Telehospice: Integrating Technology With Hospice Care

^{Photo by Yaroslav Shuraev}

Technological advances in medicine continue to grow by leaps and bounds every day. Now those advances have moved into the hospice arena. It is called telehospice, and it is changing the way hospice care is practiced.

With the increasing use of mobile devices (e.g., smartphones, tablets) in everyday life, people can communicate and share information faster. This has led to the development of promising applications to improve health and healthcare delivery for those with limited access. Hospice care, commonly provided at home, may benefit from using this technology platform. 

As hospice (and palliative care) physicians have the same pressures and requirements as their peers in other care settings, the technology, as mentioned earlier, creates broken workflows and disparate connectivity, resulting in inefficient and error-prone processes that can affect patient care. This article discusses three integrated technologies that support workflows for hospice (including that of palliative) physicians and NPs that need to be part of every organization’s integrated toolkit.

3 Types Of Technology Support For Hospice Physicians (Including Palliative Physicians And Nurse Practitioners)

1. Electronic prescribing. One piece of technological support for hospice and palliative care that some hospice physicians and NPs already use is electronic prescribing, which has been around since 2003. While many larger hospices already leverage this technology, smaller organizations continue to work directly with pharmacies by paper, phone, or other manual processes. But with the regulatory landscape changing around controlled substance reporting, all hospice organizations must use an ePrescribing application or another electronic reporting tool. While ePrescribing solutions without an EMR integration may meet regulatory needs, it will also create an administrative nightmare with manual entry into multiple disparate applications. An integrated solution will not only help meet reporting requirements but will also help make a more efficient clinical operation. 

2. Voice-to-Text. The second piece of technology support for hospice and palliative care physicians and nurse practitioners is a voice-to-text and narrative entry. Similar to electronic prescribing, voice-to-text and narrative access to information has also been around for years but, once again, have been primarily focused on acute and ambulatory providers. Like ePrescribe, existing solutions are rarely specific for hospice and palliative provider needs and are not clinical flow integration. 

It must be integrated to realize the value of a voice-to-text solution like ePrescribe fully. Having a voice-to-text option available at critical points of an assessment or other narrative entries ensures the tool is used to the fullest extent. Integrated technology also helps avoid unnecessary clicks or taps, making a process feel inefficient and creating a barrier to adoption. 

3. Direct messaging. The third piece of technology support for hospice and palliative care is provider-to-provider communication over the direct trust network, another technological advantage seen in ambulatory and acute care but often absent in hospice and relaxing settings. Whether communicating within your different locations or a community of organizations working together, care needs to be coordinated and transitioned easily through the proper implementation of technology. 

How Do People Move Forward? 

It is clear that, for many reasons, hospice and palliative physicians and providers often lack the key technologies that their counterparts have in other care settings. Fortunately, opportunities to adopt and normalize these technologies in hospice and palliative care settings are becoming more frequent. The best path forward is to begin assessing how expanded technology solutions can solve different problems:

• Identify the right partner. Whether that is your EMR or an external solution, ensure you feel comfortable in the partnership and demand integrated solutions.
• Determine an ROI. Only some solutions have a direct monetary ROI; assess for problems solved, not just efficiencies gained.
• Start small. Adopt a solution with a core group of power users. If the answer is right for your organization, your key users can bring everyone else on board.
• Engage your partner providers. Interoperability is a dialogue between providers, not just data connectivity. Demonstrate your value as a partner by building strong communication flows supported by technology.

In Closing

Adopting established healthcare technology to support physicians and NPs will pay dividends with the right solutions and workflows. To survive the ever-changing environment of hospice and palliative care, organizations must take action to get the tools they need to thrive as quickly as possible.

For additional help, check out Eleanor Gaccetta’s One Caregiver’s Journey if you are a caregiver or about to become a caregiver. This personal memoir will make you laugh or tug at your heart as the author shares her experiences providing 24/7 care to her mother for 9 ½ years until her mother’s death at age 102. The book is an easy read, honestly written, and provides suggestions and information that all caregivers can utilize. The author wrote the book over a long period, and it is a snapshot of the reality of the stages, changes, and many challenges caregivers face over time. It is a caregiver’s blueprint. Reading this book, you will feel as though you are in the author’s living room, and she is telling her story and offering an abundance of advice and information.