Serious Illness, a Growing Problem in the U.S.

More of us are living with serious illnesses than ever before. The Center to Advance Palliative Care estimates that at least 12 million adults and 400,000 children in the U.S. are living with complex chronic health conditions such as cancer, heart failure, chronic obstructive pulmonary disease and liver disease—and caring for them is driving more than half of all healthcare spending.

The problem is going to get worse. The number of people requiring comprehensive, serious illness management will continue to grow as our population increases and ages. We can respond to and prepare for this by expanding the palliative care workforce and increasing availability of palliative care services, ensuring access to the best possible support for those who need it most.

Palliative Care: The Heart of Personalized Care for Serious Illness

Palliative care is the comprehensive treatment of the discomfort, symptoms and stress of serious illness. It does not replace primary treatment. Rather, palliative care teams collaborate with the entire health team to deliver care aimed to ease suffering and improve quality of life.

Personalized, palliative care services should be designed to help the whole person under care: address pain, depression and other symptoms, improve satisfaction for people and their families, and deliver care regardless of a person’s location. When people living with serious illness get the care they need when they need it, they can avoid unnecessary emergency department and hospital stays. This care access needs to be available at all hours of the day – making sure people are connected to the resources they need anytime, anywhere. By shifting serious illness management to the home and community, palliative care and hospice reduce healthcare spending for America’s sickest and most costly populations.

Ensuring Access to Palliative Care

While access to palliative care has expanded greatly over the past two decades, there is still a large unmet need, especially in rural areas. Only 17% of rural hospitals have palliative care programs compared with 90% in cities, according to a report compiled by the Center to Advance Palliative Care (CAPC) and the National Palliative Care Research Center. Rural communities face unique challenges: including a shortage of palliative care providers, a large geographic area to serve, and relatively sparse community care resources. They have large Medicaid, Medicare and self-pay populations and serve people who are sicker, older, low-income and unemployed. This is incredibly important as we look at the current healthcare landscape, including value-based care programs. By providing truly personalized, high-quality care for the seriously ill population, Medicare beneficiaries experience better care and costs are reduced.

How can we provide much-needed palliative care to these underserved populations in rural areas? The answer is telehealth.

Telehealth Helps to Solve the Access Problem

The COVID-19 pandemic spurred a dramatic escalation in the use of telehealth, as those facing serious illnesses and their providers found, by necessity, that high-quality care can be delivered virtually. We saw this firsthand—on March 19, 2020, our team was conducting about 40% of our clinical encounters through video conferencing. Twenty-four hours later, 100% of our clinical encounters were happening via telehealth. Today, about 98% of all our interactions with people under care take place virtually.

This is because communication and relationships form the cornerstone of palliative careand these can easily be translated into a virtual environment. Our experiences have taught us that the act of delivering compassionate statements and displaying empathetic emotions on video can be powerfully effective in virtual palliative care. So, too, is allowing someone to be emotional during these virtual sessions. 

The potential of telehealth to ease the problem of access to palliative care is enormous. Virtual delivery enables people who live in a remote area to receive palliative care with minimum disruption to their daily lives, allowing them to receive individualized interventions in the comfort of their own homes. These benefits are not limited to only those who live in rural areas; anyone who would prefer to receive care and continuous monitoring at home can benefit from having palliative care delivered directly to them, regardless of geography. The pandemic has taught us that telehealth can be a powerful tool to overcome challenges in palliative care delivery. Now more than ever, people recognize the significance of virtual care and its ability to better meet the needs of us with serious illnesses. The healthcare industry has moved into a new era of telemedicine, and it is here to stay.