Telemedicine as a Tool to Provide Family Conferences and Palliative Care Consultations in Critically Ill Patients at Rural Health Care Institutions

Menon, Prema R.; Stapleton, Renee D.; McVeigh, Ursula; Rabinowitz, Terry

doi:10.1177/1049909114537110

Cited by 36 publications

(36 citation statements)

References 17 publications

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“…[1][2][3] Telehealth in its many forms offers conveniences including increased care accessibility, decreased transportation barriers, and patient empowerment. [4][5][6][7][8] Studies of video visits have demonstrated these benefits in specialty settings including wound care, prenatal genetic screening, family planning, cardiovascular care, and home care. [9][10][11][12][13][14][15] One study of patient experiences with video visits in rural areas found that they were associated with decreased travel costs and lost time/wages, increased access to social support, and better ability to tailor care delivery to patient and family needs.…”

Section: Introductionmentioning

confidence: 99%

Patient Perceptions of Telehealth Primary Care Video Visits

et al. 2017

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PURPOSE Telehealth is a care delivery model that promises to increase the flexibility and reach of health services. Our objective is to describe patient experiences with video visits performed with their established primary care clinicians. METHODSWe constructed semistructured, in-depth qualitative interviews with adult patients following video visits with their primary care clinicians at a single academic medical center. Data were analyzed with a content analysis approach. RESULTS:Of 32 eligible patients, 19 were successfully interviewed. All patients reported overall satisfaction with video visits, with the majority interested in continuing to use video visits as an alternative to in-person visits. The primary benefits cited were convenience and decreased costs. Some patients felt more comfortable with video visits than office visits and expressed a preference for receiving future serious news via video visit, because they could be in their own supportive environment. Primary concerns with video visits were privacy, including the potential for work colleagues to overhear conversations, and questions about the ability of the clinician to perform an adequate physical examination.CONCLUSIONS Primary care video visits are acceptable in a variety of situations. Patients identified convenience, efficiency, communication, privacy, and comfort as domains that are potentially important to consider when assessing video visits vs in-person encounters. Future studies should explore which patients and conditions are best suited for video visits. INTRODUCTIONT elemedicine, or telehealth, includes telecommunication via a variety of platforms designed to enhance patient-centered health care.1-3 Telehealth in its many forms offers conveniences including increased care accessibility, decreased transportation barriers, and patient empowerment. [4][5][6][7][8] Studies of video visits have demonstrated these benefits in specialty settings including wound care, prenatal genetic screening, family planning, cardiovascular care, and home care. [9][10][11][12][13][14][15] One study of patient experiences with video visits in rural areas found that they were associated with decreased travel costs and lost time/wages, increased access to social support, and better ability to tailor care delivery to patient and family needs. 16Because of these benefits, video visits are being adopted in a variety of settings. Uptake in the United States has occurred most rapidly where reimbursement is favorable. Medicare reimburses for video visits in health professional shortage areas and for specific approved services.17 As a result, much knowledge about patient experiences with video visits is limited to specific disease-related applications and to use in rural settings. [18][19][20] Video visits are increasingly used in other settings, including primary care, but there are limited data on patient experiences with primary care video visits. One study tested video visits with patients communicating via webcam with their primary care physician w...

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Section: Introductionmentioning

confidence: 99%

Patient Perceptions of Telehealth Primary Care Video Visits

et al. 2017

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“…The quantitative studies all used a cross‐sectional descriptive design and were conducted in the United States . As part of a quality improvement initiative, Brown et al used a closed‐ended survey‐styled questionnaire to evaluate the family members' perceptions of accompanying a critically ill relative during air transport to an urban tertiary care centre.…”

Section: Resultsmentioning

confidence: 99%

“…However, because the findings by Brown et al align with previously described methodologically sound studies, this study was included in the development of this integrative review. Menon et al completed a small retrospective chart review to determine the feasibility of using telemedicine family conferences to support rural family members during a relative's IFT. Although this study is methodologically sound in addressing the study aim, data from family participants were not collected.…”

Section: Resultsmentioning

confidence: 99%

Inter‐facility transfers for advanced critical care services: Impacts on rural families

