Videoconferencing makes caregivers a part of hospice planning

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Videoconferencing can be valuable in allowing family and other caregivers to be part of interdisciplinary team meetings to plan hospice care, according to a study published at Telemedine and e-Health.

The work was part of a larger study delving into how caregivers' remote participation in such meetings affected their perceptions of pain management offered to patients.

Such meetings typically include representatives of medicine, nursing, social work, and spiritual care offered to hospice patients. Family members and caregivers often are absent, though, due to distance, the frail condition of the patient and caregiving demands.

This study analyzed 114 meetings adding in caregivers, using Web-based videoconferencing and 86 meetings recorded using plain old telephone service (POTS) videophones. The Web-based video was deemed superior in image quality but less so in audio quality. In interviews with 19 caregivers, they were positive about the experience and found it useful for working with the hospice team.

Beyond just a conference phone call, video offers social cues to speaking as well as information about the number of people present, who is speaking and their reactions, the authors point out.

The videoconferencing unit allowed caregiver participation through a computer connected to high-speed Internet service that has Web camera and headphones. The videophone unit projected the caregiver's image onto a large television screen for the entire hospice team to view.

The problems more often were on the caregiver's end, including delays, poor image quality, the screen freezing up and difficulty in hearing some team members. Overall technical quality for Web-based video was rated higher by caregivers and the study's external rater.

The authors, however, did make some suggestions for improving meetings using held using this technology, including:

  • Establishing turn-taking rules to avoid interruptions and allow participants to recognize potential audio delays
  • Advising healthcare providers to make eye contact with the camera to engage with the caregiver
  • Having a facilitator address speakers by their name and title so that remote participants know who they are

Though some British studies have brought into question the cost-effectiveness and improved quality of life provided by telehealth and a New York Times article recently questioned the effectiveness of remote ICU monitoring, other research has shown benefits for monitoring conditions including hypertension and stroke.

Reimbursement has always been an issue, and the American Telemedicine Association recently warned that many Medicare recipients could lose coverage for telehealth benefits due to expected updates to federal urban/rural categorizations.

To learn more:
- here's the research

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