Technology Drives Innovation, Accessibility When Treating Chronic Kidney Disease

Incorporating new technologies in primary care and promoting kidney health were among the topics discussed during the Institute for Value-Based Medicine^® (IVBM) event held in Park City, Utah, on October 7, 2025, where experts discussed the most pressing issues in kidney health. The event was hosted by The American Journal of Managed Care^® in partnership with Intermountain Health.

Promoting, Implementing Care Strategies in Kidney Care

Health care is constantly evolving, and kidney health is no different. Several presentations during the IVBM event addressed the use of new technologies and tools to both respond to a patient’s kidney problems and proactively address these issues as soon as possible.

The night began with Wendy St. Peter, PharmD, FASN, FCCP, FNKF, a professor at the University of Minnesota, speaking on the ways that optimal medication management can help to advance kidney health. Within the past 15 years, researchers have developed additional classes of medications to treat chronic kidney disease (CKD), expanding beyond the original sodium-glucose cotransporter 2 inhibitors that previously comprised the entirety of treatment, said St. Peter.

“But the sad thing is, even though we have all these tools, we have significant underutilization,” she said. “What is it about CKD that makes physicians scared to prescribe some of these medications?”

St. Peter highlighted the American Heart Association (AHA) guidelines, which were released in 2023, for cardiovascular-kidney-metabolic (CKM) syndrome.¹ This, she said, corresponds with risk of CKD, as those with moderate risk of CKD are automatically placed in CKM stage 2 due to the overlap in risk factors. The PREVENT online calculator² was also published with the AHA presidential advisory. The calculator can help to determine the risk of cardiovascular disease (CVD) and CKD based on estimated glomerular filtration ratio and urine albumin to creatinine ratio, and it includes a calculation of the social deprivation index based on zip code.

Coordinating that care between cardiology and nephrology should be a top concern given the overlap in CKM and CKD diagnoses, said St. Peter. Collecting data from electronic health records (EHRs) to identify patients with the highest risk of CKD progression and utilizing tools such as the PREVENT calculator to determine their risk of CVD can help initiate proper treatment as soon as possible, thereby preventing worse outcomes from occurring.

Advancing Kidney Health through Optimal Medication Management is an initiative that aims to address this, ensuring every patient with CKD receives optimal medication management that is both safe and affordable, through a team of doctors and pharmacists. “We’re helping nephrology, cardiology, endocrinology, and primary care practices as well as value-based care companies to implement comprehensive medication management to improve that CKM health,” St. Peter said. The program includes implementation coaches who help teams around the country initiate the coordinating care.

Promoting kidney health was also the topic of a presentation by Chenlee Condie, MSN, RN, CNN, the director of clinical kidney services at Intermountain Health. Condie spoke about the nurse navigation program in nephrology, which informs patients about their next steps in a setting that provides privacy for them to ask questions without feeling self-conscious. Condie explained that navigation has been a staple of oncology care for the last 30 years but is only just now being attempted in nephrology care.

She noted that, alongside patients not understanding what end-stage kidney disease (ESKD) entails, ESKD also has a higher mortality than some cancers, which makes it important to give patients information in a timely and clear manner, including what their treatment options are and whether they are eligible for kidney transplant.

Condie specifically emphasized that nurses being available for a patient to ask questions is important for their trust in their own care. “Sometimes I don’t ask a question [to a physician] because I’m like, ‘Oh gosh, if I ask that question, they are going to think I am so stupid.’ So I don’t ask,” she said. “It’s amazing if we can have a navigator go in after the physician visit—particularly when the patient first comes to our clinic and they’re learning that they’ve got [CKD]—and sit down with the patient and [say], ‘Hey, what was the conversation you just had with the physician? Let’s go over what you just learned.’”

The navigation program began by manually searching for patients with risk of CKD who had not been seen yet, but Condie believes that, with the introduction of the Epic EHR, this may one day become an almost automatic recommendation. Nurse navigators also work together with nephrologists and dietitians to come up with plans for their patients, providing holistic and coordinated care to those at the greatest risk of complications.

In a similar vein, Brian Leonard, DO, senior medical director of the Primary and Preventive Care Clinical Program at Intermountain Health, spoke about proactive kidney care strategies. Primary care physicians, he said, need to screen for kidney disease, but it is often a matter of finding the time in a short doctor’s appointment among other preventive screenings across several specialties.

Leonard emphasized the importance of conversations between physicians, including specialists, as well as making sure that the EHR is up to date, to be able to discuss how to care for patients. He hopes Epic can play a part in helping to identify those who may need a nephrologist consultation after laboratory results are entered into the system. This teamwork, he said, is like rowing a boat in the same direction, which can be tricky to do but satisfying when everyone is working together.

