A demonstration project: Assessing the significance and impact of utilizing a novel telemedicine application in the delivery of community based palliative care in a rural seriously ill population.

项目摘要 以社区为基础的姑息治疗是一个重要的专业，需要帮助解决照顾的差距， 患有严重疾病的人。地理障碍和姑息治疗提供者的短缺导致患者 农村地区缺乏姑息治疗。为这些患者提供更好护理的潜在解决方案是 通过远程医疗。然而，目前的远程医疗方案无法解决与以下方面相关的所有方面： 照顾患有严重疾病、多种疾病（多种疾病）和多种药物的人。 因此，本研究的目的是测试一种新型远程医疗的可行性、可接受性和可用性 应用程序，其中包括一个虚拟药剂师，在提供以病人为中心的姑息治疗在农村 北卡罗来纳州西部的人口。这个远程医疗应用程序Adapt将包括以下内容 组件：（1）虚拟药剂师;（2）远程患者监测（症状、药物、生命体征、照片 上传）;（3）患者/护理人员与提供者/药剂师之间的信息传递;（4）与 患者、护理人员、家庭成员和/或提供者/药剂师;以及（5）提供者临床仪表板 监测.使用该应用程序，提出了以下三个目标/假设： 具体目标#1将评估虚拟药剂师对提供者的可行性、可用性和可接受性， 姑息治疗远程医疗模式中的患者。患者和提供者接受和满意度 将使用经过验证的调查来衡量应用情况。具体目标#2将确定常见药物-药物 虚拟药剂师在姑息治疗人群中的互动。具体目标#3然后将评估虚拟 药剂师对药物管理的建议。最后，探索性的具体目标#4将检查 使用经验证的调查，虚拟药房咨询对患者报告的结果的影响。 这种应用有可能解决涉及照顾越来越多的儿童的多方面问题。 老年人患有严重疾病和多种疾病，这往往与高患病率有关， 多药疗法本研究将提供关于以下方面的可行性、可接受性和可用性的关键信息： 该应用程序将为未来的临床有效性试验提供信息。

Project Abstract Community-based palliative care is an important specialty that is needed to help address the gaps in caring for people with serious illnesses. Geographic barriers and the shortage of palliative care providers result in patients lacking access to palliative care in rural areas. A potential solution to provide better care to these patients is through telemedicine. However, current telemedicine programs are unable to address all aspects related to caring for people with serious illness, multiple morbid conditions (multi-morbidity), and polypharmacy. Therefore, the objective of this study is to test the feasibility, acceptability, and usability of a novel telemedicine application which incorporates a virtual pharmacist, in the delivery of patient-centered palliative care in a rural population in Western North Carolina. This telemedicine application, Adapt, will include the following components: (1) virtual pharmacist; (2) remote patient monitoring (symptoms, medications, vital signs, photo uploads); (3) messaging between patients/caregivers and providers/pharmacists; (4) videoconferencing with patients, caregivers, family members, and/or providers/pharmacists; and (5) provider clinical dashboard monitoring. Using this application, the following three aims/hypothesis are proposed: Specific Aim #1 will evaluate the feasibility, usability, and acceptability, of a virtual pharmacist to providers and patients in a palliative care telemedicine model. Patient and provider acceptance and satisfaction with the application will be measured using validated surveys. Specific Aim #2 will identify the common drug-drug interactions by a virtual pharmacist in a palliative care population. Specific Aim #3 will then evaluate a virtual pharmacist’s recommendations for medication management. Lastly, exploratory Specific Aim #4 will examine the effects of virtual pharmacy consultations on patient-reported outcomes using validated surveys. This application has the potential to address the multifaceted problems involved in caring for an increasingly aging population with serious illness and multi-morbidity that is often associated with a high prevalence of polypharmacy. This study will provide critical information about the feasibility, acceptability, and usability of the application that will inform a future clinical effectiveness trial.