The Executive Order on Advancing American Kidney Health, signed in July 2019, included a directive for “a payment model to evaluate the effects of creating payment incentives for greater use of home dialysis and kidney transplants for Medicare beneficiaries on dialysis” (1).
Recognizing this catalyst for change and embracing the expansion of choice in kidney replacement therapy for people with kidney diseases and the need to deliver high-quality home dialysis care, in July 2021, ASN launched the Home Dialysis Task Force.
The task force, co-chaired by Edward Gould, MD, FASN, and Jeffrey Perl, MD, has seated three working groups to expand the use of and access to home dialysis through continuing education and development, training and fellowship, and policy and advocacy. Together, these working groups aim to improve awareness and outcomes of home dialysis therapies by enhancing the education of nephrologists, kidney care professionals, and trainees; addressing disparities in access to home dialysis; and advocating for policies that improve access to all dialysis treatment options in order to promote the highest quality of care.
To inform its early work in the area of training and fellowship, a survey, designed by Yuvaram N. V. Reddy, MBBS, MPH, FASN, was administered to division chiefs and training program directors to quantify:
the extent of home dialysis training that fellows receive during their fellowship
the perceptions on requirements needed by programs for competency in home dialysis
the ability for programs to meet certain threshold requirements
Results of this survey, in combination with an early focus group session, led ASN Council to approve the task force's recommendation that ASN develop and curate an online platform of educational resources and support a weekend training course and longitudinal mentorship program for fellows.
The task force's aims in the arenas of policy and advocacy offer recommendations for both ASN and the broader kidney community. These aims and initiatives will be further outlined in a perspectives piece, which will soon be submitted to a peer-reviewed journal and will describe in depth the task force's efforts in four key areas (see infographic).
The Home Dialysis Task Force recently promoted these concepts and other actions that support enhanced education for home dialysis use to the ASN Task Force on the Future of Nephrology.
Advancing American Kidney Health. Federal Register, July 15, 2019. Executive Order 13879 of July 10, 2019. https://www.federalregister.gov/documents/2019/07/15/2019-15159/advancing-american-kidney-health