title: Death in the Digital Age: A Systematic Review of Information and Communication Technologies in End-of-Life Care.
abstract: BACKGROUND
  End-of-life (EOL) communication plays a critical role in ensuring that patients receive care concordant with their wishes and experience high quality of life. As the baby boomer population ages, scalable models of end-of-life communication will be needed to ensure that patients receive appropriate care. Information and communication technologies (ICTs) may help address the needs of this generation; however, few resources exist to guide the use of ICTs in EOL care.
  
  
  OBJECTIVE
  The primary objective was to identify the ICTs being used in EOL communication. The secondary objective was to compare the effectiveness of different ICTs in EOL communication.
  
  
  METHODS
  The study was a systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched seven databases for experimental and observational studies on EOL communication between doctors and patients using ICTs, published in 1997-2013.
  
  
  RESULTS
  The review identified 38 relevant articles. Eleven types of technology were identified: video, website, telephone, videoconferencing, e-mail, telemonitoring, Internet search, compact disc, fax, PalmPilot, and short message service (SMS) text messaging. ICTs were most commonly used to provide information or education, serve as decision aids, promote advance care planning (ACP), and relieve physical symptom distress.
  
  
  CONCLUSIONS
  The use of ICTs in EOL care is a small but growing field of research. Additional research is needed to adapt older, analog technologies for use in the digital age. Many of the interventions discussed in this review do not take full advantage of the affordances of mobile, connected health ICTs. The growing evidence base for e-health applications in related fields should guide future interventions in EOL care.
authors.affiliation: 1 Rice University , Houston, Texas.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Ostherr
authors.affiliation: 2 Department of Anesthesiology, University of Texas Medical School at Houston , Houston, Texas.|3 School of Biomedical Informatics, University of Texas , Houston, Texas.|4 School of Public Health, University of Texas , Houston, Texas.
authors.forename: Peter
authors.initials: P
authors.lastname: Killoran
authors.affiliation: 1 Rice University , Houston, Texas.
authors.forename: Ross
authors.initials: R
authors.lastname: Shegog
authors.affiliation: 5 M.D. Anderson Cancer Center, University of Texas , Houston, Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D003643:Death; D006801:Humans; D011788:Quality of Life; D013685:Telecommunications; D013727:Terminal Care