“When you do have that synergy with people…and everybody’s thinking, how do we get this paid for? How do we get this to be sustainable? How do we get in front of things? It’s a really warming thought, and it’s a great group to be a part of,” he concluded.

Telehealth, At-Home Solutions Can Augment Care

The future of CKD through at-home care was a major focus throughout the panel discussions at the IVBM event. Remote monitoring and telehealth were the topics of a panel moderated by Anitha Vijayan, MD, FASN, the senior medical director of Intermountain Health.

Remote monitoring is a growing field in medicine, particularly following the COVID-19 pandemic, where physicians can evaluate patients remotely and provide them with treatment updates. Kismet Rasmusson, DNP, FNP-BC, CHFN, FAHA, a professor of clinical research at Intermountain Health, acknowledged that literature before the pandemic was flat regarding remote monitoring, but it exploded during and after the pandemic due to the need to keep serving patients when they couldn’t meet in person. In pilot programs at Intermountain, they found that patients loved having a coach for their treatment plan.

Kristen Lile, DO, a nephrologist at Intermountain Health, explained that she likes to use telehealth for return visits rather than first-time visits, as connecting face-to-face for a first visit is still very important.

“Truthfully, most of my video visits are [people of] working age. People stay at home, moms who have all of their things to do throughout the day when people are at work or in school, people who have busy schedules that it’s tough to get out and go to a visit,” she explained. “If you work a 9-to-5 [job], you’ve got a minimal 4 hours that you have to do to go to a kidney visit.… That’s a lot of time to invest in doing [a follow-up].”

Maurine Cobabe, MD, senior medical director of ambulatory quality at Intermountain Health, noted that telehealth has become easier since the pandemic, as patients can now follow up on their weight and blood pressure at home. Clinicians can also check in with patients more throughout the year, rather than just once a year, to make sure that they are adherent to their medication regimen. “A lot of that has facilitated quicker turnaround in the earlier stages of some of these illnesses so they don’t get out of hand before you get a chance to control them,” she explained.

Rasmusson emphasized that a lot of remote monitoring is data management when looking at patients as a population, which makes the team around the physician all the more important. This is also true in addressing mental health concerns in the space, said Lile.

A second panel also focused on home-based care, specifically with hospital-at-home programs from both the payer and physician perspectives. Seth Southwick, MHA, assistant vice president of kidney services at Intermountain Health, moderated this panel of experts.

Nathan Starr, DO, medical director at Intermountain Health, explained that hospital-at-home has a lot of definitions. “We are taking patients who need that high level of care and we’re bringing that necessary care into their home,” he said.

Bringing quality care into the home can improve the patient experience with care, according to Starr, who also noted that families of patients prefer an at-home option. With the shortage of hospital beds, at-home care is “an opportunity to help support patients who truly need that intensive care [so they] can get it. In patients where we have alternative solutions, we can keep them out of the hospital in better settings,” Starr said.

Anna McMillan, MHA, MSW, director of hospital-level care at home at Intermountain Health, also noted that the cost savings could also be a benefit for patients: “That is our big proactive push for hospital-at-home. Not just the clinical quality that we bring to the patient, the care, or the patient experience, but how do we actually take health care by the reins and try to control some of the most costly episodes that we see?”

When it comes to CKD specifically, Starr said that at-home dialysis is being explored for patients who are best suited for it. The biggest limitation to this is the CMS Acute Hospital Care at Home waiver, as it does not permit a patient receiving hospital-at-home care to undergo hemodialysis at a center. “There is a lot of conversation that long term, as we make this permanent, they have to fix that and allow for more flexibility, because I think we all recognize this would be tremendous for a lot of dialysis patients,” he said.

Although the program handles only 8 to 10 patients at a time, McMillan said they are hoping to add up to 30 beds by the end of 2026.

Throughout the IVBM event, experts highlighted the importance of making care for CKD accessible and easy to navigate for patients and physicians to bring patients the best care possible. Being proactive, utilizing EHRs, and bringing care to the home are some ways that CKD can be addressed as early as possible to ensure the best prognosis. Future innovations to expand the scope of these programs will make care for CKD both more medically effective and cost-effective in the future.

Author Information: Ms Bonavitacola is an employee of MJH Life Sciences^®, the parent company of the publisher of Population Health, Equity & Outcomes.

REFERENCES

1. Ndumele CE, Rangaswami J, Chow SL, et al. Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association. Circulation. 2023;148(20):1606-1635. doi:10.1161/CIR.0000000000001184
2. The American Heart Association PREVENT online calculator. American Heart Association. Accessed November 12, 2025. https://professional.heart.org/en/guidelines-and-statements/prevent-calculator