Emory University Faculty and Staff-Developed Patient Kidney App Now Available

August 2013

iChoose Kidney app

Propelled by a concise, direct, pictographic, and uncluttered design and message, Emory University's iChoose Kidney app for the iPad is now available as a free download from the iTunes App Store. The app can serve as a decision support tool for nephrologists, primary care physicians, social workers, nurses, and/or patient educators to use with end-stage renal disease (ESRD) patients to help improve informed decision-making for kidney failure treatment options. The iPhone version is nearing completion, and a corresponding website is in development.

Subtitled "Dialysis or Transplant?," the app presents various risk prediction models for dialysis vs. kidney transplant in response to such user-defined parameters as patient gender, age, race, ethnicity, patient time on dialysis, and patient history of various conditions associated with kidney decline. The risk models encompass one and three-year dialysis and transplant summaries, with the risk of death for transplant being lower than dialysis in all instances. There are also summaries comparing deceased donor transplants and living donor transplants. The data used to develop the risk models was based upon surveillance data from the United States Renal Data System from 2000-2011.

The app development team was led by Emory faculty transplant researcher Rachel Patzer, PhD, MPH, who has dual appointments in the Department of Surgery and the Department of Epidemiology. Team members included Mohua Basu, MPH, a staff epidemiologist at the Emory Transplant Center; transplant surgeon-scientist and dean of the Emory School of Medicine Christian Larsen, MD, DPhil; epidemiologist William McClellan, MD, Rollins School of Public Health (RSPH); health policy and management faculty member David Howard, PhD, RSPH; Kimberly Arriola, PhD, MPH, of the Department of Behavioral Sciences and Health Education, RSPH; and Emory School of Medicine biovisualist Michael Konomos, MS, CMI. All team members are also affiliated with the Emory Transplant Center. Michael Patzer of Patzer LLC was the mobile app developer for the project.

Dr. Patzer and her colleagues conducted a feasibility study of the app among patients with kidney disease receiving treatment at Emory Dialysis, and found that more than 40% had never had a physician discuss transplantation with them. Nearly 85% said the tool was useful in helping them make treatment decisions.

"Evidence suggests that nearly 1/3 of dialysis patients in the U.S. are not informed about transplantation as a treatment option for kidney disease," says Dr. Patzer. "Though the data exists to help patients make treatment decisions, it's not being used. iChoose takes less than a minute to complete, and is a simple, novel tool that can be used at the bedside to translate evidence-based information to patients." The team's next step will be a randomized study to evaluate the app's effectiveness in improving patient knowledge of treatment options.

Emory Transplant Center researchers are also developing an app to educate patients about the importance of taking their post-kidney-transplant medications. It is currently being evaluated through randomized testing with patients, and will ideally be available to ETC patients in a few months.