Exploring routine palliative care delivery to inform tailored digitalization approaches - a qualitative interview study

BACKGROUND: Digital technologies are increasingly being introduced into palliative care. However, little is known about the implementation of new technologies from the perspectives of healthcare professionals and informal caregivers. This study explores current specialist palliative home care, particularly the circumstances of the actors as well as information exchange and care processes, to inform the implementation of new technologies. METHODS: A qualitative study involving problem-centred interviews was conducted with healthcare professionals and informal caregivers involved in specialist palliative home care in Germany. The Interviews were analysed by structuring qualitative content analysis guided by the CARE-HOUSE Framework, with inductively developed subcategories. RESULTS: Eleven interviews were conducted with eight healthcare professionals and three informal caregivers. Participants described specialist palliative home care as holistic and well-functioning but characterized by complex and fragmented communication pathways. A wide range of actors, characteristics and means and content of current data transfer could be collected. Informal caregivers frequently act as intermediaries in information exchange, resulting in a considerable organizational burden. The participants identified challenges in current care practice related to communication, data management and institutional barriers. Both groups identified centralized digital information exchange as a major opportunity to address these challenges. CONCLUSIONS: The findings suggest that digital technologies have the potential to improve communication, coordination, and information exchange in specialist palliative home care while reducing administrative burden. Successful implementation requires adaptation to palliative care, providing a user-centred design that preserves the central role of personal interaction in palliative care and accounts for the diverse needs, competencies, and roles of healthcare professionals, informal caregivers, and patients.