George Dimiris, Ph.D, director of the Missouri Telehospice Project initiative at the University of Missouri in collaboration with 5 hospices in Missouri discusses his work, including outreach to ethnic minority groups, who have been traditionally underserved in hospice, and other challenges of his program:

We are working both with urban and rural populations. Unfortunately, as it is the case in other states, ethnic minority populations do not utilize hospice services to a great extent and we work with the existing client pool of our collaborating agencies. The challenges of implementing telehospice in rural populations include the lack of infrastructure (e.g., some homes do not have phone lines) and the lack of professionals in the area. On the other hand, hospice workers see a greater benefit in using videophones as an initial screening tool before an unexpected visit.

We are currently conducting pilot studies to determine this hypothesis (which disease group has the highest satisfaction scores and lowest burden in using the technology). We have been working so far with cancer patients and their caregivers. Our eligibility criteria included any cancer diagnosis and enrollment in the hospice agency and mental state that allows the understanding of the consent form and the decision about participation in the study. The next step is, for us, to look more carefully at the demographic and clinical data of our patients. We have designed the intervention to target primarily caregivers of cancer patients. The aim is that the use of videophones will decrease caregiver anxiety and distress. We are also looking at caregiver and patient acceptance and satisfaction.