The PADES team at the Fundació Hospital d’Olot introduces the use of telemedicine with palliative care patients

• Telemedicine with palliative patients allows the use of videoconferencing, constant monitoring via an activity bracelet and a weekly update of symptoms weekly with an online test.
• The program will be used to carry out a clinical trial scheduled for the end of 2020 and will analyse the effectiveness of telemedicine in the symptomatic control of these types of patients.

The Fundació Hospital d’Olot i Comarcal de la Garrotxa’s Programa d’Atenció Domiciliària, Equips de Suport [Home Care Program, Support Teams] (PADES) employ telemedicine in their day-to-day work to deal with palliative care patients. Until now, patient contact and the prescription of treatment was carried out through face-to-face visits and telephone calls. Since last summer, the service has been expanded and patients are offered a touch screen and an activity bracelet that complements conventional care.

Participation in the program is entirely voluntary.

Telemedicine with palliative patients is used to carry out video conferences, the monitoring of vital signs on a daily basis via an activity bracelet and the weekly measurement and evaluation of aspects such as pain, tiredness, nausea and mood, using an online test based on the Edmonton method.

The team’s objective is to use information and communication technologies to improve the service and to reach more patients, keeping in mind that the area covered by the PADES team is one county, from Besalú to Les Planes d’Hostoles. Currently, the Fundació’s PADES team is made up of a physician, a nurse, a social worker and a psycho-oncologist who are in constant contact with the primary care teams.

When a patient joins PADES, the team makes an initial visit to their home to interview them and introduce them to the concept of telemedicine, a means to exchange information between patients and health professionals. If the patient agrees to join the project, a second visit is arranged in which the activity bracelet is delivered together with the touch screen used for videoconferences and the patient completes an online questionnaire concerning their symptoms.

The tools support the healthcare professionals in monitoring their patients and allow them to carry out more exhaustive data collection while having an improved ability to react if any parameters are not correct. The medical coordinator of the Chronic Care Unit, Hugo Briceño, underlines the fact that “The team hasn’t changed the way it works, it’s the same care pathway, but with more tools and resources”. While acknowledging it is still “too early” to draw firm conclusions, he went on to say, “it is being well-received by both patients and their familie”.

PADES not only accepts oncological patients (70%), it also treats patients with advanced chronic diseases (MACA), which account for 30% of the total.

Annually, PADES provides support and treats 120 individuals, with a daily average of some 25 patients. Of those who currently receive the service, two have already joined the telemedicine program; though there is the possibility of extending it to 10 patients at a time.

Telemedicine and home care guarantee a more exhaustive and continuous follow-up of chronic patients, in this case palliative care patients.