TeleHospice: A Community-Engaged Model for Utilizing Mobile Tablets to Enhance Rural Hospice Care

2019 ◽  
Vol 36 (9) ◽  
pp. 795-800 ◽  
Author(s):  
Gary C. Doolittle ◽  
Eve-Lynn Nelson ◽  
Ashley O. Spaulding ◽  
Adam F. Lomenick ◽  
Hope M. Krebill ◽  
...  
Keyword(s):  
Rural Communities ◽  
Hospice Care ◽  
Medical Center ◽  
Cost Effective ◽  
Ease Of Use ◽  
Direct Patient Care ◽  
University Of Kansas ◽  
The University ◽  
Mobile Tablets ◽  
Kansas Medical

Background: In rural communities, providing hospice care can be a challenge. Hospice personnel sometimes travel great distances to reach patients, resulting in difficulty maintaining access, quality, cost-effectiveness, and safety. In 1998, the University of Kansas Medical Center piloted the country’s first TeleHospice (TH) service. At that time, challenges with broad adoption due to cost and attitudes regarding technology were noted. A second TH project was launched in early 2017 using newer technology; this article updates that ongoing implementation. Methods: The Organizational Change Manager was followed for the guided selection of the hospice partner. The University of Kansas Medical Center partnered with Hospice Services, Inc. (HSI), a leader in rural hospice care, providing services to 16 Kansas counties. Along with mobile tablets, a secure cloud-based videoconferencing solution was chosen for ease of use. Results: From August 2017 through January 2018, 218 TH videoconferencing encounters including 917 attendees occurred. Calls were made for direct patient care, family support, and administrative purposes. These TH calls have been shown to save HSI money, and initial reports suggest they may strengthen the communication and relationships between staff, patients, and the patient’s family. Conclusion: Finding innovative, cost-effective, and community-driven approaches such as TH are needed to continually advance hospice care. TeleHospice’s potential to supplement and improve hospice services while reducing costs is significant, but continued research is needed to understand best fit within frontier hospices, to inform future urban applications, and to address reimbursement.

Telehospice: Implementation lessons from rural hospice care with mobile tablets.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6546-6546
Author(s):  
Gary C. Doolittle ◽  
Eve-Lynn Nelson ◽  
Ashley Spaulding ◽  
Sandy Kuhlman
Keyword(s):  
Rural Communities ◽  
Family Support ◽  
Hospice Care ◽  
Medical Center ◽  
Cost Effective ◽  
Academic Community ◽  
Lessons Learned ◽  
Ease Of Use ◽  
Comfort Level ◽  
Hospice Nurses

6546 Background: In underserved rural communities, hospice personnel often travel great distances to reach patients, resulting in challenges to maintain access, quality, cost-effectiveness and safety. To address these disparities, the University of Kansas Medical Center piloted the country’s first TeleHospice (TH) service in 1998. Barriers such as technology limitations, costs and attitudes towards technology limited adoption (Cook et al., 2001). An updated academic-community project utilizes secure mobile videoconferencing to support TH services in Kansas’ frontier communities. Methods: Leveraging lessons learned from the early work, a secure cloud-based videoconferencing solution was chosen for ease of use. To maximize limited resources, the selection of hospice partners was guided by Gustafson et al.’s (2003) Organizational Change Manager, which also informed implementation gaps. The academic team partnered with Hospice Services, Inc., a leader in rural hospice care, providing services to 16 Kansas counties. Results: From February 2016 through January 2017, 116 TH encounters occurred, encompassing 707 attendees over 7,462 minutes. The most common TH uses to date have been: administrative (e.g., connecting hospice staff across 16 counties); professional-to-professional (e.g., connecting hospice nurses at homes to additional TH professionals); and family support (e.g., connecting adult children with loved ones). Initial use of videoconferencing for administrative purposes developed a comfort level in using it for clinical and family support purposes. For staff meetings alone, the hospice has saved approximately $2,500/month in travel, with TH staff noting increased morale driven by increased team communication. Conclusions: Compared with early work, technology advances and a community-centered approach have increased TH adoption. With decreasing budgets as well as rural hospice closures, innovative, cost-effective and community-driven approaches such as TH are needed to decrease disparities. As dissemination occurs in national hospice organizations, continued research is needed to understand best fit within frontier hospices, to inform future urban applications and to address reimbursement.

