Introduction People at the end of life (and their carers) require support on a 24/7 basis. Access to appropriate, immediate advice is important to optimse the quality of care, reduce anxieties and where appropriate avoid hospital admission. Use of video links to the home may allow such services to be delivered in a scalable and affordable way.
Aims To develop reliable means of deploying high quality video links between hospices and a person’s own home or residential care setting.
Methods Using standards based, resilient videoconferencing, running over domestic broadband, links were established between a hospice and patients receiving support at home and in a range of residential care settings. The service also linked patients to the local acute hospital’s teleconsultation centre. Staff at the hospice and patients/carers were able to both make and receive calls at any time. Proof of concept outcome measures included the ability to create a stable video link in a domestic setting and identification of clinical use cases where video enabled safe, appropriate care delivery. Qualitative indications of patient, carer and staff satisfaction with the approach were also recorded.
Results Where broadband speed exceeded 500kb/s (up and download) we established reliable video connexions in all cases. Service users were able to receive general symptom control and treatment advice, it was possible to avoid need for admission or to expedite admission when necessary. Staff and patient satisfaction with the approach was high, averaging 8.5/10 across a range of measures. The service is expanding to include links to all local Nursing Homes and to allow on-call palliative care consultants to join calls from their own home.
Conclusion Use of video-consultation to the home enables immediate delivery of palliative care support without need for travel and may avoid the need for some hospital admissions. The approach is valued by users.