An Empirical Chart Analysis of the Suitability of Telemedicine for Hospice Visits

Abstract

Telehospice (TH) utilizes telemedicine technology to provide care at the end of life. A bistate project was launched in 1998 to study the use of home-based telemedicine for routine hospice care. Videophones were deployed for telenursing visits and evaluations by social workers. In order to determine what proportion of home hospice visits could be performed using currently available telemedicine technology, we reviewed clinical records retrospectively for hospice nurse home visits. Clinical notes documenting home nursing visits were obtained from two large hospices, one based in Kansas, and the other in Michigan. Records were randomly selected for patients who received hospice nurse visits during the month of January 2000. The charts were reviewed for patient demographic information, patient assessments, teaching activities, and interventions. Five hundred ninety-seven nursing notes were analyzed using an 85-item coding instrument. After careful review of the records, the coders also made a subjective observation regarding the suitability of each visit for telemedicine. As part of this analysis, we found that 64.5% of home hospice nursing visits could be performed by telemedicine. Using TH, it is possible to reduce the number of in-person visits, thereby significantly decreasing the cost of providing hospice care.

Economic Evaluation of Manitoba Health Lines in the Management of Congestive Heart Failure

“…Of the 21 studies that examined home telemonitoring versus usual care, 12 were RCTs, 23,25,28,29,31,32,35,36,[38][39][40][41] and nine were observational studies. 22,24,26,27,30,33,34,37,42 There were five RCTs [43][44][45][46][47] in the telephone support versus usual care comparison. A description of the intervention and comparator in each study appears in Appendix 4a.…”

“…Ten studies were from the US, [25][26][27][35][36][37][38][39]44,45 one from Canada, 46 two from Germany, 23,34 three from Poland, 24,32,41 two from Finland, 28,42 one from Spain, 29 three from South Korea, 30,31,43 one from Italy, 33 and two from China. 40,47 Four studies received funding from industry alone, 23,24,44,46 15 studies were funded by the government alone, 22,26,27,[29][30][31]33,[35][36][37][38][39][40]43,45 four studies received funding from industry and government, 25,32,34,41 and three studies did not report the source of funding. …”

A Systematic Review of the Evidence Base for Telehospice

“…PubMed and PsycINFO databases were searched for studies published between January 1, 2000 and March 23,2010. Key words in the search included ''telehospice,'' ''telemedicine and hospice,'' ''telehealth and hospice,'' ''technology and hospice,'' and ''informatics and hospice.''…”

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement

“…The use of videophone technology gave providers, patients, and family members' new means to communicate [106]. However, it has been emphasised that it must be considered as an additional tool and not a substitute for actual visits [112]. Patients are usually satisfied with tele-hospice and often express frustration that nurses do not use those pieces of equipment more frequently [113].…”