Nx2me Connected Health is designed to help you
- Monitor and support patient adherence and potentially reduce complications
- Reduce patient burden and enhance patient confidence
- Increase patient retention through compliance monitoring and enhanced connection with patients
- Reduce effort involved in collecting flowsheets
Quality of Care: Key Potential Benefits
Compliance
Clinicians may monitor and support adherence to treatment and potentially reduce complications and hospitalizations associated with non-compliance.
Early intervention
Clinicians may identify health problems before unscheduled care is needed (eg, blood pressures, arterial or venous pressures running too high).
Notifications
Alerts patients and nurses when key clinical parameters deviate from pre-established norm to help support patient case management.
Data captured from patients and available to clinicians
- Patient’s weight and blood pressure (captured via Bluetooth® technology)
- Fluid weight removed during treatment
- Medications taken
- Dialysis fluid delivered
- Notes, and health assessments
- Two-way messaging system, similar to text messaging, enhances communication and care coordination
Once your patient finishes their treatments, data recorded in the Nx2me app will be transmitted directly to the Nx2me Clinician Portal where you can access their treatment record 24/7 for a closer look.
Nx2me works over a secure Wi-Fi network established at the patient’s home. If a patient doesn’t have Internet service, a cell data plan is available. All patient information is encrypted and transmitted using secured Internet protocols.
Nx2me has shown to improve patient retention by monitoring compliance, early intervention and education.1
Lower therapy discontinuation rate due to controllable causes
Reduction in median training time
Nx2me Impact Stories
Learn how Nx2me and NxStage Tech Support were better able to assist a patient via Link.
The Power of Link
Background
During a therapy session, a care partner attempted to increase the patient’s RF volume from 25L to 30L but pushed an incorrect button accidentally. Since the care partner did not know whether the rate or volume had been adjusted, they wisely chose to contact NxStage technical support.
Action
A NxStage Tech Support rep took the call and utilized a Nx2me Link Session to view the cycler data stream. This allowed him to see and confirm the exact volume and rates that had been programmed, as well as the data that had already been processed prior to the pause in treatment.
Impact
Using Nx2me Link’s timely and accurate data, the tech support rep was able to calculate and adjust the cycler therapy to within 1L of the specific volume goal. With the Nx2me Link Session and NxStage Tech Support guiding the way, the care partner made the adjustment.
Nx2me has shown to improve patient retention by monitoring compliance, early intervention and education.1
- 29% Lower Therapy discontinuation rate due to controllable causes
- 1 Week Reduction in median training time
A Nx2me patient was experiencing hypotension symptoms. Learn how an assertive nurse utilized the Nx2me Clinician Portal to assist.
Timely Monitoring, Timely Adjustments
Background
A NxStage patient was experiencing lightheadedness and nausea and reached out to the center for assistance. The nurse assessed the patient over the phone and recognized symptoms of hypotension related to volume removal, then instructed her to administer saline and lie back with her feet elevated. The patient began to feel better, but the nurse wanted to review her treatment record via the Nx2me Clinician Portal to ensure she hadn’t missed anything.
Nurse Action
After arriving at the clinic, the nurse used the Nx2me Clinician Portal to compare data on the flow sheet with data from the patient. She discovered the patient had been taking steroids and gained weight, which required increasing her recorded dry weight. Adjustments were quickly made, which helped the patient get back on the right course of treatment.
Patient Impact
If not for the Nx2me Clinician Portal, three weeks would have passed before the patient’s next physician clinic visit, and this critical data would not have been seen until then. Nx2me enabled fast, easy access to precise and up-to-date patient treatment information, which positively impacted clinical decision-making, patient safety, and satisfaction.
Non-Adherent No More
Background
A Home Training nurse received a call from a nephrologist about a new Home Hemodialysis (HHD) trainee he was sending over. The patient had a history of non-adherence when they were on peritoneal dialysis (PD) and was, at that very moment, in the hospital for treatment of complications brought on by a monthlong lapse in exchanges. The nephrologist was confident this patient would be great for HHD and training was scheduled.
A Pleasant Surprise
As it turned out, the nephrologist was correct. After three weeks of HHD training, the patient and spouse began using the Nx2me app on an iPad and quickly became comfortable with the technology. They were extremely adherent with their HHD training, missed zero sessions, and were sent home after completing the training.
Patient Impact
Since the patient completed training and was sent home, they have only missed one treatment. The visibility that their care team had to their treatments via the Nx2me Clinician Portal encouraged them to remain adherent with their prescription.
Fluid gains were causing problems with a patient’s therapy regimen. A nurse used Nx2me flow sheets to identify the issue and put the patient back on track!
Early Ultrafiltration Intervention
Background
A lung transplant patient who weighs just 39 kg is known to her home nurse for being very sensitive to fluid gains. Her clearance is more than adequate but keeping fluid gains under control is very difficult.
