JMIR Publications

ABSTRACT

Background:

Telehealth is important in response to restrictions during COVID 19 pandemic, especially with the assistance of smartphones due to its portability and convenience. To furtherly facilitate fluent relationship between the physicians and the family, shared decision making (SDM) integrating patient preferences is indispensable for end-of-life care communications.

Objective:

We tried to utilize smartphone-enabled telehealth for palliative care family conference, with the concept of shared decision making incorporated in the face of COVID-19 threat.

Methods:

The framework of the telehealth for palliative care family conference was developed on the basis of SDM model with “team talk”, “option talk”, and “decision talk”. Three phases of the family conference including “pre-visit”, “during-visit”, and “post-visit” were also designed according to telehealth implementation guides. The videoconferencing solution for COVID 19 threats was implemented in a national cancer treatment center in Taiwan from February 2020.

Results:

From February to April 2020 during COVID 19 era, 14 telehealth family conference in the palliative care unit were analyzed. Most patients were terminally-ill cancer patients (13 patients, 92.9%) except one stroke patient. The percentage of reaching consensus on goal of care during family conferences was 92.9%. There were 5 families feeling the family meeting to be good or very good (35.7%), neutral (9, 64.3%), and no families rating bad or very bad.

Conclusions:

The model of smartphone-enabled telehealth for palliative care family conference with integration of SDM demonstrated high satisfaction of the family and was effective in reaching consensus. The model might be applied to other countries to promote the quality of end of life care in the era of COVID-19 outbreak.