Background: This research was conducted as part of a telehospice study conducted by researchers
at Michigan State University, in a partnership with Hospice of Michigan. The study
took place from March 2000 through December 2002.
Objective: One of the primary objectives of the study was to learn more about how providers
feel about the provision of telemedicine services, in this case telehospice. Of particular importance
was learning more about how providers' perceptions of services could change over
the course of the project as they became more familiar and comfortable with providing telehospice
services. Finally, researchers were interested in how the providers' perceptions of
telehospice system might influence utilization.
Setting/subjects: Four Hospice of Michigan offices took part in this telehospice study, two
in rural areas and two in urban settings with a total of 187 patients receiving telehospice care.
Health providers who offered telehospice services were recruited to share information about
their perceptions of the technology.
Measurements: Providers were surveyed at the beginning and end of the project to track
their perceptions of telehospice services. Five focus groups with providers were also conducted
over the course of the project to allow providers to elaborate their thoughts and perceptions
in greater detail.
Results: Actual utilization of the telehospice system did not have a significant impact on
perceptions of services; for the most part, providers began the project with pre-conceived notions
about the technology and these perceptions held over the course of the project. Even
providers who praised the level of training and technical support and who were able to cite
success stories did not display a significant change in attitudes toward telehospice. Providers
did express concern regarding how telehospice would impact current aspects of their job such
as autonomy or mileage reimbursement.
Conclusions: Study results indicate that providers serve as gatekeepers to a new technology
and manner of providing care. Telehospice services in this project were primarily provided
by a handful of enthusiastic adopters. The results of this study provide important implications
if telehospice care is to disseminate for general use among hospice recipients.
