“We Talk About Everything”: Experiences with Digital Health Communication in Palliative Care

BACKGROUND: Use of digital communication tools (e.g., telehealth, patient portals) is increasing in outpatient palliative care (OPC). OBJECTIVE: Assess patient/caregiver experiences with digital communication tools. DESIGN: Qualitative. SETTING/SUBJECTS: Inclusion criteria were age ≥18 years, English/Spanish/Cantonese-speaking, and ≥1 telehealth OPC visit in the prior year. If patients could not converse by phone, we interviewed their caregivers. MEASURES: We developed an interview guide using the Capability-Opportunity-Motivation-Behavior framework. We analyzed semi-structured interviews using thematic analysis. RESULTS: Among 32 participants, 10 were caregivers, 11 Spanish-speaking, 9 Cantonese-speaking. Theme 1: Video and in-person visits have important and distinct roles. Theme 2: Establishing a trusting rapport over video is possible. Theme 3: Engagement can be high with the patient portal despite poor usability. CONCLUSIONS: A flexible approach offering both video and in-person visits is ideal. Usability is a key factor in patient portal engagement. Our findings underscore the need to advocate for a permanent Medicare telehealth extension.