Over t he last decade, nephrology has witnessed the birth and maturation of a new subspecialty : Interventional Nephrology. This subspecialty offers nephrologists the opportunity to become active participants in the continuum of renal patient care.
A Leader in Managing Vascular Access Care
In 1998, RMS Lifeline Inc. was created to improve the delivery and coordination of vascular access care to renal patients. To achieve this, Lifeline manages all aspects of physician-owned vascular access centers.
Lifeline measures clinical outcomes, oversees facility operations including quality assurance, regulatory compliance and training and management of the clinical staff. Additionally, Lifeline provides coding and billing services along with financial reporting. Ultimately, physicians are free to focus their energies on practicing medicine and providing care for renal patients exclusively.
Included in Lifeline’s offering of services is an extensive, hands-on physician training program that is accredited by the American Society of Diagnostic and Interventional Nephrology (ASDIN). As Lifeline’s leading physician trainer, I have enjoyed training physicians in this new and exciting field of nephrology. It is my opinion that as the number of interventionists continues to grow, the continuum of renal patient care will only become more streamlined and efficient.
The vascular access centers managed by Lifeline address a major problem faced in dialysis: the repair and maintenance of the dysfunctional dialysis access. Any nephrologist or renal patient knows far too well not only the importance of an adequately functioning access, but also the complications and difficulties that arise when that access fails.
Procedures performed in these centers relate to the three major types of vascular access—AV fistulas, AV grafts and dialysis catheters. Vascular mapping is performed to aid the vascular surgeon in identifying vessels that are adequate for the creation of an AV fistula. The goal is to have a patient with end-stage renal disease begin dialysis with an optimal permanent vascular access as has been emphasized by CMS’s Fistula First initiative. Additionally, angioplasty and thrombectomy procedures are performed on both fistulas and grafts to restore and maintain adequate flow in dysfunctional vascular accesses. Dialysis catheter management includes placement, removal and exchange of catheters. Efforts are made in all catheter-dependent patients to move the patient toward a permanent vascular access, preferably a fistula. As the prevalence of AV fistulae continues to increase, Lifeline has incorporated advanced techniques to aid fistula maturation and development. As a result, fewer fistulae are being abandoned due to dysfunction.
Quality, Proactive Access Care: A Winning Combination
The improvements offered by a Lifeline managed vascular access center have a tri-fold affect. Physicians, patients and dialysis units alike experience ease in patient scheduling, one of the foremost challenges in vascular access care. When scheduling, dialysis units need only to call one location to coordinate care for a patient. For emergent situations, most patients can be treated at a Lifeline managed center and returned to dialysis the same day. On average, a patient’s access dysfunction or issue can be resolved in under two hours. Furthermore, elective procedures can be scheduled on offdialysis days or when it is most convenient for the patient. This process ultimately results in fewer missed treatments. By providing timely, convenient and efficient care, costly and inconvenient hospitalizations are frequently avoided. Ultimately, these improvements mean a great deal to patients, for the better.
Lifeline routinely surveys patients treated at each managed center. Patients routinely report high levels of satisfaction with the friendliness of the staff, the technical skills of the physician as well as the overall experience of receiving treatment at the center. Lifeline has consistently observed an overall patient satisfaction rate of 90 percent with patients rating their overall experience as either very good or excellent.
Strength in Numbers
Lifeline’s coordinated network of vascular access centers offers physicians a variety of opportunities in interventional nephrology. As the largest network of its kind in the United States, physicians benefit from ongoing learning opportunities made available to them. Lifeline conducts an annual Physicians Operator Forum whereby physicians from all across the country can meet together with their peers and key thought leaders in interventional nephrology to discuss and evaluate developments, advancements and trends in the field. Physicians who own vascular access centers managed by Lifeline are also members of and participate actively in key healthcare organizations and advisory councils such as the American Society of Nephrology (ASN), the American Society of Diagnostic and Interventional Nephrology (ASDIN) and the National Kidney Foundation Dialysis Outcomes Quality Initiative (K/DOQI).
Patient outcomes are measured against industry benchmarks on a monthly basis. Lifeline has consistently maintained an overall procedure success rate of 98 percent, well above the K/DOQI and Society of Interventional Radiology (SIR) benchmark of 85 percent. More than 175,000 procedures have been performed to date in managed centers, allowing Lifeline to draw upon this data and experience to continually improve access care. A well established history of successful and efficient performance indicates that this organization has indeed held true to its original purpose: to improve the delivery and coordination of vascular access care to renal patients.
Lifeline Today
In 2006, Lifeline was awarded system-wide Joint Commission accreditation and the Gold Seal of Approval. This system-wide accreditation certifies the high standard and quality of care delivered in every vascular access center managed by Lifeline. Lifeline now manages vascular access centers in 19 states throughout the United States and Puerto Rico. RBT
As Vice President for Provider Development, Dr. Beathard works with physicians across the country to develop dedicated vascular access centers and drives in the training and development programs for these centers. Call (877) 658-6800 for more information.
