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Home Healthcare, Hospice, and Information Technology Innovations Conference

Innovations in Home Healthcare, Hospice, and Information Technology

A forum towards achieving evidence-based diffusion and implementation of innovations

Fri, Nov 3, 2017
Friday, Nov 3, 2017, Washington - D.C.
H3IT: Home Healthcare, Hospice, and Information Technology Conference Washington D.C., 2014
Sharing the journey: Technology-Enhanced
Transitional Palliative Care
Diane E. Holland
, Catherine E. Vanderboom
, Cory J.Ingram
, Ann Marie Dose
, Ellen Wild
, Kathryn H. Bowles
he majority of palliative care services are located in urban medical centers with few deliberate or consistent
approaches to coordinate care across geographically-diverse settings. This pilot study linked two proven strate-
gies, transitional care and use of health information technology, in an innovative way to extend palliative care
across settings and improve outcomes for rural patients and their caregivers. The purpose of this pilot study
was to determine feasibility, acceptability, and initial outcomes of a technology-enhanced transitional palliative care (TPC)
intervention with
Methods: In this randomized controlled trial, patients/caregivers receiving inpatient palliative care consultation in a rural
Minnesota hospital received either TPC or usual care for 8 weeks after hospital discharge. TPC consisted of one home
visit, periodic phone calls, and weekly video session visits with a nurse via iPad. Attention control patients received weekly
telephone calls by a study team member. All participants were oered a subsequent qualitative telephone interview to assess
feasibility and acceptability. Transcripts were analyzed using content analysis.
Results: Five patients and 7 caregivers were interviewed. Technology use was feasible and acceptable after minor initial
glitches were resolved; all valued viewing their nurse during video sessions. Care coordination was a dominant theme. In-
tervention patients/caregivers experienced satisfactory care coordination, enjoyed continuity provided across settings, and
valued anticipatory guidance received. Care coordination and relationship was absent for the control group; all needed to
manage care and healthcare interactions alone.
Conclusion: TPC is not only feasible, but desired by rural palliative care patients/families transitioning from hospital to
home or other care settings. Video technology was a welcomed adjunct to fostering and maintaining the provider/patient
Implications for research, policy, or practice: Palliative care should continue beyond the hospital doors; ongoing
follow-up is needed for often worsening healthcare issues for these patients. Policy needs to change to provide reimbursement
for innovative palliative care strategies that span care settings
Mayo Clinic Rochester
University of Pennsylvania School of Nursing
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