Does Telemedicine for Palliative Care Work?

It may become more common for seriously ill patients to get specialized attention without leaving their homes — a service especially valuable in rural areas.

Perhaps you have a progressing cancer and need palliative care, designed to relieve symptoms and reduce stress for you and your family.

You’d like to avoid traveling for care. That’s now possible with telemedicine. In fact, it’s now more common for people to get at-home care generally for non-life-threatening issues that once required a hospital stay.

The COVID-19 pandemic gave this movement a push, as Medicare and some private insurers began covering more at-home services to meet demand. The Medicare expansion may stick for certain services even longer, possibly including pain management, which is an important part of palliative care.

Palliative care isn’t just for people approaching the end of life. It can be helpful “at any age and any stage of a serious illness,” including dementia, Parkinson's disease, and chronic obstructive lung disease, according to the National Hospice and Palliative Care Organization. Patients near the end of life need hospice care, which is largely palliative but administratively its own medical category.

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Is telemedicine a good idea?

Telemedicine has gained fans during the pandemic, still accounting for up to 17 percent of all outpatient visits even after lockdowns were lifted, according to a July 2021 McKinsey consulting firm study. It’s most common for psychiatric and substance abuse care. But video or phone visits and other tools can be as effective for palliative care as face-to-face care with your doctor or a nurse, some research has found.

That’s particularly true if you live in a rural area and traveling to receive care would be a burden, if doing so is even possible. As of 2019, however, only 17 percent of rural hospitals had a palliative care program, compared to 90 percent of city hospitals. Virtual visits may help them expand.

One doctor turned entrepreneur, Michael Fratkin, MD, is making waves of his own with a new business called Resolution Care that offers video calls to manage medication and other ways to control symptoms for the seriously ill, working with your current medical team. It does not, however, offer hospice service.   

Iowa-based UnityPoint at Home, a company long focused on in-person home care, has expanded telehealth “for multiple populations and programs, including home care, palliative care, and hospice,” said consultant Lori Bishop, RN, who led the effort.

“Shared decision-making is enhanced through telehealth, which allows consumers to make informed decisions about their health based on their definition of quality,” Bishop says.

Do you need to see a doctor for an exam?

Not necessarily. It’s already possible to check your pulse, blood pressure, and blood sugar at home with low-cost devices. There may be other devices you need for your diagnosis. MedWand has created a device (currently $2,495) that includes a pulse oximeter, thermometer, EKG, digital stethoscope, and high-definition camera with attachments to focus on the ears, skin, and throat.    

If telemedicine could help you or someone you care about, check whether your insurance company offers it as a benefit. Ask your doctor or hospital about whether they can accommodate you. You might also contact the American Telemedicine Association with questions.

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