Table 3.

Patient and Caregiver Reported Strengths and Downsides of Palliative Care Telemedicine Visits

Theme (N by theme, % of total)a	Subtheme (N, % of theme)a	Selected patient/caregiver comment
Strengths (116 comments total)
Convenience (53, 46)	Time-savings (33, 62)	“I like that it's an option because it meant we didn't have to make the 2–3 hour drive to San Francisco. I like that it's out there because we wouldn't be able to do it if they had to go to SF every time.” (Caregiver)
	Personal comfort (11, 21)	“It's more comfortable. You can be in your pajamas with a cup of coffee if you want. If the doctor is running late, I can do other things at my leisure at home.” (Patient)
	General comments re: convenience (5, 9)	“This is very convenient and helpful.” (Caregiver)
	Cost-savings (4, 8)	“I was astonished to find out that [the video visit] was at no cost to us. It saved significant expense because it saved a drive, food, and a hotel for 2 nights.” (Caregiver)
Comparisons with other forms of communication (32, 28)	Comparisons with in-person visits (15, 47)	“Unless there is a compelling reason to be there in person such as physical exams, or labs, a video visit is a preferred way for have the interaction, especially when patients are dealing with mobility.” (Caregiver)
	Unique features of video visits (12, 38)	“Gives me a lot of time to think about how I'm really feeling. I'm more reflective at home. It's easy to go grab my meds at home…” (Patient)
	Comparisons with telephone encounters (5, 16)	“It feels a lot more intimate than a phone call. Seeing people face to face enhances the visit. It's like you are in the room with them.” (Patient)
Enhanced access (21, 18)	For symptomatic or disabled patients (10, 48)	“My husband is in a wheelchair and on a ventilator, video appointments avoid having to transport him for a visit.” (Caregiver)
	Greater frequency of communication with medical team (8, 38)	“It's easier to stay up-to-date.” (Patient)
	To specialty PC services (3, 14)	“I've spent a lot of time trying to track down any local palliative care services and we've found nothing [near home].” (Caregiver)
Technology (10, 9)	Ease of use (6, 60)	“It is easy to use.” (Patient)
	Video platform quality (4, 40)	“You can say and hear everything you need to.” (Patient)
Downsides (76 comments total)
Technology concerns (26, 34)	Video visit platform (18, 69)	“The technology didn't work and it wasted a lot of time…we had to move to a phone-call.” (Patient)
	Tech-literacy (5, 19)	“Some people might be intimidated about doing it over video…” (Patient)
	Video visit tech setup (3, 12)	“It requires that you have things at home to have a high quality video conference. Need good wifi, a good camera, a good screen.” (Caregiver)
Relationships and rapport (21, 28)	Rapport building (12, 57)	“It's not as intimate as far as communicating 1:1. I don't feel like I get to know the doctor as well compared to in-person appointments.” (Patient)
	Nonverbal communication (4, 19)	“You can see faces but sometimes you miss the body language.” (Patient)
	Value in initial in-person visit (3, 14)	“Technology creates a little distance, but it's not a big deal if you've met the person [in-person first].” (Caregiver)
	Discussing sensitive topics (2, 10)	“With sensitive topics you feel a little less empathy.” (Caregiver)
Limitations in scope of services (15, 20)	N/A	“Losing the proximity with other human beings is a real disadvantage. You can lose the more subtle signals of how people are doing over video.” (Patient)
No downsides! (14, 18)	N/A	“None, I prefer them [video visits].” (Patient)

^aPercentages may not sum to 100 due to rounding.

N/A, not applicable.