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Sandra Mierdel

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    OS16 - Unleashing Telehealth (ID 26)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
    • Coordinates: 5/28/2019, 10:00 AM - 11:00 AM, Pod 7
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      OS16.04 - Virtual Palliative Care: Supporting Patients in Their Home (ID 234)

      Sandra Mierdel, Clinical Innovation, Ontario Telemedicine Network; Toronto/CA

      • Abstract
      • Slides

      A report released by Health Quality Ontario, Palliative Care at the End of Life (2016), advocates for early palliative care intervention as well as support for care in the location of choice. The report found that although most Ontarians prefer to receive palliative care and die at home, the majority die in hospital. The report also found that caregivers, who play a critical role for patients with a terminal or chronic illness, experience burnout which is a key contributor to trips to the emergency room for patients in the last stages of life. Evidence shows that virtual care solutions are effective in monitoring patient symptoms and that team-based care with direct patient contact significantly increases the likelihood of dying at home. The purpose of this demonstration project was to support patients with a progressive life limiting illness who prefer to receive care in their home. The objectives were to promote earlier identification of patient needs, improve patient and caregiver experience with care delivery, increase access for patients and families to resources, and improve patient outcomes.

      The Ontario Telemedicine Network (OTN) worked with partners in the Champlain LHIN to co-design a virtual palliative care model that would enable a regional system with capacity for the delivery of in-home palliative care. Patients responded to a series of self-assessment surveys on a tablet from their home. Care providers received real-time feedback on the patient?s information which triggered specific events and corrective actions. Program evaluation included patient, caregiver and clinician experience and acute health service usage.

      A total of 118 patients with an average Palliative Performance Scale score of 50% were enrolled in the project. In terms of patient satisfaction, 87% were satisfied with the experience; 85% were satisfied with the coordination of resources, use of technology, and information received; 75% were satisfied with the progress made towards care goals including location of care preference; 74% would recommend the initiative to others; and 73% agreed that virtual care saved them time by not having to travel to see their provider. Patient feedback showed the potential for emergency department usage to decrease from 68% to 27%. Family caregivers reported little to mild burden in caring for loved ones. Clinicians reported that the technology enhanced their ability to do their job, increased efficiency and allowed them to monitor the health conditions of their patient over time.

      Virtual palliative care, when integrated into community care models and in the hands of the patient, demonstrated effectiveness in supporting patients with palliative care needs and in decreasing acute health services utilization. There is a need to further model how patient information is consistently reviewed and managed, and how to best leverage existing palliative care teams, specialists and other healthcare providers to ensure necessary follow-up actions are taken.

      140 Character Summary:
      The project aimed to develop a virtual care model to support patients who prefer to receive in-home palliative care.

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