Telemedicine technologies to support inter-sectoral care of nephrology patients


Ten percent of the world’s population is affected by chronic kidney disease (CKD). Figures in the European Union range from three to 17 percent, corresponding to a prevalence similar to that of diabetes mellitus. One out of every ten German citizens will be affected in the course of their life. Of 18 million inpatients in German hospitals, up to five percent suffer acute renal failure. This is frequently overlooked by both patients and doctors – with dramatic consequences: Additional diseases and a pronounced increase in mortality are not uncommon. These statistics have a financial impact as well: The Federal Republic of Germany incurs costs of more than 3 billion euros per year as a result.


The challenge

One problem is the high estimated number of unreported CKD patients (for example those with diabetes), who are treated by general practitioners. Drug safety in particular is a high-risk process for these patients, for instance due to a lack of knowledge or the misjudgment of renal insufficiency and interactive multi-pharmacotherapy on the part of the doctors providing the primary treatment.

Early complementary nephrology treatment of patients with acute renal failure and chronic kidney disease therefore has a decisive positive influence on therapy and can reduce the mortality rate. The NephroTeTe consortium as the winner of the second round of submissions in the NRW leading market competition is rising to this challenge. It includes powerful industry, science, IT development, and patient care partners.


Our contribution

The project “NephroTeTe” is developing (for the first time in Germany) an infrastructure based on the electronic case file (Elektronische FallAkte, EFA). The project focuses on the processes and the preparation of guidelines for inter-sectoral communication, in particular using data that exist in a structured form. Fraunhofer ISST has assumed responsibility for the technical conception of the overall system based on version 2.0 of its EFA specification. In addition, Fraunhofer ISST will work on standardizing a Clinical Document Architecture (HL7, CDA) nephrology form. 



The project results in an improved inter-sectoral healthcare structure through:

  • Inter-sectoral case management for inpatient treatment: Consultation with a registered nephrologist for patients admitted to hospital, treated without specialist nephrology care
  • Inter-sectoral case management for outpatient treatment: Integration of a patient-centered support concept between a registered nephrologist and the general practitioner and/or transplant center for nephrology patients in outpatient treatment.



  • Essen University Hospital Nephrology Clinic
  • MedVision AG
  • RZV Rechenzentrum Volmarstein GmbH
  • Fraunhofer ISST



  • Subsidized by: State of North Rhine-Westphalia and the European Union (EU EFRE NRW)
  • Project number: EFRE-0800734 GE-1-2-011
  • Term: March 2017 to July 2020