{"entity":{"id":"idea-acc-tele-palliative-care-default","kind":"idea","name":"Video palliative care as an equivalent default option for patients far from a team","aka":[],"tldr":"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.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Pain relief and palliative care are unavailable to most): WHO fact sheet, Palliative care","url":"https://www.who.int/news-room/fact-sheets/detail/palliative-care"}],"tags":[],"related":[],"cancers":["nsclc"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-palliative","b-workforce"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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.","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","cost":"small","horizonYears":2},"route":"/ideas/idea-acc-tele-palliative-care-default/","neighbours":{"cancer":[{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"bottleneck":[{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"},{"id":"b-palliative","kind":"bottleneck","name":"Pain relief and palliative care are unavailable to most","route":"/bottlenecks/b-palliative/"}],"paper":[{"id":"paper-temel-early-palliative-care-nejm-2010","kind":"paper","name":"Temel: early palliative care alongside chemotherapy improved quality of life, mood and survival in lung cancer","route":"/key-papers/paper-temel-early-palliative-care-nejm-2010/"}]}}