Nocturnal Home Hemodialysis

Personal Health Information Technology
2004 - 2007

Complex Tele-Monitoring: A Support System for Nocturnal Home Hemodialysis

Despite the known health benefits of home therapy, many patients feel they cannot accept the responsibility of caring for themselves due to the complexity. A support system was developed to facilitate nocturnal home hemodialysis.


Nocturnal home hemodialysis enables patients to dialyse more frequently compared to traditional hospital therapy. Previous studies suggest that nocturnal home hemodialysis improves health outcomes, reduces healthcare costs, and increases patient satisfaction. Despite the known health benefits, many patients feel they cannot accept the responsibility of caring for themselves due to the complexity of home therapy.

System Development

A support system was developed to facilitate the delivery of this therapy in the home. The user-centric development process involved interviews with clinicians and existing home hemodialysis patients. The resulting support system included:

  • real-time monitoring of dialysis and physiological parameters
  • bloodline disconnect sensing
  • patient video monitoring via a low-light pan-tilt-zoom IP camera
  • on-call staff alerting using a secured data channel to the clinical decision support system.

Technical and psychosocial metrics and were used to assess the performance and impact of the system.


A user-centric approach has permitted the development of a scalable and flexible tele-monitoring system that provides an important link between the patients at home and their caregivers at healthcare institutions. The system can be extended to support other hospital-at-home applications, such as chemotherapy and palliative care.

Funding Agencies

Bell University Laboratories, Health Communication Research Lab

Research in Motion (in-kind)

Gambro Canada (in-kind)

Misys Insight (in-kind)

Project Sponsors

Chan, C.

Easty, A. C.


Granton, J.

Jadad, A.


Milgrim, P.

Rossos, P.


Owens, R.

Leonard, K.



University Health Network

University of Toronto

Project Team

Joseph Cafazzo

Melinda Hamill

Walter Igharas

Jack Lam

Peter Picton

Kevin Tallevi

Matt Trudel