“This May Be Recorded for Quality Assurance”: Approaches to Practice Fidelity in Telehealth Palliative Care (FR407)

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  • • Review variety of telehealth programs delivering palliative care.
  • • Develop systems to ensure and report fidelity monitoring and quality assurance in telehealth palliative care.
Telehealth has demonstrated the ability to bridge specialty palliative care services to underserved populations, particularly in rural areas. Interest in telehealth models of palliative care services has grown due to the projected labor shortage in our field, the concentration of specialists in urban areas of the country, and the slow but steady progress on telehealth payment models. While telehealth programs have grown in number, the approaches to care delivery have varied. This raises an important question: what strategies are being used to ensure consistency, quality and value of palliative care telehealth practices? In this concurrent session, three presenters representing distinct telehealth practices, will share their strategies to ensuring that their palliative care services are being delivered consistently and with high quality to patients and families. The first presenter is working with both a health plan and a population health organization to design, implement and evaluate telephonic nurse case management for patients in the last 1-2 years of life. The second presenter is an academic researcher conducting clinical trials focused on nurse-led telehealth for patients and family caregivers affected by advanced cancer and heart failure. The third represents Project ECHO®, which is an all teach-all learn telementoring model that leverages technology to connect multidisciplinary teams of specialists with primary care providers to share best practices and increase access to palliative care in rural areas. Each participant will present briefly on their experiences. The focus will be on how they ensure fidelity to their model and how they measure outcomes. How do they measure success? How do they know that what is occurring in the interactions between nurse and patient, between Palliative care specialist and generalist is the same every time? Techniques such as recorded calls, data collection, and initial training of providers will be discussed.