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Author Notes:

Laura C Plantinga, Department of Medicine, Emory University, 1841 Clifton Road, Room 552, Atlanta, GA, 30329, United States, Phone: 1 4047273460, Email: laura.plantinga@emory.edu

LCP, BGJ, CMO, and RM conceived the idea of DialysisConnect. LCP obtained funding for the project and wrote the first draft of the manuscript. AEV led the initial focus groups. RM led the technical team to develop DialysisConnect. JPL, TM, CMO, and KJ served as the site champions. CG was the first and most active user of DialysisConnect and served in a peer champion role, encouraging staff at both sites to use the system. LCP, CH, AEV, and AK analyzed and interpreted the system, survey, focus group, and electronic health record data, respectively. All authors have read and approved the final manuscript.

The authors would like to thank the providers and staff at Emory Dialysis and Emory University Hospital Midtown who facilitated this pilot, especially CG, Linda Turberville-Trujillo, Michelle Young, Kathy Oliver, Ifeoma Imonugo, Tomiwa Ishmail, and Kristy Hamilton, and the staff at Apex Health Innovations for developing DialysisConnect (Richard Dacre, Amber Webster, Alice Jordan, Alex Turnbull, Jasper Kirby, and John Scott) and facilitating compliance (Charlie Bonar). The authors would also like to thank Christian Park and Grace Xu for their assistance with the focus group sessions.

RM is the chief executive officer of Apex Health Innovations, which provided the technical expertise to build DialysisConnect. DialysisConnect was not, and is currently not, a commercially available product.


Research Funding:

The research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number R18DK118467. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


  • advanced practice providers
  • care coordination
  • dialysis
  • hospitals
  • mobile app
  • nurses
  • physicians

A Web-Based, Provider-Driven Mobile App to Enhance Patient Care Coordination Between Dialysis Facilities and Hospitals: Development and Pilot Implementation Study

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Journal Title:

JMIR Formative Research


Volume 6, Number 6


, Pages e36052-e36052

Type of Work:

Article | Final Publisher PDF


Background: We piloted a web-based, provider-driven mobile app (DialysisConnect) to fill the communication and care coordination gap between hospitals and dialysis facilities. Objective: This study aimed to describe the development and pilot implementation of DialysisConnect. Methods: DialysisConnect was developed iteratively with focus group and user testing feedback and was made available to 120 potential users at 1 hospital (hospitalists, advanced practice providers [APPs], and care coordinators) and 4 affiliated dialysis facilities (nephrologists, APPs, nurses and nurse managers, social workers, and administrative personnel) before the start of the pilot (November 1, 2020, to May 31, 2021). Midpilot and end-of-pilot web-based surveys of potential users were also conducted. Descriptive statistics were used to describe system use patterns, ratings of multiple satisfaction items (1=not at all; 3=to a great extent), and provider-selected motivators of and barriers to using DialysisConnect. Results: The pilot version of DialysisConnect included clinical information that was automatically uploaded from dialysis facilities, forms for entering critical admission and discharge information, and a direct communication channel. Although physicians comprised most of the potential users of DialysisConnect, APPs and dialysis nurses were the most active users. Activities were unevenly distributed; for example, 1 hospital-based APP recorded most of the admissions (280/309, 90.6%) among patients treated at the pilot dialysis facilities. End-of-pilot ratings of DialysisConnect were generally higher for users versus nonusers (eg, “I can see the potential value of DialysisConnect for my work with dialysis patients”: mean 2.8, SD 0.4, vs mean 2.3, SD 0.6; P=.02). Providers most commonly selected reduced time and energy spent gathering information as a motivator (11/26, 42%) and a lack of time to use the system as a barrier (8/26, 31%) at the end of the pilot. Conclusions: This pilot study found that APPs and nurses were most likely to engage with the system. Survey participants generally viewed the system favorably while identifying substantial barriers to its use. These results inform how best to motivate providers to use this system and similar systems and inform future pragmatic research in care coordination among this and other populations.

Copyright information:

©Laura C Plantinga, Courtney Hoge, Ann E Vandenberg, Kyle James, Tahsin Masud, Anjali Khakharia, Carol Gray, Bernard G Jaar, Janice P Lea, Christopher M O'Donnell, Richard Mutell. Originally published in JMIR Formative Research (https://formative.jmir.org), 10.06.2022.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/rdf).
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