Action
Using the Nx2me Clinician Portal, the nurse consulted Nx2me flow sheets and a report helping her identify that the patient often performed extra treatments solely for ultrafiltration. Once this information was uncovered, the patient’s treatment times were adjusted to keep her fluid under tight control.
Impact
With adjustments made to treatment frequency and time, the patient no longer needs additional treatments for ultrafiltration. Additionally, the patient was given parameters so she can make adjustments on her own. Thanks to Nx2me and a forward-thinking nurse, the patient and her care team are all experiencing new levels of satisfaction!
When two similar patients showed the same adverse symptoms, a knowledgeable nurse took it upon herself to investigate using Nx2me. The result was a pleasant surprise.
A Proactive Dry Weight Adjustment
Background
Two newly trained Home Hemodialysis (HHD) patients were experiencing low blood pressure, and a home training RN from their clinic took note via the Nx2me Clinician Portal.
Nurse Action
Hypotension red flag alerts in Nx2me Clinician Portal prompted the nurse to dig deeper, and she noticed a correlation between the records. Both red flags occurred around the second month the patients were at home, and data showed that both patients were symptomatic at their estimated dry weight. The RN investigated the matter and learned that since starting HHD at home, the two patients had...
- Stopped taking antihypertensive medication
- Increased their activity levels
- Increased their muscle mass and dry weight
Realizing their health status had changed for the better, the nurse collaborated with the nephrologist and dry weights for both patients were increased.
Nx2me Impact
Since this adjustment, both patients have experienced fewer episodes and their dry weights are more accurate. Their alert nurse now has a new best practice – each day she uses Nx2me Connected Health to evaluate all HHD patients for clinical indicators. What’s more, her proactive routine has been adopted by the center, and it is now a required daily process for the Home Training Nurse to review and approve all patient flow sheets before they are entered into the electronic medical record.
Nx2me patient records revealed lapses in treatments and sparked concerns about non-adherence from a nurse and care team. Learn what this unified care team discovered and their solution.
Non-Adherent or Care Partner Burden?
Background
A Home Training Nurse, reviewing records on Nx2me Connected Health, noticed that a couple of patients were occasionally missing their home hemodialysis (HHD) treatments, specifically on weekends. It appeared to be a case of non-adherence.
Action
The social worker, nephrologist and home training nurse had conversations with one of the patients and discovered that the patient’s care partner was overburdened – trying to balance the responsibilities of a job and helping administer HHD. A multidisciplinary team met to discuss the situation and identify solutions that would allow the patient to continue dialyzing at home.
Impact
Meeting with the patient and care partner separately, the social worker, physician and home nurse used Nx2me Clinician Portal data to help explain concerns about missed treatments. Solo HHD was an option proposed as a way to maintain the patient’s home therapy while reducing the caregiver’s hardships. One patient is now being trained to do Solo HHD and the second patient is considering trying Solo HHD therapy as well!
Not only was the multidisciplinary team able to retain a patient, they were also able to decrease a care partner’s burden, bringing relief to everyone involved!
Contact Us For More Information
For more information on Nx2me Connected Health, complete the form below and a NxStage representative will contact you.
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References
- Weinhandl E, Collins A. Relative Risk of Home Hemodialysis Attrition in Patients Using a TeleHealth Platform. Hemodialysis International. December 2017.
Risks and Responsibilities
The reported benefits of home hemodialysis (HHD) may not be experienced by all patients.
The NxStage system is a prescription device and, like all medical devices, involves some risks. The risks associated with hemodialysis treatments in any environment include, but are not limited to, high blood pressure, fluid overload, low blood pressure, heart-related issues, and vascular access complications. When vascular access is exposed to more frequent use, infection of the site, and other access related complications may also be potential risks. The medical devices used in hemodialysis therapies may add additional risks including air entering the bloodstream, and blood loss due to clotting or accidental disconnection of the blood tubing set.
Home hemodialysis with the NxStage system during waking hours may not require a care partner, provided a physician and a qualified patient agree that solo home hemodialysis is appropriate. Patients performing nocturnal treatments are required to have a care partner. Care partners are trained on proper operation and how to get medical or technical help if needed.
Certain risks associated with hemodialysis treatment are increased when performing solo HHD because no one is present to help the patient respond to health emergencies. If patients experience needles coming out, blood loss, or very low blood pressure during solo HHD, they may lose consciousness or become physically unable to correct the health emergency. Losing consciousness or otherwise becoming impaired during any health emergency while alone could result in significant injury or death. Additional ancillary devices and training are required when performing solo HHD.
Certain risks associated with hemodialysis treatment are increased when performing nocturnal therapy due to the length of treatment time and because therapy is performed while the patient and care partner are sleeping. These risks include, but are not limited to, blood access disconnects and blood loss during sleep, blood clotting due to slower blood flow and/or increased treatment time, and delayed response to alarms when waking from sleep.
Patients should consult their doctor to understand the risks and responsibilities of performing these therapies using the NxStage system.
