“We're Taking Something So Human and Trying to Digitize”: Provider Recommendations for mHealth in Palliative Care

• DOI: 10.1089/jpm.2019.0216
• Publication Date: 2019-09-17T14:47:27Z
• Authors: Jennifer Dickman ...; Kelsey Ford; David B. Bekelman; Rebecca S. Boxer; Jean S. Kutner; Sara Czaja; Kira Elsbernd; Sheana Bull
• Keywords: Palliative Care; digital health; mobile device; patient reported outcomes; social support; Mobile Applications; Telemedicine; health information technology; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Caregivers; Humans; 0305 other medical science; Qualitative Research; family caregiving; Aged

Background: Mobile health (mHealth) is a promising tool for improving health outcomes. However, the benefits of using mHealth in palliative care are under studied. Objective: As a first step to designing meaningful palliative care-specific mobile applications, this research explored provider perspectives regarding the utility of mHealth in palliative care. Design: A qualitative phenomenological study with semistructured interviews. Setting/Subjects: Providers from multiple disciplines working in palliative care settings at an academic medical center. Results: Thematic analysis resulted in five provider recommendations regarding the utility and design of palliative care-specific mHealth, including (i) thoughtfulness to language, context, and delivery when assessing palliative care needs; (ii) include tools for prognosis and advance care planning; (iii) tailor health and quality-of-life goals; (iv) emphasize supports for family and caregivers; and (v) consider technology abilities of older adults. Conclusions: Palliative care providers are enthusiastic about the use of mHealth to improve care coordination, facilitate communication, enhance symptom monitoring, and improve patient-family support. However, providers have reservations about mobile functionality and depersonalized assessment and care. Providers stress the utility of mHealth to facilitate palliative care rather than replace important multidisciplinary services.