SMHC
2008-2011

Development and evaluation of a tele-homecare platform for patients with cancer and their family caregivers

Arnaert, A., Bonneville, L., Ferrie, F., Fichten, C.S. (Dawson College), Hoch, J.S., Hutchinson, T., Yaffe, M., Prchal, J., Farley, J., & Nadeau, A.C.

About 90% of cancer care is delivered in an out-patient setting, and thus many individuals face the impact cancer has on their lives at home. Studies show that patient-centered communication and access to timely supportive care from an oncology nurse improve patient well-being and quality of life. In 1998, the Quebec government initiated the role of the Infirmière Pivot en Oncologie (IPO) to ensure better continuity of care to those who need it. They also recognized the use of tele-homecare (THC), including monitoring and interactive video, to provide remote care to patients at home.

The present 3-year research program proposes to develop, implement and evaluate a supportive THC platform, using new developments in web-based video-conferencing, in order to increase access to quality care, improve the quality of life of out-patients with cancer and family caregivers, and decrease costs. The program includes two studies: a needs assessment and a THC pilot project. The main objectives are: 1) assess the needs of patients, families, and nurses, and explore their readiness using THC; 2) identify which type of out-patients with cancer can be assigned to THC; 3) determine which nursing care interventions show the greatest potential for THC delivery; 4) create a THC nurse training program; 5) develop measures that capture the relational and communication factors during a THC interaction; 6) develop cost measures; 5) determine the technical and human factors requirements of a THC system; and 6) implement a THC pilot project to determine its cost, acceptability to patients and families, and its effect on their adaptation to illness. In year 3 of this program a grant proposal will be prepared to conduct a full scale THC intervention study.

This program will be carried out in collaboration with the inter-disciplinary cancer care team of St. Mary’s Hospital Centre, researchers from nursing, medicine, psychology, health economics, engineering, and an industrial partner. A collaborative approach will be used as to enhance the integration of THC in the existing out-patient cancer services in St. Mary’s Hospital, and ensure its sustainability. This program will provide research training opportunities in various disciplines, which will support the development of a future research infrastructure at St. Mary’s Hospital.

The results of this innovative program of research will provide insights as to the feasibility and acceptability of using THC in St. Mary’s Hospital for the delivery of supportive cancer care to out-patients. In addition the results will enable decision-makers to successfully integrate similar THC models in out-patient oncology clinics, and be useful to policy-makers in Quebec in determining the shape that homecare should take in the restructuring of the current healthcare system.