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

Area of Science:

• Palliative Care
• Health Services Research
• Digital Health

Background:

• The integration of virtual visits into healthcare services is expanding, yet specific guidance for palliative care is limited.
• Organizations face challenges in deciding between in-person and virtual care modalities and establishing effective service delivery models.
• The COVID-19 pandemic accelerated the need for virtual care solutions, highlighting implementation hurdles and benefits.

Purpose of the Study:

• To develop and evaluate a prototype virtual visits model for palliative care.
• To identify clinical, ethical, and logistical considerations for implementing virtual visits in palliative care.
• To provide guidance for long-term service design integrating virtual and face-to-face palliative care.

Main Methods:

• Development of a prototype virtual visits model within a palliative care setting.
• Retrofitting guidance and an ethical framework to support the virtual visits model.
• Analysis of clinical, ethical, and logistical issues encountered during implementation, considering both COVID-19 specific and generic challenges.

Main Results:

• Virtual visits offer significant potential but are not a universal solution for all palliative care needs.
• A 'one-size-fits-all' approach is unsuitable for the diverse palliative care population.
• Implementation challenges were identified across clinical, ethical, and logistical domains, with some exacerbated by rapid COVID-19 related deployment.

Conclusions:

• Virtual visits can enhance palliative care services when implemented thoughtfully.
• Tailoring virtual visit strategies to individual patient needs and organizational capacity is essential for success.
• Further research and development are needed to optimize the integration of virtual visits into comprehensive palliative care.