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Web-based videoconferencing for rural palliative care consultation with elderly patients at home

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Abstract

Purpose

Providing specialized palliative care support to elderly patients in rural areas can be challenging. The purpose of this study was to gain a preliminary understanding of the experience of using mobile web-based videoconferencing (WBVC) for conducting in-home palliative care consults with elderly rural patients with life-limiting illness.

Methods

This was a descriptive, exploratory, proof-of-concept study with a convenience sample of 10 WBVC visits. A palliative care clinical nurse specialist (PC-CNS), in the home with the patient/family and home care nurse (HC-N), used a laptop computer with webcam and speakerphone to connect to a distant palliative care physician consultant (PC-MD) over a secure Internet connection. Data was collected using questionnaires, interviews, and focus groups.

Results

Analysis of qualitative data revealed four themes: communication, logistics, technical issues, and trust. Participants reported they were comfortable discussing concerns by WBVC and felt it was an acceptable and convenient way to address needs. Audiovisual quality was not ideal but was adequate for communication. Use of WBVC improved access and saved time and travel. Fears were expressed about lack of security of information transmitted over the Internet.

Conclusions

Using WBVC for in-home palliative care consults could be an acceptable, effective, feasible, and efficient way to provide timely support to elderly rural patients and their families. Having a health care provider in the home during the WBVC is beneficial. WBVC visits have advantages over telephone calls, but limitations compared to in-person visits, suggesting they be an alternative but not replacement for in-person consultations.

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Acknowledgments

Support for this study from the Information Technology portfolio of Alberta Health Services is gratefully acknowledged. Thanks are due to Rakib Mohammed, Provincial Director, Clinical Telehealth; Jason Kettle, Provincial Director, Unified Communications and Telehealth Technology; and Katie Woo, Provincial Research Program Manager, Clinical Telehealth. Support from the University of Calgary and the AHS Palliative and End of Life Care and Integrated Home Care portfolios is also appreciated. Members of the AHS Calgary Zone Rural Palliative Care Consultation Team are acknowledged for their participation and their contributions to data collection and analysis (Dr. Gilian Ho (GH), Dr. Ron Spice (RS), Linda Read Paul (LRP), Marie Webb (MW), Jill Uniacke (JU)). Lastly, thanks are due to Madalene Earp PhD for her editorial input on this manuscript.

Funding

This research was funded by the Canadian Frailty Network (CFN) (known previously as Technology Evaluation in the Elderly Network, TVN) Health Technology Innovation Grant (HTIG) 2014-10. CFN is supported by the Government of Canada through the Networks of Centres of Excellence (NCE) Program.

Author information

Authors and Affiliations

  1. Palliative Care Consult Service – Rural, Calgary Zone, Alberta Health Services, 11 Cimarron Common, Okotoks, Alberta, T1S 2E9, Canada

    Linda Read Paul & Ron Spice

  2. University of Calgary, TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada

    Charleen Salmon

  3. Palliative / End of Life Care, Calgary Zone, Alberta Health Services, 710 South Tower, Foothills Medical Centre, 1403 - 29th Street NW, Calgary, Alberta, T2N 2T8, Canada

    Aynharan Sinnarajah

Authors
  1. Linda Read Paul
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  2. Charleen Salmon
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  4. Ron Spice
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Corresponding author

Correspondence to Linda Read Paul.

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Ethical approval

This study was approved by the Calgary Conjoint Health Research Ethics Board (Ethics ID# REB15-0429). Written informed consent was obtained from all individual participants included in the study, and they were able to withdraw from the study at any time.

Conflict of interest

The authors declare that they have no competing interests.

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Read Paul, L., Salmon, C., Sinnarajah, A. et al. Web-based videoconferencing for rural palliative care consultation with elderly patients at home. Support Care Cancer 27, 3321–3330 (2019). https://doi.org/10.1007/s00520-018-4580-8

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  • DOI: https://doi.org/10.1007/s00520-018-4580-8

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