Can you hear me now?: Improving palliative care access through telehealth

Abstract

Telehealth has been increasingly used to expand healthcare access over the last two decades. However, this had not been the case for palliative care (PC), because telehealth was considered nontraditional and impractical due to the sensitive nature of conversations and a "high touch" philosophy. Motivated by limited PC access to rural and underserved populations and positive PC telehealth studies, clinical PC telehealth models have been developing. However, nearly overnight, the COVID-19 pandemic accelerated the use and uptake of telehealth across health care and especially in PC. As a result, clinicians, administrators, and others agree that telehealth is "here to stay," and will likely maintain widespread use and refinement beyond rural areas. The purpose of this review is to describe exemplar PC telehealth programs in research and clinical practice, including pros and cons, lessons learned, and future directions for the ongoing development and expansion of PC via telehealth across diseases and the lifespan.

COVID‐19 and hospice community palliative care in New Zealand: A qualitative study

“…In the UK, for example, teleconsultation and video conferencing have been broadly used by general practitioners and palliative care teams (Antunes et al., 2020 ; Kasaraneni, 2020 ). In line with other studies, however (Allen Watts et al., 2021 ; Pastrana et al., 2021 ), these successes did not come without a cost, particularly noted with regard to the challenges to effective telehealth assessments (e.g., inability to always identify nonverbal cues) and related staff exhaustion from the additional work involved. This point illustrates that in moving forward, teleconsultation should not be seen as a replacement for visits in person but should be gradually integrated into care delivery.…”

“Hard to Say Goodbye Over iPad”

“…However, these services were limited to institutions and people with sufficient resources and funds. Other than financial barriers, lack of appropriate technical skills, language barriers, inability to participate, and cybersecurity were other reported concerns among the providers that may potentially reduce the acceptance and effectiveness of telehealth among patients and families 33,34 . A multisite study during the pandemic explored the effectiveness of virtual PC and reported proper equipment setup, connectivity issues, and effective communication skills as major barriers.…”

Socioeconomic and racial/ethnic disparities in receipt of palliative care among patients with metastatic hepatocellular carcinoma

“…Furthermore, patient‐focused efforts on increasing awareness, education, and access to PC information through community educational talks, articles, social media, and institutional websites are necessary, especially in minority communities where there may be stronger hesitancy toward utilizing PC. In low resource settings, utilizing telehealth services and developing pilot projects for nursing home and community‐based PC programs are key strategies to expanding PC access in these areas 31,32 …”