Using Web-Conferencing to Increase Learner Engagement

2013 ◽  
pp. 74-88
Author(s):  
Kristin Whitehair ◽  
Kathy Tally
Keyword(s):  
Classroom Environment ◽  
Medical Center ◽  
University Of Kansas ◽  
Web Conferencing ◽  
Learner Engagement ◽  
Scholarly Literature ◽  
The University ◽  
Kansas Medical

This chapter examines themes in scholarly literature regarding web-conferencing as applied at the University of Kansas Medical Center (KUMC). The chapter profiles how applications of web-conferencing can dramatically change the “classroom” environment for both users on campus and at a distance. We conclude that successful implementations of web-conferencing offer new opportunities in the classroom, increasing learner engagement, but also require adequate resources to support faculty and students.

scholarly journals Identifying Awareness, Use, and Perceptions of text4baby among Family Medicine and Obstetrics and Gynecology Practitioners at the University of Kansas Medical Center

2014 ◽  
Vol 7 (4) ◽  
pp. 132-138
Author(s):  
Brent Bjornsen ◽  
Mark McHaney ◽  
Katie Merando ◽  
Cameron Tusken ◽  
Christie Befort ◽  
...  
Keyword(s):  
Family Medicine ◽  
Nurse Practitioners ◽  
Low Income ◽  
Medical Center ◽  
Supporting Evidence ◽  
Care Providers ◽  
University Of Kansas ◽  
Widespread Agreement ◽  
The University ◽  
Kansas Medical

Background. Low income minority women who receive inadequate or no prenatal care have greater infant morbidity and mortality in the postnatal period. Mobile health or mHealth initiatives such as text4baby are presumed to be a means to reach underserved pregnant and postpartum women to increase their use of prenatal and postnatal care. Providers are an important referral source for mHealth initiatives. It is important, therefore, to assess the awareness, use, and perceptions of the text4baby program among Family Medicine and Obstetrics/Gynecology (Ob/Gyn) providers to determine the means to increase referrals and improve outcomes for pregnant mothers and infants. Methods. Family medicine and Ob/Gyn providers (attending physicians, residents, nurse practitioners, nurses, and medical assistants) at the University of Kansas Medical Center (KUMC) completed a survey assessing awareness of use and perceived utility of text4baby as well as experience with technology and reservations about mHealth in general. Results. Seventy-eight providers (38 in Family Medicine and 40 in Ob/Gyn) responded to the survey. Awareness of text4baby among all providers was 18%. Among the 14 providers who knew about text4baby, one individual stated he/she regularly refers patients to text4baby and 11 agreed that text4baby is a useful tool for the care of pregnant patients. Comparison of text4baby awareness by demographic factors showed no significant differences between any of the groups. Providers who knew of mHealth applications were more likely to know about text4baby (p = 0.04). Older providers were less likely to have reservations about using mHealth in their practice (p = 0.02). There was widespread agreement (87%) that providing evidence to clinicians that text4baby improves outcomes would increase use of the service in clinical practice. Conclusions. Awareness of text4baby among practitioners at KUMC is minimal; use is negligible. Our study identified lack of awareness of the text4baby service and of supporting evidence about its effectiveness as the primary barriers to referral.

scholarly journals Incidence and Clinical Predictors of Ocular Candidiasis in Patients withCandidaFungemia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ayesha Khalid ◽  
Lisa A. Clough ◽  
R. C. Andrew Symons ◽  
Jonathan D. Mahnken ◽  
Lei Dong ◽  
...  
Keyword(s):  
Medical Center ◽  
Multivariable Analysis ◽  
Ocular Involvement ◽  
University Of Kansas ◽  
Clinical Predictors ◽  
The Mean ◽  
The University ◽  
Fundoscopic Examination ◽  
Rule Out ◽  
Kansas Medical

Purpose. The aim of this study is to determine the incidence and the predictors of ocular candidiasis among patient withCandidafungemia.Methods. We retrospectively reviewed the charts of all patients diagnosed with candidemia at the University of Kansas Medical Center during February 2000–March 2010. Data regarding patients’ demographics, clinical characteristics, laboratory results, and ophthalmology examination findings were collected.Results. A total of 283 patients with candidemia were enrolled. The mean age (± standard deviation) was 55 ± 18 years; 66% were male. The most commonly isolatedCandidaspecies wereC. albicans(54%),C. parapsilosis(20%),C. glabrata(13%), andC. tropicalis(8%). Only 144 (51%) patients were evaluated by ophthalmology; however, the proportion of patients who were formally evaluated by an ophthalmologist increased during the study period (9%in 2000 up to 73%in 2010;P<0.0001). Evidence of ocular candidiasis was present in 18 (12.5%) patients. Visual symptoms were reported by 5 of 18 (28%) patients. In multivariable analysis, no predictors of ocular candidiasis were identified.Conclusions. The incidence of ocular candidiasis among patients with fungemia remains elevated. Most patients are asymptomatic and therefore all patients with candidemia should undergo fundoscopic examination to rule out ocular involvement.

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