Connecting with Compassion: National Strategies for Telepalliative Care

Key Message: Telepalliative care is an effective solution to expand access to specialty palliative care in rural America. Evidence regarding telepalliative care and strategies for implementation will be examined and demonstrated. Collective wisdom from nationally recognized telepalliative programs will provide a roadmap for institutions to develop and implement their own telepalliative programs.

Abstract:

Background: Multiple studies show that patients with serious illness in rural areas experience higher rates of morbidity and mortality compared to urban counterparts, yet access to specialty palliative care remains limited. (1) Building an in-person service is hindered by workforce and funding limitations, administrative and organizational challenges, cultural and community barriers, and geographic isolation. (2,3) Telepalliative care increases access and can improve outcomes for patients with serious illness. (4) This interactive session will combine didactics and audience participation to present current evidence and practical strategies for establishing telepalliative care programs.

Session Description and Format: Interdisciplinary clinical leaders from five U.S.-based telepalliative care programs, each with unique experiences in developing, implementing, and sustaining services across inpatient and outpatient settings (5) will facilitate this session in three parts:

1. Didactic Presentation: Authors will present an overview of current evidence regarding telepalliative care, with an emphasis on inpatient models serving rural populations.

2. Panel

Discussion: Panelists will present their institution’s telepalliative care model, focusing on clinical and operational highlights. A dynamic moderator will guide discussion regarding key challenges, solutions, and lessons learned, then address additional questions submitted by participants via an audience-response system (e.g. Slido).

3. Interactive

Case: A real-life telepalliative case will be presented and participants will vote on best approaches using an audience-response system. Panelists will provide expert commentary, linking the case to broader themes in telehealth delivery.

Conclusion: The session will close with open discussion between panelists and participants regarding their interests and experience in providing telepalliative care, focusing on fostering connections and shared solutions. Facilitated dialogue will engage participants in applying general principles to unique circumstances each faces in their communities and systems. A summary with key takeaways from this session will be created in real-time and access will be shared by a QR code displayed at the conclusion.

References: (1) Probst JC, Zahnd WE, Hung P, et al. Rural-Urban Mortality Disparities: Variations Across Causes of Death and Race/Ethnicity, 2013-2017. Am J Public Health. 2020 Sep;110(9):1325-1327. doi: 10.2105/AJPH.2020.305703. Epub 2020 Jul 16. PMID: 32673111; PMCID: PMC7427230.

(2) Disler R, Pascoe A, Hickson H, et al. Service Level Characteristics of Rural Palliative Care for People with Chronic Disease. J Pain Symptom Manage. 2023 Oct;66(4):301-309. doi: 10.1016/j.jpainsymman.2023.06.003. Epub 2023 Jun 20. PMID: 37343902.

(3) Kimball J, Hawkins-Taylor C, Anderson A, et al. Top Ten Tips Palliative Clinicians Should Know About Rural Palliative Care in the United States. J Palliat Med. 2024 Sep;27(9):1220-1228. doi: 10.1089/jpm.2024.0032. Epub 2024 Mar 15. PMID: 38489603.

(4) Bekelman DB, Feser W, Morgan B, et al. Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease: The ADAPT Randomized Clinical Trial. JAMA. 2024 Jan 16;331(3):212-223. doi: 10.1001/jama.2023.24035.

(5) CAPC. Telehealth to Extend Palliative Care Access to Rural Care Settings. Jan 6, 2025. https://media.capc.org/innovation-project-files/Telepalliative_Care_to_Rural_Care_Settings_FINAL.pdf (Online).