Open AccessReinventing Palliative Care Delivery in the Era of COVID-19: How Telemedicine Can Support End of Life Care
Author(s) -
Katherine Ritchey,
Alice Foy,
Erin McArdel,
David A. Gruenewald
Publication year - 2020
Publication title -
the american journal of hospice and palliative care/the american journal of hospice and palliative care (online)
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.803
H-Index - 51
eISSN - 1938-2715
pISSN - 1049-9091
DOI - 10.1177/1049909120948235
Subject(s) - telehealth , palliative care , telemedicine , nursing , videoconferencing , medicine , end of life care , quality (philosophy) , health care , medical emergency , multimedia , computer science , philosophy , epistemology , economics , economic growth
Telemedicine technology has become essential to healthcare delivery in the COVID-19 era, but concerns remain regarding whether the intimacy and communication that is central to high-quality palliative care will be compromised by the use of this technology. We employed a business model approach to identify the need for system innovation in palliative care, and a quality improvement approach to structure the project. Products from this project included a standard operating procedure for safe use of tablet computers for inpatient palliative care consultations and family visitations; tablet procurement with installation of video telehealth software; and training and education for clinical staff and other stakeholders. We describe a case illustrating the successful use of palliative care telehealth in the care of a COVID-19-positive patient at the end of life. Successful use of video telehealth for palliative care involved overcoming inertia to the development of telehealth infrastructure and learning clinical video telehealth skills; and engaging front-line care staff and family members who were open to a trial of telehealth for communication. Information gleaned from family about the patient as a person helped bedside staff to tailor care toward aspects meaningful to the patient and family and informed best practices to incorporate intimacy into future palliative video consultations and family visit.