I am in a program that is low on funds. we don’t have any grants to help offset the costs. Iwould like our unit at least to have a nxstage for us to share if we want to travel. What does one cost? I’ll do what I can to earn the cash, and If it is as good as you guys say it is the 14 others will help. does anyone know how I can get one?
Although it may sound like a simple thing to group purchase a dialysis machine to use for vacations, it isn’t. First, to get a home dialysis machine and supplies requires a doctor’s prescription. It also requires that a patient be trained to use it which means that a nurse needs to be trained first so he/she can train you. Finally, a home hemodialysis machine is supposed to be used on only one patient.
I don’t know if NxStage would sell a machine to a patient who has a doctor’s prescription and someone to train him/her. However, you might want to ask NxStage. You can find their phone number or send them an email through the NxStage website (see “contact us”) at www.nxstage.com.
I think your idea is a good one and will be interested in hearing how you make out. I have thought along these lines myself. I think at some point our staff will be receptive to the idea of having a NxStage for travel just because it is such a hassle arranging transient treatments. Beth, I don’t think there would be a problem because more than 1 patient used the machine. I have heard more than once that centers “used” to lend out the redy machines to patients going on vacation. If the machine was sterilized (whatever that takes) what would be the problem letting more than 1 patient use it. They don’t have 1 machine per patient in-center. I can tell you how patients can purchase the equipment. I have purchased RO’s for our center. The first one I bought, I just called the company and told them I wanted to make a donation to the our center of one of their RO’s. They called the center, the center said they wanted the RO. The RO got shipped to the center and I got the bill.
Another time I just talked to the personnel at the center. Gave them a check for a donation with the stipulation it was to buy an RO and thats what the money was used for. These RO’s are actually owned by the center so no need to get a Drs. Script. I have actually considered getting a NxStage for our center. I was just waiting until I could collect more information on how good they are and more patient statements. I think at some point in time when the machine has proven itself our center would go along with having one for vacation purposes. It would solve problems for them as well as for patients.
I vote in favor of this too, however, I think there is a barrier because the NxStage and its supplies are not sold a la carte. At this time I think the NxStage and the supplies are sold as a package so there is a monthly charge that is based on the machine getting used all month.
A travel only machine would be idle some of the time ie not generating revenue but there would still be the same monthly charge no matter how much the machine is used. I hope this segment of the market will be developed by NxStage but I think it would require a different pricing model - perhaps a bigger upfront payment (that we patients could fund raise for) and then a supply pricing strategy that would allow our dialysis units to buy supplies as needed.
I didn’t mean to sound negative because it would be a great idea to have a machine that patients (especially those that do daily or nocturnal dialysis) could check out and use on vacation, but there are a few wrinkles that would have to be worked out.
The current Medicare regulations (called the Conditions for Coverage) that govern dialysis cilnics require that dialysis machines for home use only be used by one patient. This issue has come up in nursing homes where they must have ben trying to use the same machine on multiple patients. New draft regulations were published in early February. They are posted in a PDF on the Home Dialysis Central home page (pages 6246 to the end). You might want to write a comment about how the government can assure patient safety while allowing people on home hemodialysis to travel more easily.
The machine would need to be disinfected between patients. There would need to be a way set up to do that. Perhaps the “loaner” machines would be sent back and forth to NxStage.
There would be the question of how the clinic would bill for use of the machine and supplies. NxStage might have a daily rental fee for the machine (like a rental car). Since there are limits on what a clinic can bill Medicare (and many insurances) for dialysis and it wouldn’t include this added expense, could the clinic legally bill the patient any additional expense (not with Medicare) or would the clinic have to absorb the extra expense as an extra service they offered patients? Clinics are nervous about offering extra services that could be viewed as an “inducement” for people to come to their clinic because of federal regulations and hefty fines.
There is also the training issue. I suspect the training on other machines would give people the skills to be able to operate the machine, but I’m sure it has some basic principles that would need to be learned. It might be a simple process to do this assuming the clinic nurse is trained on the machine.
There may be other issues that I haven’t considered.
Beth was that you? I think the NxStage could be safely used among several patients because all of the fluid paths are part of the disposable supplies. No dialysate or blood ever touches the actual machine.
