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

Background: Telehealth models are one way to improve access to specialty palliative care (SPC) among advanced cancer patients living in underserved communities. Objectives: Iteratively evaluate a pilot telehealth SPC delivery model in community oncology clinics. Design: Two interventions were tested with patients with a high risk of mortality and deemed appropriate for SPC: telemedicine and e-consult models. Setting/Subjects: Three community oncology clinics within the UPMC Hillman Cancer Center network in Western Pennsylvania. Measurements: Feedback from physicians at each site and the referral completion rate were used to refine the intervention from one site to the next. Results: Mortality screening tools need to be adapted to hematologist-oncologists' practice patterns. Clinic workflows influence the effectiveness of telemedicine and e-consultation models. Conclusions: Telehealth delivery models have the potential to connect underserved communities with SPC, but it is crucial to incorporate feedback from site clinicians to tailor the intervention to their clinical practice and patient population.