Vasc-Alert as a Tool for Case Management

Case management has been shown an effective tool to help organizations improve long term outcomes while reducing overall costs. For patients with Stage 5 chronic kidney disease (CKD), quality of care is often measured by morbidity and mortality rates, the efficacy of dialysis treatment, and patient perception of coordination of their care.

Vascular access complications are one of the top clinical areas that impact morbidity and mortality rates in the CKD Stage 5 patient and carry the largest cost burden. Recent studies show that when a patient’s vascular access is well cared for, clinically followed, consistently monitored, and frequently trended through the use of a surveillance program, patient outcomes are far more positive and the cost of overall care decreases. This is because meaningful trend data allows the organization to coordinate early referrals for possible intervention.

Vascular access should be a key focus for caregivers of CKD Stage 5 patients, as suggested by the National Kidney Foundation’s updated K/DOQI Clinical Practice Guidelines and Recommendations. The guidelines emphasize a number of key components for obtaining better outcomes while reducing overall costs associated with vascular access. Guideline 4 recommends the use of a proactive surveillance program, along with the clinic’s existing clinical monitoring program (understood to be in use in all dialysis clinics and paid for by CMS as part of the patient’s composite rate). As a result of effective surveillance, users may provide quick intervention to potential vascular access site issues.

Vasc-Alert Surveillance Program accomplishes this goal by providing timely reports that can show valuable trend information for patients based on each dialysis treatment. Staff can easily interpret these trends and take appropriate action to prevent vascular access complications. What’s more, this fully computerized surveillance tool gathers information without staff input and provides results that are easily accessible to the entire clinical team. As a result, the Vasc-Alert Surveillance Program can be easily adapted and integrated into to the day-to-day duties of a hemodialysis case manager, nephrology physician extender, or vascular access coordinator. For case studies of Vasc-Alert customers, click here.

Benefits of Vasc‑Alert

  • Vasc‑Alert tests the access with every dialysis treatment. This results in multiple readings each week that are trended, providing insights into potential problems much earlier than other surveillance programs. New reports are produced weekly and reports can be viewed online at any time.
  • The reports are data driven so they are objective. Furthermore, no staff time is required to test the access, so no additional staff time is required for data collection.
  • Vasc‑Alert has shown to be a very effective marker for identifying the growth of stenosis (arterial and venous) relatively early in the lesion development process for both fistula and grafts. Studies have shown sensitivity and specificity in the 85% to 95% range with False Positive results in the 5% to 10% range. [Link to Studies page]
  • The Patient Detail Report provides an overview of relevant information about the operational parameters of dialysis sessions, i.e. average blood flow rate, venous, and arterial pressures, thus bringing key clinical data together into one easily understood report.
  • The reports for patients who are identified as at risk for clotting are sent to the case manager or surveillance team weekly. This same information can also be viewed online at any time, enabling all members of the medical care team to access the information in a timely fashion. Coordination with the intervention center is smoother since the intervention can be scheduled and planned in advance.
  • Vasc‑Alert provides information on grafts and fistulas, and on both the venous and arterial side of the access with equal results. All of this information is shown within one report including the trending of each element.