The Marquette Palliative Care System

Worldwide, major clinical barriers to effective palliative care are the absence of a. current data on symptom type and intensity; b. immediately accessible information on practical, affordable, and effective interventions; and c. self-sustaining systems to facilitate physician engagement in continuing palliative care. Our adaptable system, developed for Bangladesh and Nepal, addresses these barriers. A tele-home palliative care program facilitates home care, minimizes expense, and encourages efficient professional practitioner involvement employing two information technology tools: a patient cell-phone "app" on the Android platform with a 15-item symptom questionnaire and an Internet website with health information sections for patients/families and for clinicians. The physician section contains a guide for patient symptom review, clinical practice palliative care guidelines, secured patient demographics, medical summaries, and current and past symptom reports along with prescription-writing capability. The system is managed by a local organization that registers patients and their physicians, instructs patients on the free downloadable application and completes their demographic and medical summaries, and arranges collection of a modest fee. The organization also ensures regular physician/clinic visits by the patient or by a family member with a patient phone check-in, at least every 2 weeks.