 The long-term goal of this project is to improve access to peritoneal dialysis care and the quality of lives of patients on dialysis by evaluating ways to eliminate the geographic barrier. The objective here is to determine if specifically telemedicine has this capacity. By evaluating and establishing a framework by which home dialysis care could be provided via telemedicine and determining the impact on quality of life for these patients, policy could be informed as to coverage of telemedicine as a substitute for the current face-to-face requirement by Medicare. Furthermore, this intervention has the possibility of improving quality of life and if effective possibly increasing the utilization of peritoneal dialysis both by patients rural and urban due to increased convenience of the therapy with respect to in-center hemodialysis. The central hypothesis is that implementation of telemedicine visits as a substitute for the 2 out of 3 monthly face-to-face visits over a 6 month period will improve quality of life as judged by the quality of life QoL indices Kidney Disease Quality of Life - Short Form and the Illness Intrusiveness Ratings Scale when compared to QoL scales taken during a time period when the patient is on standard of care. 