Expanding Access to Palliative Care via Telehealth: Lessons Learned and Key Considerations

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• Advanced cancer patients in underserved communities face barriers accessing specialty palliative care (SPC).
• Telehealth offers a potential solution to bridge this access gap.
• Pilot programs are essential for evaluating and refining new healthcare delivery models.

Purpose of the Study:

• To iteratively evaluate a pilot telehealth SPC delivery model.
• To assess the feasibility and effectiveness of telemedicine and e-consult interventions.
• To gather clinician feedback for model refinement.

Main Methods:

• Pilot study involving two telehealth interventions (telemedicine and e-consult) for high-risk advanced cancer patients.
• Implementation across three community oncology clinics.
• Iterative refinement based on physician feedback and referral completion rates.

Main Results:

• Mortality screening tools require adaptation for hematologist-oncologists' workflows.
• Clinic workflows significantly impact the effectiveness of telemedicine and e-consult models.
• Iterative feedback facilitated intervention tailoring.

Conclusions:

• Telehealth models show promise for connecting underserved populations with SPC.
• Incorporating site-specific clinician feedback is crucial for successful implementation.
• Tailoring interventions to clinical practice and patient populations enhances model effectiveness.