Abstract
BackgroundAdvances in technology have made the use of telehealth in the home setting a feasible option for palliative care clinicians to provide clinical care and support. However, despite being widely available and accessible, telehealth has still not been widely adopted either in Australia or internationally. The study aim was to investigate the barriers, enablers and perceived usefulness for an established home telehealth program in paediatric palliative care from the perspective of clinicians.MethodsSemi-structured interviews (n = 10) were undertaken with palliative care clinicians in a tertiary paediatric hospital to identify attitudes to, satisfaction with, and perceived benefits and limitations of, home telehealth in palliative care. Iterative analysis was used to thematically analyse data and identify themes and core concepts from interviews.ResultsFour themes are reported: managing relationships; expectations of clinicians; co-ordination, and the telehealth compromise. Core concepts that emerged from the data were the perceived ability to control clinical encounters in a virtual environment and the need to trust technology. These concepts help explain the telehealth compromise and low utilisation of the home telehealth program.ConclusionsEffective communication between caregivers and clinicians is recognised as a core value of palliative care. Home telehealth has the potential to provide a solution to inequity of access to care, facilitate peer support and maintain continuity of care with families. However, significant limitations and challenges may impede its use. The virtual space creates additional challenges for communication, which clinicians and families may not intuitively understand. For home telehealth to be integrated into routine care, greater understanding of the nature of communication in the virtual space is required.
Highlights
Advances in technology have made the use of telehealth in the home setting a feasible option for palliative care clinicians to provide clinical care and support
The use of video-consultation in the home to provide palliative care, sometimes referred to as telehospice, is one area of significant interest and numerous studies undertaken have investigated the effects for clinicians and patients [4,5,6,7]
At the Royal Children’s Hospital (RCH) in Brisbane Australia, interest in the use of video-consultation in patients’ homes to support paediatric palliative care has been significant and sustained over the last decade. This can be attributed to several factors: 1) the vast geographical size of Queensland, and the dispersion of families away from specialised paediatric services in regional, rural and remote locations make the use of telehealth a practical and logical choice; and 2) a collaborative relationship between the Queensland Children’s Cancer Centre and the University of Queensland’s Centre for Online Health, has been successful in securing funding over several years to support telehealth projects
Summary
Advances in technology have made the use of telehealth in the home setting a feasible option for palliative care clinicians to provide clinical care and support. Video consultation in the home has been used to provide: At the Royal Children’s Hospital (RCH) in Brisbane Australia, interest in the use of video-consultation in patients’ homes to support paediatric palliative care has been significant and sustained over the last decade This can be attributed to several factors: 1) the vast geographical size of Queensland, and the dispersion of families away from specialised paediatric services in regional, rural and remote locations make the use of telehealth a practical and logical choice; and 2) a collaborative relationship between the Queensland Children’s Cancer Centre and the University of Queensland’s Centre for Online Health, has been successful in securing funding over several years to support telehealth projects. The use of telehealth was considered by the health service to be an appropriate tool to improve access to services for families, and provide education and support for local clinicians
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