The Call for Telehealth in Palliative Care

By Lily Mercer

Telehealth is of great potential value to patients receiving palliative care. The palliative care community benefits from continuous monitoring and symptom management, both of which are enhanced by telehealth services. Additionally, telehealth allows care providers to monitor for functional decline and intervene early, so that patients can return to comfort as soon as possible.

Is The Palliative Care Community Receptive To Telehealth?

While telehealth can undoubtedly enhance palliative care, the success of a telehealth program is directly tied to patient adherence and willingness to participate in telehealth interventions. Several studies have demonstrated that the palliative care community is in fact receptive to telehealth.

Patients with advanced diseases are willing to use telehealth to self-report symptoms, and they are also amenable to using video-conferencing as an adjunct to in-person care. These findings provide additional support for the adoption of telehealth in the palliative care community.

The Research Behind Telehealth In Palliative Care

Last month, a case report was published highlighting the benefits of telehealth among patients receiving palliative care. The case report described a 57-year-old man with stage 4 metastatic non-small cell lung cancer who participated in a telehealth trial initiated by a community palliative care center. The patient lived with his wife, who was an active participant in her husband’s care. The patient and his wife stood to receive substantial value from telehealth, as they lived approximately 45 minutes from the nearest hospice.

Although this case report cannot be generalized to an entire population of patients, it does provide valuable insight into using telehealth in the palliative care community. The findings from the report outlined several positive outcomes of the palliative care telehealth program:

  • Video-conferencing increased feelings of support and connectivity to care providers

  • Telehealth empowered the patient to actively participate in his care

  • Telehealth reduced travel needs, removing the physical and financial burdens associated with travel

The telehealth program described in the case report consisted of daily symptom self-reporting, caregiver reporting when necessary, and video case-conferences with the patient’s general practitioner and palliative care nurse. When symptom reports reached predetermined thresholds, the patient’s palliative care nurse was notified. In response to these notifications, the patient could participate in video-conferences with his nurse as an alternative to an in-person office visit, when it was medically appropriate to do so.

Video-Conferencing Can Bring Telehealth To Life

A particularly noteworthy component of this telehealth program was the video-conferencing feature. Video-conferencing between patients and clinicians has been proven to be critical to the success of telehealth in palliative care. In this study, video-conferences connected the patient and his care providers in three different locations:

  • The patient and his wife at their home

  • The primary care doctor at his/her office

  • The palliative care nurse at his/her office

The patient and his wife both reported that the video-conferences helped them feel connected to the care team and facilitated more personalized interactions than a phone call would have allowed for. Additionally, video-conferences reduced the need to travel, thus removing the costs and physical burdens that are often associated with lengthy travel times.

The Future Of Telehealth In Palliative Care

While remote monitoring did not replace in-person clinical care in this case study, it did prove to be an effective way to attend to the patient’s needs. Telehealth introduced unique methods of communication between the patient and his care providers. It also served as a source of motivation for the patient to become an active participant in his own care.

Telehealth provides substantial benefits to palliative care patients who live in remote areas with limited access to care. These patients can receive care with minimal disruption to their daily lives. Additionally, they can be provided with individualized interventions from the comfort of their own homes. These benefits also apply to those patients who do not live in remote areas, but would prefer to receive care and continuous monitoring at home.

The future of telehealth in palliative care is promising. This patient population reaps numerous benefits from remote monitoring and they are also receptive to this type of care. Telehealth presents palliative care providers with novel opportunities to enhance the care they provide to their patients in their homes.

 

Click Here To Learn More About Telehealth and Palliative Care

 

References

Morgan DD, Swetenham K, To THM, et al. Telemonitoring via Self-Report and Video Review in Community Palliative Care: A Case Report. Healthcare (Basel). 2017 Aug 31;5(3).

Hennemann-Krause L, Lopes AJ, Araújo JA, et al. The assessment of telemedicine to support outpatient palliative care in advanced cancer. Palliat Support Care. 2015 Aug;13(4):1025-30.

Holland DE, Vanderboom CE, Ingram CJ. The feasibility of using technology to enhance the transition of palliative care for rural patients. Comput Inform Nurs. 2014 Jun;32(6):257-66.

Vuononvirta T, Timonen M, Keinänen-Kiukaanniemi S. The compatibility of telehealth with health-care delivery. J Telemed Telecare. 2011;17(4):190-4. 

 

Tags: disease management, remote patient monitoring, Patient Engagement, communication, Hospice & Palliative Care

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