their "missed" dialysis treatment in real time. Participating physicians and dialysis clinics would be required to enroll in this program in order for a given patient to participate with this app. When the patient selects an open time and chair, an encrypted notification would be sent to the prescribing physician to give/approve the order for the dialysis treatment. The app would securely deliver their dialysis prescription that has been entered by their physician, to the treating facility in order for the dialysis clinic to treat the patient. The open chair/time slot should be compatible with the time of the prescribed treatment, and if it is not, an encrypted text message could be sent to the prescribing physician to modify the treatment if the physician agrees. The Medicare billing data should also be included in the patient data so the dialysis clinic will be able to bill appropriately for the dialysis treatment. The app should have the ability for the patient to rate of the clinic and their experience during the treatment for other patients to see and use to determine if they would want to schedule future appointments in that clinic. The app should also have notes to the prescribing physician from the treating clinic, reporting if the patient arrived on time or if they completed the entire prescribed treatment and discharge weight. Treatment notes, such as blood pressures and patient problems or complaints could also be included. This chair availability technology is present in many clinics across the country with programs that report the daily treatment schedule with put-on times, take-off times, and patient attendance, showing openings when patients do not attend their scheduled treatment. With use of this program, patient quality of life will improve and the country will see a significant improvement in patient morbidity and mortality with decreasing hospitalization rates. Dialysis clinics will also work harder to improve patient comfort and care in order to secure better patient ratings through the app.