Palliative care aims to increase the quality of life of people with diseases at an advanced stage and without curative treatment options. The benefits of this specific care are obtained through symptom and pain control, social and emotional support and advance care planning.
At Tucuvi we have been working for more than 1 year in the follow-up of advanced palliative patients admitted to the Home Hospitalisation Unit of the Vinalopó Hospital, part of the Ribera Salud group. The main objectives include prioritising the home over the hospital as a therapeutic setting, increasing continuity of care and obtaining regular information in real time on any warning signs.
What is the current situation of palliative care in Spain, and how is Tucuvi using its technology to alleviate the shortcomings in this area of care?
Every year, around 40 million people in the world require palliative care, although only 15% of these patients receive it. In Spain, according to the National Institute of Statistics, some 200,000 people suffer a terminal illness each year; while the NHS Palliative Care Strategy indicates that between 20 and 25% of people who die annually require palliative care.
However, the Spanish Society for Palliative Care (SECPAL) reports that more than 80,000 patients die every year without being able to access the palliative care they need. In part, this situation arises because access to palliative care is far from equitable: Spain has 260 specialised palliative care services, which means an average of 0.8 teams per 100,000 inhabitants, a rate that is below the European average. Another structural reason for this precariousness is the lack of specific resources dedicated to such attention, which makes it difficult to offer structured and continuous care at all levels of health care.
Continuum of healthcare is an essential aspect of palliative care, as it is necessary to address the many complex needs of these patients, and is directly related to their satisfaction and quality of life. It is also associated with less intervention and fewer hospitalisations.
To guarantee continuity in the care process, home care is a very important healthcare model, whose effectiveness depends on the stability of care programmes and the frequency with which the patient is followed up. Establishing an appropriate follow-up for each patient, which is adapted to their casuistry and allows the early identification of palliative needs, enables advance care planning, contributing to:
In this context, telephone calls are a simple and direct way of contacting patients, and are the most common and preferred alternative to face-to-face visits. Phone interviews are a complementary activity to in-person appointments, and allow to assess the occurrence of complications and to prioritise care for those patients who require it.
Tucuvi’s virtual assistant, Lola, has been integrated into the Home Hospitalisation Unit of the Vinalopó Hospital, part of the Ribera Salud group, in order to automate follow-up calls to advanced palliative patients. Within this unit, 32% of admissions correspond to this patient profile, and the care network established is made up of three interconnected elements: the HHU itself, an In-Hospital Palliative Care Unit, and a Palliative Patient Follow-up Programme (PSPP). When the patient is admitted to the unit, they are included in this programme and the clinical team explains the two agents involved in the follow-up: the nurse case manager and Lola, who is always supervised by the physicians.
The follow-up protocol is based on a weekly clinical assessment call, with the aim of establishing whether the patient remains clinically stable or has worsened and requires intervention by the healthcare team. In order to optimise the professionals’ time to the maximum, the operating dynamic established in the unit is as follows: Lola´s calls are made first thing in the morning, so that the nurse manager has all the necessary information to prioritise and plan the home visits for that day.
This improvement in health planning has a direct effect on the quality of care, as it increases the coordination and speed of interventions and allows for a significant optimisation of time and resources.
Between June and October (2021), 142 patients with an average age of 78.6 years have been monitored with Tucuvi and have received Lola’s calls every week. More than 90% of the patients have generated at least one alert, totalling more than 1,500 in that period of time. These incidents have been reported to healthcare staff in real time through our clinical platform, so that professionals received daily structured and prioritised data on the status of their patients, improving workflows and facilitating decision making.
Specifically, patients included in the programme have reduced their visits to A&E and Health Centres by 20% and 25%, respectively. In addition, thanks to Lola monitoring, nurses have had to make 70% fewer calls to patients who did not really need them, and have been able to prioritise their time to provide better healthcare coverage to the most urgent patients.
In terms of patient satisfaction, 100% of the patients surveyed expressed usefulness and a desire to continue with the follow-up. 96% of the patients appreciated the fact that Lola calls them once a week and they feel more reassured by the continuous follow-up. Furthermore, 64% agree that they would have needed the visit with their doctor without the calls, 27% say they have reduced their visits to the ER and 9% perceive less frequent hospitalisation.
To go deeper into the impact that our technology has on the lives of professionals and patients, in the following link we share a video made by Ribera Salud with several testimonies and experiences:
At Tucuvi we continue to work to help professionals to plan care in a more efficient and personalised way, increasing the quality of life of patients, responding to their needs and improving healthcare at home.
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