App Review

2020; Volume 21, No 8, August
Dr. Romayne Gallagher

VitalTalk: Talking maps to guide conversations about serious illness

By Romayne Gallagher, MD
IAHPC App Reviewer

Emotionally intelligent communication is both essential for compliance and therapeutic for patient and family. VitalTalk is a free app designed for Android and iOS (phone only) that presents key communication learnings in serious illness in the form of “talking maps” that remind clinicians to cover essential points and respond therapeutically to patients. The VitalTalk website has many more teaching and mentoring videos and resources. Seeing this, I realized the app is intended as a memory aid when preparing for a talk with a patient, their family, at a family meeting, or having a conversation where conflict is anticipated. Putting this on the introductory page of the app may make people aware of the extensive content the app represents.

The app, used with the website, is a great start for clinicians in training but also a reminder to those who don’t do this often or who need to improve their skills. The content of the app could be viewed as the evidence-based “skeleton” of effective communication in serious illness. As well as the common conversations of diagnosis, prognosis, goals of care, dying, and communication mistakes, there is useful advice about online communication with patients that will help doctors avoid potential unprofessional hazards of the Internet. The content on culture has excellent key messages and references, but the “cultural tip sheets” are dated and tend to present cultural stereotypes. Currently, the app has communication tips for COVID-19 care, which are useful guides but seem aimed at an American audience as the direct language may seem brusque to many other cultures.

To access the accompanying medical literature papers and videos, sustained and reliable Internet is needed, limiting its use in remote areas or constrained-resource countries. The key “talking maps” and tips are downloaded onto the phone. The app is unable to remember and return to where you left if your phone times out or if you leave the app to check out online content. It is frustrating to see the slow-loading splash page repeatedly, and this alone could discourage reading the resources. There is a feature in the settings icon advertising a daily tip, but in the month or so I had it on my phone, I did not receive one.

The VitalTalk app is a useful reminder of therapeutic communication in serious illness and, combined with taking the time to review the excellent resources on its website, could be key learnings for beginners and those wishing to improve their skills in serious illness communication.

The app is available for free at the Apple App Store and Google Play.

Reviewer bio: Dr. Romayne Gallagher was founding director of the Division of Palliative Care at the University of British Columbia, Canada, where she helped establish undergraduate, postgraduate, and interprofessional teaching in palliative care. She has retired clinically after being a palliative care consultant for more than 25 years but is still a Clinical Professor in the Division of Palliative Care. Dr. Gallagher established a public forum on death and dying, replicated by others in North America and Europe, and developed the iPal Global app.

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