- ‘Travel Dialysis Era’ ② Clinic director Lee promotes safe dialysis in overseas travel
For end-stage renal disease (ESRD) patients, traveling overseas is a challenge because they need hemodialysis at least three times a week. As most ESRD patients accompany cardiovascular or cerebrovascular disease, they cannot take a long flight. Besides, it is not easy to find a medical institution to receive dialysis in a foreign country.
ESRD patients either give up going on an overseas trip or choose self-applicable peritoneal dialysis before traveling. It is the same with those who go on a business trip overseas.
However, some Taiwanese patients with the disease started to see a change in their travel life. In 2007, Taiwan began “travel dialysis” for ESRD patients and established the Taiwan Association for Dialysis Patients’ Quality of Life (TDQ).
The travel dialysis has spread from Taiwan to Japan and Korea, creating a network of medical institutions that provide dialysis treatment for tourists.
Established in 2016, World Travel Dialysis Medical Network (WTDM) helps out ESRD patients who wish to travel overseas. MTDM signed a memorandum of understanding with clinics in Korea, Japan, and Taiwan and ensures that ESRD patients receive dialysis in a tourist site. WTDM collaborates with TDQ for medical care.
Before signing an MOU with a local medical institution, WTDM dispatches a person to monitor the clinic’s dialysis environment. In Korea, seven medical institutions – two in Seoul, three in Busan, and two in Incheon – are working with WTDM.
WTDM provides standardized medical record forms for safe dialysis. It makes sure that the local clinic receives a patient’s two weeks of dialysis record, before the travel, so that the clinic can check the health status of the patient upon his or her arrival. The cost of dialysis has been set at a similar level in the three countries.
Beomil Yonsei Internal Medicine Clinic, located in Busan, is the most active one in Korea to work with the WTDM. On June 18, 10 Taiwanese patients with ESRD received hemodialysis, which was the largest “group dialysis” that the clinic provided through WTDM.
In an interview with Korea Biomedical Review, Beomil Yonsei Director Lee Dong-hyung said, “Travel dialysis is trending now.”
Caring for ESRD patients for a long time, Lee felt that the patients were in desperate need of travel dialysis, he said. Many patients looked for a local clinic for dialysis only to find that the quality was poor, or got “ripped off” by an agency, according to Lee.
|Lee Dong-hyung, director of Beomil Yonsei Internal Medicine Clinic, emphasizes that hospitals and clinics need to build an international network to help ESRD patients receive travel dialysis, in a recent interview with Korea Biomedical Review.|
Question: How did you come to know travel dialysis?
Answer: I participated in the meeting of Japanese Society for Dialysis Therapy (JSDT) in 2016, met an official at Oyama Suginoki Clinic, talked about travel dialysis, and I said I was interested in the matter. Since then, two people from Suginoki Clinic’s tour team visited my clinic and checked the facilities. The next year, I went to Japan to sign an MOU with Suginoki Clinic.
Q: Compared to Korea, Taiwan and Japan were quick to introduce travel dialysis, right?
A: Taiwan started the travel dialysis service in 2007 and established TDQ. Travel dialysis has become common for ESRD patients in Taiwan. In Japan, it instead thrived too much, and the mushrooming of travel dialysis agencies became a problem. A Japanese ESRD patient, who operates an agency, tried travel dialysis, uploaded online reviews on a blog, and received commissions from other patients to introduce them to medical institutions.
The form was similar to that of promoting a restaurant via online reviews. Suginoki Clinic led the creation of WTDM to curb the excessive growth of agencies for travel dialysis.
Travel dialysis thrived in Taiwan and Japan, particularly because ESRD patients do not have to pay for dialysis in the two countries. Taiwan has about 80,000 ESRD patients, which is similar to that of Korea, and Japan, about 330,000. In Korea, patients pay about 10 percent of dialysis cost. However, in Taiwan and Japan, patients pay zero.
Even when Taiwanese and Japanese ESRD patients receive dialysis overseas, they can submit the diagnosis statement and receipt to the government and get the costs reimbursed.
Q: Why do we need a global network for travel dialysis?
A: Medical textbooks still recommend peritoneal dialysis for frequent travelers with ESRD. In that case, a patient not only has to carry around a dialyzer but take the risk of infection. So, physicians rarely recommend peritoneal dialysis these days. ESRD patients have to receive dialysis before getting a kidney transplant. They need a system to receive dialysis and enjoy travel safely. My clinic works with TDQ and WTDM to help ESRD patients enjoy traveling without worries over dialysis. Patients won’t need to search for local clinics for dialysis, either.
Q: Which part do you care the most when providing dialysis for travelers with ESRD?
A: An emergency in an ESRD patient during air travel is the biggest problem. So, before sending off a patient, I put top priority on checking the patient’s status. A patient not in good condition should not board a plane in the first place. For ESRD patients, the safest flight time is two to three hours. That explains why Japan, Taiwan, and Korea formed a network for travel dialysis.
Q: What would you like to say to Korean doctors interested in travel dialysis?
A: You better not do it if you want to make a profit because there’s so much work to do. You have to file all the related documents in English and see foreign patients. It would help if you had commitment. However, if you’re a dialysis specialist, mainly caring for ESRD patients, you will end up providing travel dialysis service. Many ESRD patients have to go overseas for business, not only for travel.
If a patient returns safely from travel through a medical institution’s help, the doctor will earn more trust from the patient.