Clinical Solutions
Palliative app connects patients with clinicians
May 12, 2021
BRAMPTON, Ont. – Researchers from Humber River Hospital, William Osler Health System, and the Bruyère Research Institute are tackling the difficulty that palliative care patients have in keeping caregivers up-to-date on their symptoms through an app called RELIEF. The app enables the remote self-reporting of symptoms, and it has now gained support for further development, thanks to $1.4 million in funding from Health Canada.
Led by Dr. Martin Chasen (pictured), medical director of palliative care at William Osler Health System and clinician-researcher at the Bruyère Research Institute, and Dr. Pete Wegier, research chair in Optimizing Care Through Technology at Humber River Hospital, RELIEF will allow patients to regularly report their symptoms online from anywhere while being monitored by their team of healthcare providers.
“We developed RELIEF in partnership with uCarenet Technologies Inc. as an easy method for the remote self-reporting of symptoms by patients to their healthcare providers,” said Dr. Chasen. “In a previous pilot study, we found RELIEF to be an effective method for remote symptom reporting for patients with palliative care needs, and that RELIEF reduced visits to the emergency department for a number of patients and led to substantial healthcare cost avoidance.”
For patients with palliative care needs, access to care is often constrained by health system resources and a requirement to visit their clinician for assessments. Assessments typically only occur every 4-8 weeks, a delay which can result in otherwise avoidable emergency department visits for patients.
More frequent symptom assessments would provide more timely and earlier interventions for patients by their healthcare providers should intervention be required; however, a key barrier to effective symptom management and patient comfort is the lack of real-time symptom status.
Using RELIEF, patients report their symptoms daily and healthcare providers receive alerts for any sudden changes in symptom status or worrying trends.
These alerts allow for timely acute interventions or close passive monitoring, reducing patient stress through the knowledge that their healthcare provider is monitoring their symptoms. RELIEF can be scaled up across the healthcare system, improving communication between patients and providers while also improving navigation across the continuum of care.
“Thanks to support from Health Canada, we are now able to expand RELIEF to a number of healthcare settings to study its effectiveness as a remote monitoring tool for a diverse group of Canadians,” said Dr. Wegier.
In addition to Humber River Hospital and William Osler’s Brampton Civic Hospital, RELIEF will be implemented with healthcare partners in the North East, North West, and Champlain LHINs in Ontario, and Lakeshore General Hospital in Québec. These sites will allow the research team to see how RELIEF can help serve a number of different populations, including the homeless and vulnerably housed, rural and remote communities, Indigenous communities, Anglophones in Québec, and Francophones outside Québec.
In addition to Chasen and Wegier, the RELIEF team includes a variety of research scientists and clinicians, including:
- Dr. Ravi Bhargava, physician-scientist at the Global Institute of Psychosocial, Palliative and End-of-Life Care, University of Toronto
- Dr. James Downar, chair of Palliative and End of Life Care at the Bruyère Research Institute
- Dr. Sarina Isenberg, chair of Mixed Methods Palliative Care Research at the Bruyère Research Institute
- Bonnie Keating, clinical nurse specialist at William Osler Health System
- Saranjah Subramaniam, the RELIEF Research project manager at Humber River Hospital
“Digital health technologies are allowing the clinicians and healthcare professionals to deliver more personalized and proactive care,” said Dr. Bhargava.
“We will be able to assess the impact of RELIEF on important patient outcomes such as avoidance of unnecessary trips to the emergency department and associated cost savings, satisfaction with the app, engagement with the app, and connectedness to the healthcare team,” said Dr. Isenberg. “Our evaluation of economic outcomes will enable us to determine the impact of RELIEF on the broader healthcare system and further bolster support to disseminate RELIEF across the province.”
“The COVID pandemic has shown us that virtual and remote care solutions are the future,” said Barb Collins, president & CEO of Humber River Hospital. “Patients with access to RELIEF will no longer be limited in their ability to access high-quality palliative care services as a consequence of their geographic location, socioeconomic status, or healthcare needs. Healthcare provider capacity will also increase, as a single provider will be able to monitor and address the issues of a larger number of patients.”
“Osler welcomes Health Canada’s support of RELIEF,” said Dr. Naveed Mohammad, president & CEO, William Osler Health System. “The development of this innovative app speaks to our commitment to patient-inspired healthcare by ensuring that patients have convenient access to high-quality care and technology that will enable better health outcomes. We are pleased to have played a critical role in creating the app and look forward to supporting the project team as RELIEF is implemented in other healthcare settings.”
Learn more about RELIEF at Home – Alt1 | uCarenet uCareRelief App