The COVID-19 pandemic has dramatically impacted nearly every aspect of our “normal” way of life. By including the use of technology in palliative care and hospice services, telehealth has ensured the continuity of services, wherever the patient resides, in the midst of the health crisis. 

As Transitions quickly shifted to telehealth visits, we received overwhelming support from our partners, patients/families and team members. Nearly 20 of our skilled nursing providers we serve quickly embraced and supported the use of telehealth for both palliative care and hospice visits. Also, patients welcomed receiving care at home, allowing our team to provide the necessary services and resources.

Lessons Learned:

The use of telehealth has ensured timely assessments and interventions to support improved clinical outcomes and increased patient/family satisfaction. However, implementation was not without a few bumps along the way. 

After identifying our internal procedures and implementation plans, we reached out to each administrator to discuss their facility’s current status, and if telehealth could be a possibility. A few important areas that needed to be addressed at each facility included:

  • Determining the process for the telehealth visit, like obtaining appropriate consents,
  • Providing digital devices pre-loaded with the Zoom app and instructions
  • Cleaning procedures, and; 
  • Training for staff and patients/families. 

When visiting a patient at home, creativity has been key. Each patient/family situation is unique, and so are connectivity and access. Developing appropriate procedures and workflow for conducting timely visits were key to keeping communications in sync.

It has been a growing experience for our Interdisciplinary teams (IDT), who are especially used to delivering high-touch, in-person care, to work in a virtual environment. Each team had to become more comfortable with providing remote services in ways that engage patients/ families and follow telehealth care planning process. The bonus to the virtual format is that our team has been able to have more frequent calls to check in on their patients. Providing necessary training, resources and tools has been integral to our overall success. 

We have realized many benefits to implementing telehealth including:

  • Safely educating and informing patients/families regarding palliative care and hospice services. 
  • Being able to connect with patients/families from a mobile device via FaceTime or Zoom.
  • Securely sharing and signing consents via DocuSign.
  • Staying connected by utilizing secure email, text and phone for check-ins.
  • Seamlessly engaging with IDT members to keep informed on the plan of care. 

Transitions patients/families have been providing positive feedback for the use of telehealth, especially due to enhanced access to our team, anytime and from any device. 

Leadership Considerations for Telehealth Implementation

  1. Form a cross-functional team to determine your telehealth plan, including protocols, procedures and satisfaction tracking. 
  2. Work with key care partners, including hospice and palliative care, medical specialists, therapy and other clinical providers, to develop consistent protocols, workflow for visits/scheduling, IPC protocols for any equipment cleaning, etc.
  3. Keep up-to-date on any changes to Emergency Preparedness from the Centers for Medicare and Medicaid Services (CMS). Read more>
  4. Review the Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit for guidance and resource links from CMS.
  5. Engage patients and families in the telehealth process. Provide necessary devices, education and support as appropriate.
  6. Provide training and resources to support the entire IDT as telehealth continues to play an important role in care delivery.