Table 3.

Challenges and Areas for Future Research/Intervention

Distressing/difficult-to-witness signs and symptoms

Finding more effective ways to educate patients, caregivers, and hospice providers about managing common symptoms at the end of life

Implementing telemedicine technology to better track symptoms and notify providers when escalation of symptoms occurs

Developing better predictors to identify patients who may require enhanced symptom management

EMS versus hospice response times

Developing partnerships between hospices and EMS

Utilizing synchronous telemedicine technology to communicate with patients/caregivers at times of crisis

Patients requiring palliative interventions not deliverable at home

Assessing patient and caregiver knowledge in regards to more intensive hospice services (e.g., CHC, GIP)

Earlier identification of patients who need CHC or GIP level of care

Expanding palliative care interventions (e.g., ultrasound) that can be performed at home and studying its impact on hospitalization/quality of care

Desire to seek care from nonhospice physicians and hospital

Incorporating and involving physicians into patients' hospice care plan

CHC, continuous home care; EMS, Emergency Medical Services; GIP, general inpatient.