 Peritoneal Dialysis is used by over 100,000 patients worldwide but only about 7 of patients in the United States. 1 As it is much less expensive than its in-center hemodialysis counterpart and provides improved quality of life, strategies are needed to increase its utilization. One potential barrier to peritoneal dialysis is the geographic barriers to care which exist in geographically diverse and large countries such as Canada, India, Australia, and the United States. 2,3 Access to an experienced home dialysis unit is limited in many parts of the United States and can contribute to low utilization rates by physician discomfort with the therapy as well as increased technique failure rates with inexperienced centers. 4-7 Prakash et al recently have shown that only 55 of dialysis units are certified to provide home dialysis. 8 In more rural networks such as network 8 Alabama, Mississippi, and Tennessee, this number drops to 38 thus increasing the geographic barriers to the provision of home dialysis care. Patients currently living in rural areas and on a home therapy are faced with long commutes and time commitments adding up to significant financial hardships for the patients. Furthermore, these commutes impact quality of life. Telemedicine and telemonitoring may provide a means to bridge these geographic barrier thus improving access to home dialysis care and improving patient quality of life on the therapy and thus increasing its utilization. 