The Feasibility of Using Technology to Enhance the Transition of Palliative Care for Rural Patients

Abstract

Palliative care services for patients with life-limiting conditions enhance their quality of life. Most palliative care services, however, are located in hospitals with limited transitional care for patients who live in distant locations. The long-term goal of this program of research is to use existing technology for virtual visits to provide transitional care for patients initially hospitalized in an urban setting by a nurse practitioner located closer to patients' homes in distant, rural settings. The purpose of this proof-of-concept study was to determine the resources needed to use the system (efficiency) and the quality of the audio and visual components (effectiveness) to conduct virtual visits between a clinician at an academic center and community-dwelling adults living in rural locations. Guided by the Technology Acceptance Model, a mixed-methods field design was used. Because of the burden of testing technology with patients with life-limiting conditions, the sample included eight healthy adults. Participant satisfaction and perceptions of the ease of using the technology were also measured. Virtual visits were conducted using a 3G-enabled Apple iPad, cellular phone data service, and a Web-based video conference service. Participants and clinicians perceived the technology as easy to use. Observations revealed the importance of the visual cues provided by the technology to enhance communication, engagement, and satisfaction. Findings from this study will inform a subsequent study of technology-enhanced transitional care with palliative care patients.

Patients’ experiences of eHealth in palliative care: an integrative review.

“…This approach also promoted patients' motivation and adherence to monitoring symptoms and governing their own care. Video meetings have had positive effects on patients' knowledge and provided social support for people with chronic illness (49), which agrees with the results of this study. However, safeguarding the integrity of patients in the context of video meetings is crucial to maintain a sense of security.…”

“…Communication between patient, close relatives and team members was facilitated through eHealth, and patients' experienced increased access to care since physical distance was not an issue. Patients found that the use of video consultation, strengthened communication since visual features are included, also described in other studies (48,49). Another bene t found in our review was that despite life-threatening illness and being close to the end of life, patients could take an active role and govern their own care if they want to, thus promoting individualized care.…”

Patients’ experiences of eHealth in palliative care: an integrative review

“…Communication between patient, close relatives and team members was facilitated through eHealth, and patients' experienced increased access to care since physical distance was not an issue. Patients found that the use of video consultation, strengthened communication since visual features are included, also described in other studies [53,54]. Another benefit found in our review was that despite lifethreatening illness and being close to the end of life, patients could take an active role and govern their own care if they want to, thus promoting individualized care.…”

Patients' experiences of eHealth in palliative care: An integrative review

“…Communication between patient, close relatives and team members was facilitated through eHealth, and patients' experienced increased access to care since physical distance was not an issue. Patients found that the use of video consultation, strengthened communication since visual features are included, also described in other studies (53,54).…”