I just bought a plane ticket for South America - leave October 22 return December 3. Now I get to set up treatments in Ecuador, Peru, Chile, Argentina and Brazil it would be so much easier to just take a machine with and have the supplies sent ahead. We are a long way from doing that . I was talking with the staff at my home unit and they said there is still a Redy machine in Columbian customs. In the 80’s an NKC patient was traveling to Columbia but the machine was not allowed through customs. Maybe some day.
Yes. That was me. I’d signed in but was doing too many things all at once and was logged out without knowing it. Your trip sounds like fun!
Beth, Maybe the machine wouldn’t be considered a home patient machine if it were just loaned out by the center for traveling. I know I have read where they used to let patients use the redy machine for vacations. If fact I think within the last month Chuck on the Renalweb board made a post referring to when they used to do that.
I am with Bill there is no contamination that can happen on the machine. So the risk of infection passed among patients is a mute point. If my Fresenius machine were to break down to the point where service was going to be a couple of weeks they would just supply me with another “used” Fresenius Machine. When patients get transplanted etc. the machines they used are brought in center sterilized and given to another patient. The Ro’s are also considered medical equipment we used to get a different one every month. Patients in our program used to exchange their RO’s each clinic visit so the staff could clean them. You brought in your RO got a clean one, yours was cleaned and given to the next patient when his was brought in.
I didn’t know that part of buying the NxStage machine was agreeing to purchase X number of supplies. If it could be set up so Centers could buy the machine and supplies as needed, I think it could work. I can also see another instance when having a NxStage on hand would come in handy. If a home machine needed repairs that was going to take a oouple of weeks, this would be a good way for the home patients to get by without having to find room in-center for treatments.
I would think the centers could bill for your treatments when you travel just as they would if you were at home. For years George Harper traveled with a Fresenius in the Mobile Home.
I am making the assumption that training isn’t going to be a big issue. No more than 1 week. If our training nurse thought she could teach me the Aksys in 1 week the NxStage should be easier you can skip the cleaning.
I was also under the impression the reason the nursing homes got in to trouble wasn’t so much because they were using the same machine but because CMS felt if they were doing it that way they should be set up as a center.
If your traveling it is still 1 person and 1 machine at a time.
Bill, if anyone needs a NxStage for traveling it’s you. Is there any place in this world you haven’t been? If the answer is yes, I only have one other question when are you going there. Someday I’ll be on this board not asking about dialysis but for vacation advice.
Hi Marty,
I talked to the head of our center Wayne and told him I was waiting for the nxstage to be available so I could put wheels on it and roll it into our van and have a laptop with the right software so we could be in any hotel that had internet service and be hooked up for the night to Saratoga and be in Montana-- He thought it was a great idea but we are not there yet!
My husband and I are used to traveling by car and this would be just super! He told me that there was another machine that they are waiting for FDA approval for {the SOBO} not sure of the name but would be interested in anyone that has heard of it so I can do some checking. Sorry we missed you at clinic this month.
Pat :lol:
Pat, Chris changed our time to 11:15. I think your conversation with Wayne was an interesting one. The one thing I like about the Rubin is that they do keep looking at technology and for ways to make things better for the patients. If you hear any other buzz let me know, Marty1@infoblvd.net.
Is it possible that the new machine that your clinic is waiting for is the Allient Sorbent machine made by Renal Solutions? You can see a picture and read about that machine under Equipment and Products / Home Hemo Machines. It makes dialysate from 6 liters of tap water. It weighs 110 pounds.
Thank you all for your insight I want to be like bill when I grow up! I just want to travel my husband is from the bahamas and I haven’t been in 4 years. The last time we went halfway thru I flew to miami to dialyze since I was told it was 150 per hr there! There has got to be a way. I even asked my doctor about giving me a pd cath to use on vacation she said that wouldn’t work. Bill how do u do it???
I have been speaking with NxStage it is possible for a center to get a machine and allow it to be used for traveling if the center is willing to train the patients and go along with this. Bill you are correct in the fact that the machine and supplies are sold a la carte. However, I was told it didn’t have to be sold this way and if a machine was sold that wasn’t going to be used monthly different arrangements could be made. From my perspective of what I know right now; I think it very doable for the patients to buy the machine for the center if the center is willing to go along. The person I spoke with at NxStage seemed willing to assist in accomplishing this. I think we all know there can be many a slip between the cup and the lip. Perhaps if I were to follow through on this something might turn up that no one has thought about but for what I know now it can be done.