Department of Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria.
Parkville Integrated Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Victoria.
Intern Med J. 2022 Jul;52(7):1144-1153. doi: 10.1111/imj.15721. Epub 2022 Apr 6.
In Australia during the COVID-19 pandemic new funding models were introduced to support telehealth consultations, resulting in their widescale adoption in palliative care service delivery. Clarity around the clinical circumstances and patient populations that might be most appropriate for telehealth models was required.
To evaluate patient and physician satisfaction, acceptability and utility of outpatient palliative care provision through telehealth.
This is a multi-site prospective, cross-sectional, observational study conducted during a time of significant public health restrictions. A survey was used to collect matched patient- and physician-reported perceptions of palliative care telehealth consultations across three metropolitan hospitals in Victoria, Australia.
There were 127 matched patient-physician data of telehealth consultations and a further 812 physician-only assessments. Telehealth was generally acceptable and satisfactory, with patients providing greater positive scores than clinicians. Telehealth incorporating both audio and video were more acceptable and satisfactory, particularly with the presence of a carer, and during routine reviews. Physicians were less satisfied using telehealth when there was increasing symptom complexity across all domains (pain, psychological, and other symptoms).
Telehealth has high utility in palliative care practice. A future hybrid model of care comprising both face-to-face and telehealth consultations seems favoured by patients and physicians but must be accompanied by targeted support for specific patient groups to ensure equitable healthcare access. Further evaluation of telehealth during a time of fewer public health emergency measures and lower community anxiety is required to fully understand its ongoing role.
在澳大利亚 COVID-19 大流行期间，引入了新的资金模式来支持远程医疗咨询，这导致远程医疗在姑息治疗服务中得到了广泛应用。需要明确哪些临床情况和患者群体最适合远程医疗模式。
评估通过远程医疗提供门诊姑息治疗的患者和医生满意度、可接受性和实用性。
这是一项在澳大利亚维多利亚州的三家大都市医院进行的多地点前瞻性、横断面、观察性研究。在公共卫生限制严重的时期，使用问卷调查收集了患者和医生对姑息治疗远程医疗咨询的匹配的患者和医生报告的看法。
有 127 对远程医疗咨询的患者-医生数据和另外 812 名医生的评估。远程医疗通常是可以接受和满意的，患者的评分比临床医生更积极。同时包含音频和视频的远程医疗更受欢迎和满意，特别是有照顾者和进行常规评估时。当所有领域（疼痛、心理和其他症状）的症状复杂性增加时，医生对远程医疗的满意度降低。
远程医疗在姑息治疗实践中具有很高的实用性。一种由面对面和远程医疗咨询组成的混合护理模式似乎受到患者和医生的青睐，但必须为特定患者群体提供有针对性的支持，以确保公平获得医疗保健。需要在公共卫生紧急措施减少和社区焦虑降低的时期进一步评估远程医疗，以充分了解其持续作用。
