Bridging the Gap: Telehealth Applications in Palliative Care (P20)

Abstract

•Describe the various modalities and settings of telehealth use in palliative care—inpatient, community-based, and Project ECHO.•Identify the legal and billing/insurance issues relevant for telehealth in palliative care.•Summarize advantages, challenges, and barriers to the implementation of telehealth in palliative care.•Develop a workplan for instituting or expanding telehealth in palliative care. As with many specialties, it is difficult to sustain palliative care programs in rural areas. This is particularly true in areas such as the Southeast where non-urban hospitals tend to be small and for-profit, two characteristics associated with lacking palliative care services. Early efforts to address rural inequities focused on moving specialists into areas of need, but some of these succumbed to a lack of consistent volume and revenue for the time expended by specialists. More recently, efforts to address rural inequities have shifted to using technology to bridge the distances. Through detailed descriptions of initiatives at three major palliative care centers, participants will understand the strengths and opportunities for leveraging telehealth to expand and sustain palliative care. Workshop leaders will describe how and why they have implemented these four models: tele-medicine by palliative providers to a rural clinic; tele-consultation for inpatient palliative care; tele-monitoring to increase efficiency and communication for home-based palliative care; and tele-mentoring to push palliative care practices from major centers out to community providers. Workshop leaders will provide detailed implementation checklists for each model; descriptions of advantages and disadvantages of each; technological, regulatory, and legal considerations including variation across states; and concise summaries of the evidence base for each. Slides and additional tables summarizing the essential strengths and pitfalls for implementing each model will be provided, as well as references to articles and other resources. Throughout the workshop, participants will be encouraged to discuss their own efforts to reach rural patients. Worksheets will be used to give participants an opportunity to begin fleshing out their own version of each model, and to apply the strengths and weaknesses of each of these models in their own communities.