Virtual visits in palliative care: about time or against the grain?

Abstract

While the additional value from adding the option of virtual visits is not in question, numerous issues are raised around how to decide between face-to-face and virtual visits in individual cases and how best to set up such provision within an organisation. With only limited palliative care-specific literature and no time to set up and evaluate pilots, we had to get on and set up a prototype ‘virtual visits’ model, retro-fitting guidance and a supporting ethical framework. We looked at the issues spanning clinical, ethical and logistics domains; identifying areas of benefit as well as drawbacks, some specific to the rushed implementation because of COVID-19’s infective risks and the ‘rules’ of lockdown, but many are generic areas to help guide longer term service design. Unsurprisingly, it appears clear that a ‘one-size-fits-all’ mentality is a poor fit for the individualised needs of the heterogeneous palliative care population. Virtual visits have great potential even if they are not a panacea.

Satisfaction and Experience of Palliative Patients with 24/7 Hotline Service During the COVID-19 Pandemic in Saudi Arabia

“…Shortly after the pandemic, PC patients in Saudi Arabia were helpless and distraught because their access to healthcare became interrupted and their fear of catching COVID-19 was increasing. A multi-factor analysis to assess the option of virtual visits related to PC was undertaken in the United Kingdom in 2020 [5]. Stakeholders preferred virtual treatment because it decreases utilization of Personal Protective Equipment (PPE), decreases uncertainty of the COVID-19 pandemic, and improves time regulation [5].…”

“…A multi-factor analysis to assess the option of virtual visits related to PC was undertaken in the United Kingdom in 2020 [5]. Stakeholders preferred virtual treatment because it decreases utilization of Personal Protective Equipment (PPE), decreases uncertainty of the COVID-19 pandemic, and improves time regulation [5]. Families and patients preferred a virtual visit because of its convenience, privacy, and some even preferred it because it allowed them to read lips, which was not an option under mask mandates in office environments [5].…”

“…Stakeholders preferred virtual treatment because it decreases utilization of Personal Protective Equipment (PPE), decreases uncertainty of the COVID-19 pandemic, and improves time regulation [5]. Families and patients preferred a virtual visit because of its convenience, privacy, and some even preferred it because it allowed them to read lips, which was not an option under mask mandates in office environments [5]. Telehealth in palliative home care is thought to be accessible and could potentially improve the quality of specialized palliative home care [6].…”

“…It is achieved through prevention and relief of suffering by early diagnosis, thorough evaluation, and treatment of pain and other difficulties such as medical, psychosocial, and spiritual issues [4]. Telemedicine use in palliative care has long been accepted, but the literature on virtual palliative care-specific advantages and drawbacks is still scarce [1,5]. Many considerations play unique roles in the virtual treatment of PC patients, such as practical, clinical, and ethical factors [5].…”

“…Telemedicine use in palliative care has long been accepted, but the literature on virtual palliative care-specific advantages and drawbacks is still scarce [1,5]. Many considerations play unique roles in the virtual treatment of PC patients, such as practical, clinical, and ethical factors [5]. The benefits of video consultations are summarized as being practical, inclusive of a multidisciplinary team, and that also promotes collaboration between healthcare practitioners [6].…”