Telemedicine in community-based palliative care: evaluation of a videolink teleconference project.

A national shortage of consultants in palliative medicine in the UK has led St David's Foundation Hospice Care to begin an innovative telemedicine project. This enabled the foundation's clinical nurse specialists (CNSs) in palliative care to access consultant advice and support. Each week the CNSs held a 2-hour teleconference session with a consultant in palliative medicine by video link to discuss patients with one or more unresolved symptoms or significant palliative care issues. The use of teleconference time was structured and targeted, which allowed the limited time available to be used productively. After each session, the participants completed a number of questionnaires which were used, with data collected during focus-group sessions, to analyse the project. Despite the relatively new and complex technology, the nurses involved were very comfortable using the teleconferencing equipment. All the nurses involved rated the advice given during the teleconferences as helpful or very helpful. The project has shown that telemedicine can provide a useful, and probably cost- and time-effective, addition to current services.