Digitalisation in the field of palliative care to support multi-professional collaboration

The world of palliative care is characterised by a holistic, person-centred approach to care that is geared towards the subjective needs of patients and their relatives. The focus is not on healing or prevention, but on alleviating physical, psychological, social and spiritual suffering. Their professional self-image is therefore based on the principle of multi-professional collaboration, which integrates different competences and perspectives in order to provide the best possible care and support for patients and their relatives. Due to the special framework conditions, the palliative care sector is much more sceptical about digitalisation and has so far been transformed to a lesser extent than other medical fields. However, digital health applications are also on the rise in palliative care. For example, health technologies for symptom management or monitoring of vital and movement parameters, telemedicine and electronic documentation systems are being used (DGP 2022; Ott et al. 2023). In most cases, the patient/patient/relatives – healthcare staff level is addressed.

The PALLADiUM project based at bidt, on the other hand, focuses on multi-professional collaboration and shows that palliative-specific, practical digital innovations can strengthen communication and collaboration processes and improve the flow of information and knowledge – and thus patient care. What is essential here is how relevant information and the (case/specialist) knowledge of the team members can be made available and utilised for a shared understanding of the case (Schneider/Stadelbacher 2018).

In multi-professional palliative care work, there is an intensive exchange of information and knowledge between the various stakeholders involved (e.g. healthcare professionals, patients, relatives). In principle, information is available to everyone – regardless of the specific access options and the question of when which information is relevant for whom. While information is (objectively) decontextualised, can be understood and shared (e.g. “Mrs Müller is here for the new admission to room 7”), knowledge (subjectively and intersubjectively shared) is required for information to become effective: What does this information mean and to what extent does it result in what relevance for action (e.g. “The patient wants to complain a lot about her suffering. My impression is that this is psychologically superimposed.”)? In addition to a targeted, patient- and situation-related transfer of information between the various professions involved, it is essential that digital innovations also take into account relevant aspects of knowledge (e.g. empirical knowledge, existing case knowledge, gut feeling) and take seriously the limits of what can be meaningfully digitised (Huchler 2017; Weihrich/Jungtäubl 2022). In this context, the importance of face-to-face interaction in and for the team (e.g. with regard to joint situation processing or team-internal reflection), which is largely blocked by digitalisation, should be emphasised.

Comparability with analogue phenomena

Although knowledge divergences in the form of different perspectives, relevance settings, situation definitions or treatment logics that are assessed as meaningful are – in the sense of normal – commonplace, they have a direct effect on multi-professional collaboration (e.g. lead to misunderstandings and mistrust) as well as concrete practical decisions and can delay or complicate the respective task at hand. The targeted inclusion of knowledge/knowledge aspects in the development of digital technologies – in this case palliative-specific technologies – contributes to the visibility of professional group and person-related relevance and knowledge divergences in the team, making them reflexively accessible and thus workable.

The added value of knowledge-based digital innovations in the field of palliative care with regard to the aforementioned enablers lies, among other things, in the increased changeability of established or previously unquestioned content and processes (documentation, considerations, decisions) as well as the utilisation and objectification of the wealth of unstructured data that is generated in daily documentation. A common definition of the team’s situation in the sense of a collectively shared understanding of what is the case, i.e. what is to be done/not to be done by whom and why/when, is promoted – thus strengthening continuous patient (continuing) care.

Social relevance

The strictly user-oriented handling of the digitalisation deficit in palliative care has a twofold social relevance: On the one hand, it demonstrates new solutions for comparable working environments (e.g. inpatient hospices, geriatrics, outpatient palliative care) in order to resolve the tension between digitalisation and informal working, raises awareness of the needs and gives the actors involved/affected the opportunity to shape the process through direct participation. On the other hand, the importance of palliative care in terms of health policy will continue to increase in the future due to demographic and epidemiological developments in Germany and the western world, and with it the need for suitable digital innovations.

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