Hospice care is a benefit offered by Medicare for terminally ill patients. A less familiar but related service known as palliative care, benefits patients by providing pain and symptom control, coordination between support team members, emotional support and relief for family/caregivers. The difference between the two is that the former is for anyone of any age at any stage of a serious illness and can be provided along with curative treatment. Meanwhile, hospice patients are no longer receiving curative treatment and may only have months to live. Telemedicine just happens to be something they have in common.
The term used for telemedicine in hospice care is telehospice, and is the new frontier of telehealthcare delivery. Even if it only involves an I-Pad with Skype installed so that an on-call nurse or doctor can communicate remotely with a caregiver, it is a telehealth application. In the case of hospice, the patient is suffering and so time and communication are both of the essence. “Hands-on” visits are by no means replaced. Customary communication and comfort provided in person are merely assisted by the immediate remote visualization provided by telehealth. That care is even more greatly enhance during an on-call crisis.
In order to fully grasp where telehealth fits in, it should help to review just what the benefit of hospice care entails. Service under the Medicare Hospice Benefit include:
Remember that on-call crisis referred to earlier? Unfortunately, these are likely to occur with serious illnesses. A caregiver may be called upon to reposition a catheter. That caregiver should be a nurse or ideally, someone with expertise will be at least present to infuse the situation with some measure of calm and guide the procedure. In reality, none of this may be possible in a moment of crisis. However, even a family member can be talked through simple procedures using a videophone. Support staff at a nursing home can use the same technology to reach an on-call doctor. The worst-case scenario facing our healthcare system, staffing shortages, only makes the necessity of telemedicine more urgent, especially when it comes to meeting the needs of hospice patients.
The tools of telehospice are the same telecommunication devices used by other telehealth practitioners. The range of equipment includes but is not limited to:
Again, this list is hardly comprehensive or exclusive, barely an introduction. It is more important to note are the improvements that they can add to hospice. Patients will be assessed quicker. Interventions will be timelier. Caregivers will be able to benefit from educational opportunities, “show and tell” demonstrations that spread valuable knowledge more evenly throughout the support team. Additional comfort and stress relief will be offered via music and visualization therapies. Most importantly, hospice providers will be able to generate crucial feedback for the engineers and designers of this technology that will allow telemedicine to be more specifically tailor-made for hospice patients.