title: The feasibility of using technology to enhance the transition of palliative care for rural patients.
abstract: Palliative care services for patients with life-limiting conditions enhance their quality of life. Most palliative care services, however, are located in hospitals with limited transitional care for patients who live in distant locations. The long-term goal of this program of research is to use existing technology for virtual visits to provide transitional care for patients initially hospitalized in an urban setting by a nurse practitioner located closer to patients' homes in distant, rural settings. The purpose of this proof-of-concept study was to determine the resources needed to use the system (efficiency) and the quality of the audio and visual components (effectiveness) to conduct virtual visits between a clinician at an academic center and community-dwelling adults living in rural locations. Guided by the Technology Acceptance Model, a mixed-methods field design was used. Because of the burden of testing technology with patients with life-limiting conditions, the sample included eight healthy adults. Participant satisfaction and perceptions of the ease of using the technology were also measured. Virtual visits were conducted using a 3G-enabled Apple iPad, cellular phone data service, and a Web-based video conference service. Participants and clinicians perceived the technology as easy to use. Observations revealed the importance of the visual cues provided by the technology to enhance communication, engagement, and satisfaction. Findings from this study will inform a subsequent study of technology-enhanced transitional care with palliative care patients.
authors.affiliation: Author Affiliations: Department of Nursing (Drs Holland, Vanderboom, and Dose), College of Medicine (Drs Holland, Dose, Ingram, and Borkenhagen), and Palliative Care Consulting Service (Mss Borkenhagen and Skadahl), Mayo Clinic (Mr Pacyna and Ms Austin), Rochester, MN; and Professor of Nursing (Ms Bowles), School of Nursing, University of Pennsylvania, Philadelphia.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Holland
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Vanderboom
authors.forename: Cory J
authors.initials: CJ
authors.lastname: Ingram
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Dose
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Borkenhagen
authors.forename: Phyllis
authors.initials: P
authors.lastname: Skadahl
authors.forename: Joel E
authors.initials: JE
authors.lastname: Pacyna
authors.forename: Christine M
authors.initials: CM
authors.lastname: Austin
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Bowles
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000639:trends*; D011788:Quality of Life; D019035:Rural Health Services; D017216:Telemedicine; D049269:Videoconferencing