Patterns of communication technology use in routine palliative care: a cross-sectional survey

Abstract

Abstract Background Communication is central to palliative care, spanning patients, family caregivers, and institutions across diverse care situations. Digital technologies are increasingly discussed as a means of supporting palliative care delivery, yet quantitative evidence on how communication technologies are actually used in routine practice — with which partners, in which situations, and whether use differs between professional groups — remains limited. This study examined patterns of communication technology use in routine palliative care and assessed differences between professional groups. Methods We conducted a cross-sectional survey of healthcare professionals working in palliative or hospice care in Brandenburg, Germany. A self-administered questionnaire, developed from prior qualitative work and pilot-tested, was completed online (LimeSurvey) or on paper between September and November 2023. For each combination of communication partner and care situation, participants indicated which of six channels they typically used (telephone, email, fax, messenger services, PalliDoc/documentation software, video consultation). Descriptive statistics were calculated, and Pearson chi-square tests compared physicians, nurses, and other healthcare professionals (90 tests; Bonferroni-corrected α = 0.00056), with effect sizes reported as Cramér’s V. Reporting followed the CROSS guideline. Results Of 162 completed questionnaires, 71 (43.8%) were from physicians, 36 (22.2%) from nurses, and 55 (33.9%) from other healthcare professionals. Telephone was the most frequently used channel overall (59.8%), followed by email (21.2%), fax (12.3%), messenger services (9.4%), documentation software (6.5%), and video consultations (1.3%). Overall use intensity was highest among physicians (23.3%), then nurses (17.3%) and other healthcare professionals (12.9%). After Bonferroni correction, five group differences were statistically significant, the strongest at organisational interfaces: for prescription requests to pharmacies, large effects emerged for telephone (V = 0.509) and fax (V = 0.477), with physicians using both far more than nurses and other professionals (telephone 83.1% vs. 47.2% vs. 27.3%; fax 57.7% vs. 41.7% vs. 14.5%). Moderate effects were also found for telephone communication with clinics following hospital discharge (V = 0.341) and for emergency communication with patients (V = 0.321) and relatives (V = 0.319). Conclusions Communication in routine palliative care in Germany still rests on established channels — the telephone in particular — while video consultations remain marginal despite their prominence in digital health discourse. Use patterns are shaped by professional roles and institutional structures, with the clearest differences at organisational interfaces such as pharmacy coordination. Digitalisation in palliative care may be best understood not as a linear progression toward advanced technologies, but as the selective integration of digital tools into existing communication practices, guided by practicability, familiarity, and the specific demands of palliative care.