The National Palliative Care Research Center

Curing suffering through palliative care research.


Katharine L. Cheung MD, PhD

Assistant Professor

University of Vermont

Grant Year
Grant Term
2 year
Grant Type
Junior Faculty Career Development

Project Description
Telemedicine Facilitated Palliative Care Consultations in Rural Dialysis Patients
There are over 703,000 patients receiving dialysis in the U.S. and 20% die annually. Dialysis patients experience a high symptom burden as well as depression, anxiety, existential tension and spiritual needs that are not addressed by current dialysis care models. Perhaps for these reasons, 60% of dialysis patients regret starting dialysis and 20% withdrawal from treatment. Compared to patients with cancer or heart failure, dialysis patients have more frequent hospitalizations and invasive procedures at the end of life and less use of hospice services. Palliative care has not yet been integrated into dialysis care but could enhance goal concordant care, enhance prognostic understanding and improve outcomes. It may also reduce cost by avoiding non-beneficial and unwanted treatments. There are barriers to implementing palliative care into dialysis care: 1) the scarcity of palliative care providers and 2) time-intensive and often tiring dialysis treatments that limit desire to travel outside of the unit for additional appointments. We propose an innovative solution to address these barriers: telemedicine facilitated palliative care consultations in rural dialysis units. At the University of Vermont, we have a rapidly expanding telemedicine network with a rigorous consultative program in several disciplines. We propose the following aims: 1) Assess the feasibility and acceptability of delivering palliative care consultations to rural dialysis patients, 2) Explore the content and process of telemedicine palliative care consultations that are associated with patient rated quality of communication, and 3) Benchmark the trajectory of 6- month health service utilization (hospitalization, withdrawal from dialysis, hospice rates) in patients receiving telemedicine facilitated palliative care consultations. The proposed career development award will combine focused training in communication measurement, prospective interventional studies and telemedicine science, and will support Dr. Cheung in becoming a leader in renal palliative care with expertise in serious-illness communication among older adults with kidney disease.


Katharine L. Cheung, MD, PhD is an Assistant Professor of Medicine at the University of Vermont Larner College of Medicine and is a practicing nephrologist. Her research focuses on improving the care for older adults with advanced kidney disease including access to palliative care, improving functional status and resilience. She received her B.A. in Women’s Studies at Tufts University, M.Sc. in Physiology and Biophysics and M.D. from Georgetown University and Ph.D. in Clinical and Translational Science at the University of Vermont. Dr. Cheung completed her residency and chief residency in Internal Medicine, and Nephrology Fellowship at Stanford University. During this Career Development Award she will determine the feasibility of telemedicine facilitated palliative care consults in rural dialysis patient, characterize the content and processes related to quality of communication and benchmark the health service utilization related to these consults.