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Extending
the range of
home tele-services that can be
brought to today's patients.
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Telehospice:
Needed & Improved Service Delivery at End of Life
April 2004
 Telehospice:
It’s the increased use of communications (the tele component)
to provide hospice services for end-of-life patients and their caregivers.
Still
uncertain about using technologies in hospice, the highest touch,
lowest tech healthcare service of all? Here’s an opportunity
to learn about the advantageous uses of technology as an adjunct
to conventional care. Telehospice is not mechanizing the home hospice
process nor forcing us to choose between nurse and patient contact
or machine and patient contact.
Telehospice can, instead provide, more means for communications
to keep patients and their caregivers in closer contact with nursing
and other hospice staff. Services can be delivered more promptly,
and can include:
- quicker
assessments of patients via easy-to-use physiologic tracking tools
(like the telecommunications-ready blood pressure cuff or glucose
meter)
- more timely
interventions (for pain management, for example, using pre-programmed
telecommunications-ready ambulatory infusion pumps)
- teaching
family or other lay caregivers (through audio and video resources
that reinforce nurses’ in-person directions) how to provide
needed comfort measures.
These
possibilities are discussed in the Tele-Help
Tools for Hospice segment below.
Telehospice
Case Studies will note examples of providing more kinds
of comfort than simply replicating the conventional in-person visit.
Telling looks at telehospice’s use in care in prisons and in
rural America are provided.
Today, only
1 in 4 Americans who die have been admitted to hospice care, and
it is believed that many people do not know about its availability,
while others think of it and shun it as “home care for the
dying.” Our Look Homeward
segment provides details on work that is being done in telehospice
to extend that definition of hospice care at home. Experts in the
field provide details about targeted care for patients who might
not otherwise be reached or have their needs met, underserved ethnic
minority patients being one example.
Telehospice
today: it is new, programs are small, results are limited as yet.
All the more reason to begin looking at Needed
Directions
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Tele-Help
Tools for Hospice.
A small sampling…
- Telehealth
workstations. Needed for more frequent tracking
of patients’ status, include a range of physiologic
monitoring tools, such as blood pressure cuff and
glucose monitor. One example is the HomMed
system.
- Vidoephones
and videocameras. Two staples in today’s telehospice
toolbox, used most often for teaching and reminders.
One example is the Starview
system.
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Telehospice
Case Studies
… what’s working.
Two
case studies indicate telehospice's effectiveness in providing
comfort care, which is key to accomplishing hospice's mission.
- telehospice
care in correctional facilities-- better than usual
hospice care is described by a provider.
- in
rural telehospice, more than overcoming barriers of
distance are at issue, as noted in this case.
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Look
Homeward
With 3 experts working in the telehospice arena who
describe how it’s been possible to reach out to a broader
community and educate them about hospice’s value and
possibilities for patients and their caregivers.
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Needed
Directions
Start thinking about “how” to invest
our time and energies in telehospice That means thinking protocols,
planning, and pathways. We provide recommended reading on these
topics right here. |
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