Palliative and Hospice Care

What exactly is tele-palliative care and tele-hospice?  Palliative care provides specialized care and support for patients who are experiencing serious illness at any stage of their illness.  Hospice care focuses on the quality of life for patients in the final stages of an incurable conditions.  In both situations, interprofessional care teams work with patients and families to provide medical, social, emotional and practical support.  This care is generally provided in hospitals, nursing homes, outpatient clinics, or in the patient's home. Telepalliative care and telehospice leverage electronic information and telecommunications technologies to provide this care and support at a distance.

• The National Care Planning Council has put together About Telehospice Care as part of their Guide to Long Term Care Planning.

How is tele-palliative care and tele-hospice used and how does it add value?  Telepalliative care and telehospice help to address many of the challenges related to geography, workforce shortages and patients and families with  physical/ functional limitations.  See this recent publication for more information:  Targeted Digital Health Intervention in End-of-Life and Hospice Care: A Scoping Review

What are some practical tips for helping me to get started?  Here are some great resources that we've curated for you!

• The Journal of Palliative Medicine has published an article on Top Ten Tips Palliative Care Clinicians Should Know About Telepalliative Care

• The National Hospice and Palliative Care Organization (NHPCO) has put together Best Practices for Using Telehealth in Palliative Care.

• The Shiley Haynes Institute for Palliative Care has developed the following six recorded sessions as part of their Telemedicine Now (and How!) Connecting at a Distance Open Forum Series:

• • Session 1:  Effectiveness and Connection via Telemedicine: Getting Past the (Real and Imagined) Hurdles

• • Session 2: Expert Q&A on Symptom Management and Patient Education at a Distance

• • Session 4: Best Practices for Hosting Sensitive Conversations by Video

• • Session 5: Boundaries and Intimacy: How Deeply Can We Connect at a Distance?

• • Session 6: Emergency Medicine, Nursing Home Residents, and Tele-Palliative Care: Past, Present, and Future

• Husch Blackwell has developed this Hospice Telehealth Flowchart: How to Provide Medically Necessary Hospice Physician and Nurse Practitioner Visits via Telehealth to Medicare Hospice Patients During the COVID-19 Pandemic

• The Center to Advance Palliative Care has put together a comprehensive Telehealth and Palliative Care Toolkit with both downloadable guidance documents and web-based resources in the following areas for its members:
  • Setting Up a Program
  • Preparing Patients and Families
  • Conducting Telehealth Visits: Etiquette
  • Conducting Telehealth Visits: Remote Physical Examination
  • Telehealth Documentation and Billing

• Medicare has made several policy changes related to telehealth. Section 2207 of the Full-Year Continuing Appropriations Act, 2025 extended the use of telehealth by a hospice physician or hospice nurse practitioner to conduct a face-to-face encounter for the sole purpose of hospice recertification. This temporary extension is through September 30, 2025 unless Congress acts to further extend or make permanent this provision.
  • Visit the CMS Hospice Center for the latest coverage rules.