Burns

Petrucka

2019

Nursing in Critical Care

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Aims and Objectives: The aim of this article is to provide an integrative review of rural family members' experiences of a relative's inter-facility transfer to an urban tertiary care centre for advanced critical care services.Background: Although there is an increasing awareness of the negative consequences of a relative's critical illness for family members, there has been limited research conducted on the impacts of this experience for families of patients in rural settings who require an inter-facility transfer for advanced services.Search strategy: The search strategy for this review was framed by the study purpose, research question, and a conceptual structure of key constructs. Databases and reference lists were electronically and manually searched.Inclusion and exclusion criteria: Articles were included if they were research articles, available in English, and focused on family members' experiences of inter-facility transfer during critical illness. Articles focusing on critical care transfers within a single urban setting, elective transfers undertaken for patient or family preference, transfers not associated with critical illness, and systematic or scoping reviews were excluded.Conclusion: Stress and anxiety are central to the rural family members' experience of this phenomenon. These constructs are influenced by modifiable factors, including the actions of health care providers, the financial burden associated with the transfer, the family members' physical proximity to the patient, and their access to information and support networks. Further research is required to explore potential short-and long-term consequences of this experience and the experience of family members who are left behind and to develop and test interventions to support families.Relevance to clinical practice: This review highlights the concern that health care providers frequently misunderstand the needs of family members who are experiencing this phenomenon. Through a better understanding of this phenomenon, health care providers will be better positioned to effectively support these individuals during this unique experience. K E Y W O R D Scritical illness, family, integrative review, interfacility transfer, rural

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“…Studies of telemedicine in NHs have evaluated the use of technology to improve access to services such palliative care through remote consults, 45 teledermatology, 46-50 telepsychiatry 51-55 and potentially other specialties such as cardiology, pulmonary and neurology. Thus, telemedicine could be leveraged more broadly as a platform for providing other services, such as enhanced access to other specialty care, elevating the technology to a ‘horizontal,’ cross-cutting intervention within a NH and potentially increasing the associated clinical and financial benefits.…”

Section: Discussionmentioning

confidence: 99%

Nursing Home Provider Perceptions of Telemedicine for Reducing Potentially Avoidable Hospitalizations

Driessen

Bonhomme

Chang

et al. 2016

Journal of the American Medical Directors Association

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Objective Potentially avoidable hospitalizations (PAHs) of nursing home (NH) residents are common, costly, and can have significant economic consequences. Telemedicine has been shown to reduce emergency department and hospitalization of NH residents, yet adoption has been limited and little is known about provider's perceptions and desired functionality for a telemedicine program. The goal of this study was to survey a nationally representative sample of NH physicians and advanced practice providers to quantify provider perceptions and desired functionality of telemedicine in NHs to reduce PAHs. Design/Setting/Participants/Measurement We surveyed physician and advanced practice providers who attended the 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine Annual Conference about their perceptions of telemedicine and desired attributes of a telemedicine program for managing acute changes of condition associated with PAHs. Results We received surveys from 435 of the 947 conference attendees for a 45.6% response rate. Providers indicated strong agreement with the potential for telemedicine to improve timeliness of care and fill existing service gaps, while disagreeing most with the ideas that telemedicine would reduce care effectiveness and jeopardize resident privacy. Responses indicated clear preferences for the technical requirements of such a program, such as high-quality audio and video and inclusion of an electronic stethoscope, but without strong opinions about who should be performing the consults. Conclusion Among NH providers, there is a high degree of confidence in the potential for a telemedicine solution to PAHs in NHs, as well as concrete views about features of such a solution. Such consensus could be used to drive an approach to telemedicine for PAHs in NHs that retains the theoretical strengths of telemedicine and reflects the needs of facilities, providers, and patients. Further research is needed to objectively study the impact of successful telemedicine implementations on patient, provider, and economic outcomes.

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Telemedicine as a Tool to Provide Family Conferences and Palliative Care Consultations in Critically Ill Patients at Rural Health Care Institutions

Cited by 36 publications

References 17 publications

Patient Perceptions of Telehealth Primary Care Video Visits

Patient Perceptions of Telehealth Primary Care Video Visits

Inter‐facility transfers for advanced critical care services: Impacts on rural families

Nursing Home Provider Perceptions of Telemedicine for Reducing Potentially Avoidable Hospitalizations

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