A social enterprise serves as a working model for the future of palliative care
Technology provides new funding sources.
An innovative model for palliative care is taking shape, and with financial support from a modern-day funding initiative: crowdfunding. Palliative medicine practitioner Michael Fratkin, MD, conceived the idea for ResolutionCare, a social enterprise. Fratkin's goal is to combine nonprofit and professional organizations that share the same mission, ensuring that soulful and capable care is available to everyone everywhere as life approaches completion.1
Fratkin turned to the Indiegogo international platform to raise the funds needed to support his enterprise. The campaign was wildly successful, with contributions totaling more than $37,000 over his $100,000 goal by the end of the campaign.2
CHANGING THE FIELD WITH TECHNOLOGY
ResolutionCare is out to change the delivery of palliative care medicine. Fratkin and his team utilize modern technology to distribute care to a broad patient population, in their homes. If a team member cannot make a house call in person, they arrive in patients' homes via teleconference. Not just for one consultation either, but on an ongoing basis as long as is necessary. ResolutionCare's palliative care team members are physicians, nurse practitioners, social workers, community health workers, and chaplains. They work closely with the patient's own clinicians to gain insight about the patient and to provide their expertise and support. This team does not replace the treatment team, but enhances it providing expertise in such fields as oncology, pain management, nephrology, and dialysis. The hope is that by working this way, with the doctors and nurses who are familiar to the patient and in the comfort and familiarity of the patient's home environment, the patient's quality of life is also enhanced.
Of course, palliative care is most effective when brought into the continuum of care early. The ResolutionCare model assures that patients receive palliation in their own homes before hospice comes in. Patients do not experience the stress of hospitalizations and there are no unnecessary costs in time or money. Patients determine what medical care they receive, which can be seriously empowering, especially at the end of life.
ResolutionCare also addresses the need to educate health care providers about palliative care and help them enhance their basic palliative care skills. Fratkin's enterprise partnered with Project ECHO from the University of New Mexico (UNM) School of Medicine to accomplish this goal. Project ECHO provides a hub-and-spokes model of professional medical education throughout the United States. An academic institution serves as the hub, and primary care clinicians in the community are the spokes.3
Project ECHO provides many levels of expertise to its partners throughout the United States and the world. The goal is to bring medical expertise to the patient, minimizing the need for sick patients to travel to their health care providers. To this end, the project holds weekly teleECHO clinics, similar to grand rounds but by teleconference, where primary care providers present cases from their own communities to primary care clinicians in other communities and to mentoring academicians at the hub. These clinics give the local providers the opportunity to discuss recent developments in their patient cases and to gain input from experts on what the next steps in treatment should be.
Among ECHO's other projects, the program provides expertise in holistic and multidisciplinary pain management to the United States Armed Forces. Formal educational lectures with case-based learning are offered to medical providers at military treatment facilities worldwide.
A HUMAN EXPERIENCE
Fratkin says, “Dying is not a medical experience; it is a human experience.”1 ResolutionCare can ensure that expert palliative care reaches patients in need, in their own homes, no matter how far away patients are from the advanced care available in medical academia.
Bette Weinstein Kaplan is a medical writer based in Tenafly, New Jersey.
1. Bringing capable and compassionate care to everyone everywhere as life approaches completion. ResolutionCare Web site. http://resolutioncare.com/. Accessed January 14, 2015.
2. ResolutionCare: care and guidance before hospice. Indiegogo Web site. https://www.indiegogo.com/projects/resolutioncare-care-and-guidance-before-hospice. Accessed January 14, 2015.
3. Project ECHO: a revolution in medical education and care delivery. UNM School of medicine Project ECHO Web site. http://echo.unm.edu/. Accessed January 14, 2015.