GoTo Telemed, the nation’s leading integrated telehealth ecosystem serving over 10 million patients nationwide [4†L52-L53], today announced the launch of its Kidney Stone Management Program, a comprehensive virtual care service that addresses the full spectrum of stone disease—from acute renal colic and medical expulsive therapy to metabolic evaluation, dietary counseling, and long‑term recurrence prevention. Delivered by a multidisciplinary network of urologists, nephrologists, registered dietitians, and telehealth nurses, the program brings evidence‑based, guideline‑aligned stone care directly to patients nationwide.

Nephrolithiasis is a prevalent and costly condition, affecting approximately 1 in 11 adults (about 9.9% of the U.S. population) with the number of stone formers steadily increasing. While historically considered a male‑predominant disease, recent data show that prevalence in women aged 20–39 years increased from 4.7% (2007–2008) to 6.4% (2017–2020), and overall rates among women now approach those of men. Stone disease is also associated with a higher risk of hypertension, diabetes, chronic kidney disease, and cardiovascular events, making effective management essential to overall health.

“Kidney stones are not simply an acute pain episode—they are a chronic, recurrent metabolic disease that requires ongoing risk assessment, lifestyle modification, and often medical therapy to prevent future stones and reduce associated cardiovascular risk,” said a GoTo Telemed spokesperson. “Our Kidney Stone Management Program brings together urology, nephrology, and nutrition experts in a single virtual clinic. From the initial episode of renal colic through 24‑hour urine metabolic testing and personalized dietary counseling, we provide a seamless, evidence‑based pathway that improves outcomes and reduces the burden of recurrent stone disease.”

Acute Management of Renal Colic and Medical Expulsive Therapy

The program offers same‑day virtual consultation for patients presenting with suspected renal colic. Based on current guidelines, acute pain management follows a stepped protocol:

First‑line analgesia: Non‑steroidal anti‑inflammatory drugs (NSAIDs) are recommended as first‑line therapy for acute ureteric colic. When NSAIDs are insufficient, oral morphine or other opioids may be prescribed.

Medical expulsive therapy (MET): For patients with small‑ to medium‑sized ureteral stones (typically ≤10 mm), an alpha‑blocker (tamsulosin 0.4 mg daily) is prescribed to relax the ureteral musculature, facilitate spontaneous stone passage, and reduce the need for surgical intervention. A 2025 network meta‑analysis found that combining alpha‑blockers with corticosteroids or PDE‑5 inhibitors increases stone clearance rates 2.7 to 3.1 times compared to alpha‑blockers alone.

Anti‑emetic and supportive care: Oral anti‑emetics (ondansetron) are provided for nausea and vomiting, and patients are counseled to maintain adequate oral hydration.

Patients receive clear “when to seek emergency care” instructions, including fever, inability to tolerate fluids, intractable pain, or anuria, and are scheduled for follow‑up imaging (low‑dose CT or ultrasound) to confirm stone passage.

Telemedicine‑Based Diagnostic and Preventive Evaluation

GoTo Telemed’s program operationalizes a hybrid “Care, Remote Monitoring, Medication optimization, Nudges pathway” that links early risk identification to telemonitoring and medication titration. All stone patients undergo a structured metabolic evaluation that includes:

24‑hour urine collection coordinated through local laboratories, assessing urinary volume, calcium, oxalate, citrate, uric acid, sodium, and pH.

Basic metabolic screening (serum creatinine, electrolytes, calcium, uric acid) to identify underlying systemic conditions such as hyperparathyroidism or renal insufficiency.

Stone composition analysis performed on recovered stones, allowing stone‑specific prevention strategies.

A growing body of evidence supports the feasibility of telemedicine for stone disease. A quality improvement study focusing on ureteric colic successfully avoided 71.1% of face‑to‑face follow‑ups while maintaining high safety and patient satisfaction (93.1%). In multidisciplinary virtual kidney stone clinics that combine urology, nephrology, and nutrition, patients have reported high satisfaction scores, and virtual visits have overcome the limitations of physical clinic space and provider schedule coordination.

Personalized Dietary and Fluid Counseling

Nutritional management is the cornerstone of stone prevention. The program provides structured, personalized dietary guidance delivered virtually by a renal dietitian:

Fluid intake targets: Adults are instructed to consume 2.5 to 3 liters of fluid daily, with pediatric volumes adjusted for age. Patients are advised to spread fluid intake evenly throughout the day and aim for light‑colored urine.

