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Using Telehealth to Ensure Access to Adequate Care and a Compassionate Death in the Age of Coronavirus 

Even for an organization that deals with health crises every day, the COVID-19 pandemic is sobering and calls for new tactics.

In the early days of the pandemic, our seriously ill and terminally ill supporters began expressing deep-seated concerns: concerns that they were more vulnerable to contracting the coronavirus and dying prematurely, concerns that the idea of a “compassionate, pain-free death” was no longer possible given healthcare shortages, and concerns that they might die alone, suffering, without access to hospice and palliative care to ease their pain. 

For Compassion & Choices, this was a call to action like no others. Although we could not directly affect the trajectory of the COVID-19 pandemic, we knew we could play an important role in expanding the number of terminally ill patients who had access to legal and compassionate end-of-life care during this most challenging time.  

The question was, given the massive demand being placed on our healthcare system and the anticipated shortage of healthcare professionals, what could be done? 

Telehealth became the obvious solution. In recent years, more clinicians have been taking advantage of telehealth to deliver medical care to their patients. Nine out of 10 physicians recognize the benefits of telehealth, with two-thirds (66%) indicating that virtual care improves patient access, and more than half (52%) recognizing it improves patient satisfaction. However, adoption rates remain relatively low, likely a result of limited policies and restricted payment structures to support the practice. Moreover, both clinicians and patients alike are slow adapters by nature. When the status quo works, in this case in-person office visits, there is little incentive to try a new mode of medicine, even if the evidence clearly shows its potential. 

However, as the COVID-19 pandemic evolved, office visits became a setting with increased risk for exposure to the coronavirus. We quickly realized telehealth presented the fastest and easiest way to ensure that vulnerable populations got the best care possible in the safety of their homes. It also would allow clinicians to better deliver quality pain and symptom management to people remotely, and for quarantined providers, to continue safely practicing, helping to mitigate the healthcare provider shortage.  

Compassion & Choices quickly joined the telehealth movement, with Sylvia Trujillo, a 20-year health policy veteran who previously worked at the American Medical Association, serving as our senior legal counsel. Her decades of experience navigating the federal policy landscape, including telehealth, ensured we were well-positioned to immediately advocate on behalf of terminally ill patients.  

Within just a few weeks, we delivered two letters to congressional leadership asking for provisions to the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Five of our requests were included in the final bill. These provisions include allowing use of telehealth to recertify eligibility for hospice care, expanding access to telehealth and increasing access for patients receiving services in federally qualified health centers and rural health centers. Read more about the benefits of this legislation.   

This is an important first step in helping to ensure that more patients can access the care they want, nothing less and nothing more, during this difficult time. We are also advocating for changes on the state level to improve the delivery of healthcare via telehealth, given that much of the practice of medicine is regulated by the states. 

The current global crisis notwithstanding, people are still dying from excruciating diseases like cancer. They can’t put their terminal illness on hold, and we cannot put our work on hold. On a daily basis, we are identifying when and where we can push forward as appropriate. These are scary and difficult times. We remain committed to continuing to advance our mission thoughtfully, given this new reality.   


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