Domains of telehealth and specific applications in kidney care delivery
| Domain | Definition | Relevant applications | Advantages | Disadvantages |
| A. Synchronous domains | ||||
| - Interactive videoconferencing | Use of real time video and audio for communicating (consulting, teaching, discussing treatment) | - Group clinic sessions to improve compliance - Training of nephrologists/nurses in LMICs - Promoting appropriate CKD management | - Events take place in‘real time’ - Questions and answers will reflect real time discussions and can instantly be revisited | - Requires a good Internet and other equipment (TV monitor, computer screen, cables) - May not be effective for practical hands-on demonstrations (eg, renal biopsy, urine microscopy) |
| - Phone (Mobile Health; mHealth) | Telephone call | - Patient referral - Consultation | - Audio discussions take place in ‘real time’ | - Cost of long-distance calling |
| B. Asynchronous domains | ||||
| - Store-and-forward | Transmission via email of medical or laboratory data and images to an expert for remote review | - Consultations and referral - Screening/prevention programmes - Training of nephrologists/nurses in LIC and LMICs - Improving compliance and appropriate CKD management | - Large data (image) can be sent | - Information sent may be too bulky to read in a short time - Needs capacity for storage of data sent - Lack of personal voice interaction |
| - Phone (mHealth) | Use of SMS or other methods of mobile text messaging for communication | - Screening/prevention programmes - Reminders to attend clinics - Promoting appropriate CKD management | - No need for hospitalisation - Opportunity to provide individualised care | - |
| - Self-monitoring and management | Involves one or more types of sensors deployed in, on, or around a human body to collect physiological signals | - Management of patients in remote areas - Promoting appropriate CKD management | - No need for hospitalisation - Allows for long-term and continuous monitoring / tracking of health status - Opportunity to provide individualised care | - Need to always carry (wear) a sensing device - Inconvenience of frequent buzzing / beeping sounds - False alarms may be sent due to malfunctioning of device |
CKD, chronic kidney disease; LIC, low income countries; LMIC, low middle-income countries; mHealth, Mobile Health.