Sodium restriction: Reducing dietary sodium to below 2,300 mg/day lowers urinary calcium excretion and reduces stone risk.

Moderation of animal protein: High animal protein intake increases urinary acid and calcium. Patients are counseled to limit red meat, poultry, and fish portions.

Calcium and oxalate balance: Patients are counseled to maintain adequate dietary calcium (800–1,200 mg/day) from food sources rather than supplements, which can paradoxically increase stone risk. For individuals with high oxalate excretion, specific guidance on reducing high‑oxalate foods (spinach, nuts, tea) and pairing them with calcium is provided.

Citrate supplementation: For hypocitraturic stone formers, oral potassium citrate is prescribed, with dosing titrated to urinary pH and patient tolerance.

Remote video‑based dietary counseling has been shown to provide unique advantages: during home video visits, clinicians can observe the patient’s kitchen, living environment, typical food choices, and food preparation resources, enabling more relevant and actionable dietary advice than an in‑office consultation. Moreover, a pilot study is currently investigating a video‑informed dietary counseling protocol aimed at reducing sodium consumption among kidney stone formers, leveraging the growth of telehealth to improve dietary education.

Mobile Health Tools and Remote Monitoring

The program integrates a customized kidney stone mobile health care plan designed for patients with chronic or recurrent stones. The plan incorporates each patient’s specific 24‑hour urine results to reinforce dietary management, daily fluid intake targets, and medication adherence through personalized reminders and educational content delivered directly to the patient’s smartphone.

A robust systematic review of mobile and eHealth technologies for nephrolithiasis found that these tools have significant real‑world applications for improving fluid intake adherence, monitoring stone‑related quality of life, and sustaining behavior changes. Emerging evidence also suggests that embedding kidney stone prevention within a cardiovascular‑kidney‑metabolic continuum supports value‑based outcomes, linking early risk identification to telemonitoring and medication optimization protocols.

Multidisciplinary Virtual Kidney Stone Clinic

The program formally adopts a comprehensive multidisciplinary care model that brings together a board‑certified urologist (for surgical decision‑making and acute management), a nephrologist (for metabolic evaluation and medical prevention), and a registered dietitian (for personalized dietary and fluid counseling). All team members access the same unified electronic health record, share treatment plans through secure messaging, and coordinate care via regular virtual tumor‑board style case conferences.

A 2024 peer‑reviewed report described the successful implementation of such a multidisciplinary virtual stone clinic, which yielded high patient satisfaction while overcoming the limitations of physical clinic space and provider schedule coordination. This integrated model ensures that patients receive complete, evidence‑based care—including metabolic testing, dietary counseling, and medical prevention—without the fragmentation and travel burden of traditional referral pathways.

Integration Within GoTo Telemed’s Comprehensive Urology Ecosystem

The Kidney Stone Management Program operates as a fully integrated component of GoTo Telemed’s unified telehealth platform:

Unified electronic health record: All 24‑hour urine results, stone analyses, medication histories, and dietary plans are consolidated in the patient’s lifetime record, accessible to urologists, nephrologists, and primary care providers.

Automated adherence reminders: Smartphone‑delivered reminders for daily fluid targets, medication dosing (tamsulosin, potassium citrate, thiazides), and upcoming 24‑hour urine collections.

Seamless care coordination: Warm handoffs to surgical urology for shock‑wave lithotripsy (SWL), ureteroscopy, or PCNL when indicated, based on stone size, location, and patient preference.

Patient education portal: Access to condition‑specific videos, dietary handouts, fluid‑tracking logs, and peer‑support resources.

Availability

GoTo Telemed’s Kidney Stone Management Program is available immediately to patients nationwide through the GoTo Telemed platform. Patients may enroll directly or be referred by their primary care provider, emergency department physician, urologist, or employer wellness program. Urologists, nephrologists, renal dietitians, and urology nurses interested in joining GoTo Telemed’s provider network are invited to apply through the company’s credentialing portal.

GoTo Telemed is actively forming strategic partnerships with health systems, accountable care organizations (ACOs), and urology groups to integrate virtual stone care pathways into value‑based contracts.




Media Contact:
GoTo Telemed Media Relations
[email protected]
(660) 628-1660
https://gototelemed.com/