Web-Based Videoconferencing (WBVC) for Rural Palliative Care Consultation in the Home
Web-Based Videoconferencing (WBVC) can help patients have faster access to expert help without having to leave home. It can also help Palliative Care doctors and nurses see more patients and improve productivity.
Findings: Participants included 10 patients (mean age 77), 13 family members, nine Home Care Nurses (HC-Ns), three Palliative Care Clinical Nurse Specialists (PC-CNSs) and two Palliative Care Physician Consultants (PC-MDs). Participants reported they were comfortable discussing concerns by WBVC and felt their needs and concerns were addressed as well as in person. Some patients and family members worried about the privacy and security of the internet connection, despite reassurances. Participants in the home valued being able to “see” the PC-MD and have a thorough discussion of issues as a whole team. Audiovisual quality was not ideal but adequate to enable communication. The WBVC was very convenient for patients and families. It helped them have faster access to the PC-MD without the burden of leaving home. The PCMDs saved the time and travel needed for an in-person visit, freeing up more time to see more patients. Overall, participants felt WBVC was better than a phone call but not as good as an in-person visit.
Impact of findings: Through the use of mobile WBVC for clinical consultation in the home, frail elderly patients and their caregivers will have improved access to clinical specialists and other professional caregivers, resulting in improved support and surveillance in the home. Patients and their caregivers will be able to engage in more timely, comprehensive communication around complex care issues, Advance Care Planning, and treatment planning. Lastly, patients, families, and consultants will save the time, cost, and burden of travel to an in-person visit, and the efficiency and productivity of clinical consultation will be improved, particularly in a dispersed rural population.
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About the Project
Seriously ill, frail elderly patients in rural areas often have limited access to specialist palliative care support. It is hard for them to travel to medical visits, and barriers of time and weather can prevent timely home visits by consultants. WBVC offers an alternate visit format that allows patients to see, hear and talk to a health care provider without anyone having to travel.
In this pilot phase, we tested the use of WBVC for rural palliative care consults in the home. A PC-CNS, who was in the home with the patient/family and HC-N, set up a laptop computer with a camera and speakerphone and linked to a distant Palliative Care Doctor over the Internet so everyone could take part in the consult visit. Written surveys, interviews and focus groups helped us learn how well WBVC works for this purpose and the best ways to use it.
For more details on the project objective, hypothesis and research plan, click here.
Linda Read Paul, RN, MN, CHPCN(C) -- University of Calgary
Gilian Ho, MD, CCFP -- Alberta Health Services
Ayn Sinnarajah, MD, MPH, CCFP(PC) -- University of Calgary
Ron Spice, MD, BMedSc, CCFP(PC), FCFP -- University of Calgary
Jill Uniacke, RN, MN, CHPCN(C) -- Alberta Health Services
Marie Webb, RN, MSc, CHPCN(C) -- Alberta Health Services
Project Contact: Linda Read Paul -- Linda.ReadPaul@ahs.ca