# Improving Serious Illness Care for Underserved Populations: Patient and Caregiver Experience with Tele-Palliative Care

> **NIH NIH R01** · RAND CORPORATION · 2024 · $576,140

## Abstract

Project Abstract
There is significant unmet need among seriously ill patients and gaps in quality of communication with health
care providers, which are particularly pronounced among historically underserved populations, including
patients of racial/ethnic minorities, low socioeconomic status (SES), limited English proficiency (LEP), and
those who live in rural areas who are underserved in health care. For patients suffering from serious illness,
palliative care provides expert pain and symptom management and planning for end-of-life care. In particular,
palliative care offered via telehealth may improve access to outpatient palliative care services, which are
predominantly offered in large academic medical centers in metropolitan areas. Despite an increase in
telehealth for outpatient palliative care since the beginning of the COVID-19 pandemic, little is known about
the perspectives of historically underserved patients on modality of palliative care and how communication
may be impacted by a virtual mode of delivery for these patients who already experience inequities in receipt of
goal-concordant care. In this prospective cohort study, we will enroll a cohort of adult patients referred to
outpatient palliative care who are of low SES, non-White, LEP, or rurally-residing communities to compare
care experiences of in-person versus tele-palliative care visits provided to historically underserved patients and
their caregivers and understand the nuances around their needs and preferences for modality of care. Using
mixed methods we will 1) evaluate both patient- and caregiver-reported experience with in-person and tele-
palliative care over time using patient and caregiver-specific surveys and in-depth interviews with patients and
caregivers; 2) compare communication quality and use of recommended communication processes between in-
person and tele-palliative care using an analysis of recorded in-person and telehealth visits; and 3) examine
perspectives of in-person visits versus tele-palliative care including perceived barriers and facilitators to both
modes of delivery using qualitative interviews with palliative care providers. The proposed research will
improve understanding of the experiences of historically underserved patients and their family caregivers to
address issues around mode of delivery of palliative care. Findings will provide a roadmap for health systems to
improve patient-provider communication and identify strategies to promote cultural competence to improve
experience and overall quality of palliative care delivered both in person and via telehealth.

## Key facts

- **NIH application ID:** 10890601
- **Project number:** 5R01NR020788-02
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** Julia Bandini
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $576,140
- **Award type:** 5
- **Project period:** 2023-07-19 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10890601

## Citation

> US National Institutes of Health, RePORTER application 10890601, Improving Serious Illness Care for Underserved Populations: Patient and Caregiver Experience with Tele-Palliative Care (5R01NR020788-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10890601. Licensed CC0.

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