Virtual Visits in Hospice: Lessons Learned and Directions for the Future (FR441D)

Abstract

•Describe a novel approach to providing triage and symptom management with the use of electronic tablet-based communication.•Explain the caregiver perceptions in the use of electronic tablet-based communication. Healthcare is evolving at a rapid pace, and technology adaptation has changed the delivery of hospice and palliative care. Tele hospice is an on-demand provision of care, using virtual visits facilitated by electronic tablet-based communication. Hospice caregivers use Angela's Virtual Assist (AVA), an innovative technology that allows the hospice patient and caregiver to have access to face-to-face assistance from triage staff. The AVA program uses Vivify's Remote Patient Monitoring platform and Zoom's communication platform. Virtual visits can be provided twenty-four hours a day, seven days a week, which increases timely interventions. The effectiveness of telehospice was examined over the past two years. Four hundred fifty-three survey responses from caregivers were collected and analyzed. Lessons learned from caregiver surveys are used for continuous program improvement. Feedback was overwhelmingly positive, with minimal negative comments mostly centered on connectivity. Family members reported a sense of security and peace of mind with the presence of AVA, and decreased stress of caregiving. Patients were able to virtually attend important life events, such as weddings and funerals. Multiple family members were able to connect with the technology from remote locations for virtual team and family meetings. The focus of the AVA program is on patient and caregiver comfort, interpersonal and inter professional communication and family empowerment for symptom control. The value of the virtual hospice visit to clinical decision making cannot be overemphasized. The ability to see the patient while assessing their clinical condition is key to success of the virtual care center. The nurse immediately addresses urgent patient needs and provide support and education without delays of travel time for a visit. While the virtual visit is not intended to replace in-person visits, some issues may be resolved by virtual visit alone. Individualized Care pathways were used for medication reminders, supply and medication refill requests, and requests for medical social service consults.