Virtual nephrology services: Enhancing localized care and expanding access

Specialized virtual nephrology requires a commitment to providing high-quality care led by a dedicated team of board-certified nephrologists, many of whom have a background in intensive care. Virtual nephrology programs should be designed to support hospitals with varying levels of resources, enabling them to provide comprehensive kidney care without requiring patient transfers to distant facilities.

Nephrology services should cover consultations for both routine and complex nephrology cases, including the management of conditions such as acute kidney injury, chronic kidney disease, and multi-organ dysfunction. In addition, clinical syndromes like acid-base disorders, hypertension, and electrolyte imbalances must be addressed. This breadth of service allows virtual nephrologists to work alongside local care teams to manage a wide range of nephrology cases with ease and expertise.

One unique offering is virtual oversight for hemodialysis and continuous veno-venous hemofiltration. Teams handle initial consultations and ongoing follow-up for these patients, closely monitoring treatment adherence to local quality standards. This virtual oversight has proven valuable in cases where a patient's condition requires meticulous management but in-house nephrology resources may be limited.

Each program is tailored to the specific needs and resources of the institution we support. A notable example of this personalized approach occurred last year at a critical access hospital in Oregon, where Equum Medical launched a virtual hemodialysis program. This allowed patients with end-stage renal disease to receive hemodialysis locally, avoiding a two-hour transfer to the nearest facility with dialysis capabilities. Our program enabled these patients to remain in their home community, receiving seamless care that transitioned back to their usual outpatient nephrology provider upon discharge. This initiative not only enhanced patient satisfaction but also proved valuable to the hospital and the community by reducing the strain on transfer resources and keeping patients close to home.

Another important component of our nephrology program is admission decision support. In this role, we assist smaller hospitals in evaluating whether a patient with a nephrology-related issue can be managed locally or needs to be transferred for specialized care or procedures. By offering this guidance, our virtual nephrologists help local providers feel supported in their decision-making, ensuring patients receive the most appropriate care pathway. This collaborative approach strengthens the level of support at smaller hospitals and improves continuity of care.

Our services are currently integrated within both critical access hospitals and large, multi-center health systems. In each setting, our goal is to keep patients at their local institutions whenever possible, thereby reducing the burden on larger medical centers while preserving continuity of care. Our nephrology specialists work closely with other Equum subspecialists and bedside care teams to provide a comprehensive, coordinated approach to virtual nephrology care.

With Equum Medical’s virtual nephrology services, we’re transforming the way kidney care is delivered in rural and underserved communities, ensuring patients receive the specialized care they need without sacrificing quality or accessibility. Through our virtual programs, we continue to support hospitals in enhancing their nephrology services, allowing patients to stay local and access the high-quality care they deserve.

NRHA adapted the above piece from Equum Medical, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.

About the author: Dr. Anisha Mathur serves as chief medical officer of Equum Medical, overseeing a prestigious group of physicians specializing in critical care and other multi-specialty services. She continues to practice as an intensivist bedside and virtually and serves as a rural health virtual infectious disease physician. Dr. Mathur specializes in optimizing patient flow logistics through the strategic deployment of telemedicine programs in the emergency room directed at offloading patient burden on inpatient units or entire hospital systems. Her passion also lies in bringing sub-specialty care to critical access hospitals, facilitating personalized care locally, retaining hospital revenue, and strengthening community ties across diverse settings.