# Video palliative care as an equivalent default option for patients far from a team

Source: https://onco.cc/ideas/idea-acc-tele-palliative-care-default/  
OnCo record `idea-acc-tele-palliative-care-default` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A large trial showed that palliative care delivered by video works as well as in person for people with advanced lung cancer. Payers should cover it so that distance from a hospital no longer decides who gets it.

## Summary

The REACH PC trial (Greer and colleagues, reported 2024) found that early palliative care delivered by video was equivalent to in-person care on quality of life in advanced non-small-cell lung cancer. Most palliative care teams are in cities; most patients are not. Making video delivery a reimbursed, guideline-endorsed default, with in-person visits when needed, would extend the reach of a scarce workforce.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Regions covering tele-palliative care will increase the proportion of rural patients with advanced cancer receiving specialist palliative care within eight weeks of diagnosis by at least 25 percentage points.
- Rationale: Equivalence has been shown in a large randomised trial; the constraint is payment policy and team workflow.
- Proposed test: A payer rollout with rural versus urban uptake, time to palliative contact, and end-of-life quality indicators as endpoints.
- Maturity: being-tested-at-scale
- Actor: payer

## Sources

- Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care: https://www.who.int/news-room/fact-sheets/detail/palliative-care

## Connected records

- cancers: [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- bottlenecks: [Not enough oncologists, nurses, pathologists, physicists](https://onco.cc/bottlenecks/b-workforce/), [Pain relief and palliative care are unavailable to most](https://onco.cc/bottlenecks/b-palliative/)
- key papers: [Temel: early palliative care alongside chemotherapy improved quality of life, mood and survival in lung cancer](https://onco.cc/key-papers/paper-temel-early-palliative-care-nejm-2010/)

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