Telehealth and Palliative Care
Palliative care through telehealth—interacting with patients and families via telephone and video—offers many benefits to palliative care programs, patients, and clinicians. This toolkit covers all aspects of palliative care telehealth delivery, including selecting the technology platform, setting up a hotline, billing for services, and conducting a visit.
See the "Setting Up a Program" section below to download CAPC's Telehealth Start-Up Guide. For telehealth tools specific to COVID-19, see our COVID-19 Response Resources.
What’s in the Toolkit
Setting Up a Program
These tools provide guidance on selecting a platform, training your clinicians, and operationalizing hotlines and telehealth services.
Key components of telehealth service delivery, especially in a home-based palliative care program.
Covers hotline service design, staffing and workflow, and considerations if incorporating external palliative care clinicians to staff the hotline.
Provides suggestions for solving tech problems that may come up via a video visit. Sample orientation for clinicians new to the telehealth platform. Shared by Mount Sinai Health System.
Slide deck providing information on how telehealth, if developed with intention, can improve access and equity especially in rural, underserved populations.
Mercy Health, a 135,000 lives ACO, added in palliative care consultations virtually to the top 5% of its virtual complex care patients.
A review of pros/cons and lessons learned from early palliative care telehealth models. Authored by the team at University of Alabama at Birmingham.
Preparing Patients and Families
With wide variation in available technology, experience, and comfort levels of patients and families, these tools can assist with patient preparations.
Provides advice for first-time patients on preparing for virtual health care visits.
Provides advice for first-time patients on preparing for virtual health care visits.
Key components of telehealth service delivery, especially in a home-based palliative care program.
Practical tips and links for improving internet access for patients, especially those in rural areas without sufficient broadband. Courtesy of the Rural Health Information Hub.
Conducting Telehealth Visits: Etiquette
These tools cover telehealth visit etiquette, including starting and ending the visit, and conducting a physical examination.
This on demand master clinician series, describes how telehealth group medical visits are a potential answer to expand access Palliative Care and Psycho-Oncology.
Palliative care use cases, team considerations, and tips for virtual visit etiquette. Updated May 12, 2020.
Tips for acknowledging patient emotions via phone and video.
Sample outline for a palliative care visit conducted remotely with audio-visual devices.
Description of program at UAB varying telehealth services for African-American and White patients.
Dr. Michael Fratkin makes the case for telemedicine and provides tips for the best possible interaction during the COVID-19 pandemic.
Information from the Chaplaincy Innovation Lab on planning, staffing, and delivering telechaplaincy services.
Conducting Telehealth Visits: Remote Physical Examination
While not traditional, remote physical exam using audio and video technology is feasible. These resources provide guidance.
A list of physical examinations possible via videoconferencing, along with some tips for completing. Courtesy of Mount Sinai Health System.
A collection of brief videos providing guidance on completing specific examinations over videoconferencing. Courtesy of ResolutionCare and Partnership Health Plan
Randomized controlled trial of AI-based smartphone application shows improvements in pain levels and reductions in hospital admissions. Journal of Clinical Oncology
Telehealth Documentation and Billing
Medicare and most Medicaid and private health plans are reimbursing telehealth visits more flexibly under the COVID-19 public health emergency. These tools summarize such changes.
Guidance on coding and documentation for telehealth visits that replace in-person visits. Courtesy of Mount Sinai Health System.
Sample palliative care COVID-19 note template for an EHR. Developed by the Mount Sinai Health System.
Sample note for palliative care teams performing telemedicine assessments. Shared by Presbyterian Healthcare Services.
Ready-to-use algorithm from a March 23, 2020 article in the AAFP's Family Practice Medicine blog.
5-minute video synopsis of video and audio (phone) telehealth documentation and billing practices that apply during COVID-19. Includes who can provide and bill for services, which services are billable, acceptable technology, and recent changes to payment amounts based on site and type of service. Presented by Chris Jones, MD, Director of Outpatient, Non-Oncology Palliative Care at Penn Medicine.
A slide deck that reviews the why, what, and how of Medicare payment for telehealth and telephone encounters during the COVID-19 public health emergency.
A summary document of Medicare-reimbursable codes for telehealth and telephone encounters.
