Advancing Spiritual Care Through Research A New Resource for Telechaplains

Fabian Winiger, M.Sc., PhD

Senior Research Fellow

University of Zurich

In 2016, the American Medical Association surveyed 1,300 physicians on their use of digital technologies in patient care. At that time, a small minority of 14% used virtual visits (“Tele-Visits”) to care for their patients. When the survey was repeated in 2019, this had climbed to 28%, and in the most recent survey, conducted in 2022, four-fifth of physicians claimed to do so. In the same period, the proportion of physicians who monitor their patients remotely also almost tripled to 30% (AMA, 2022).

What happened? Clearly, the Covid-19 pandemic has increased the familiarity, perceived relevance and thus enthusiasm for digital tools in the medical profession. This increase is in clear evidence across all age groups, genders and medical specialties. As the survey shows however, this trend began well before the Coronavirus hit American communities and continues as pandemic-related pressure on health systems is easing. While the effect of the pandemic is evident in the massive increase of virtual visits in the most recent survey, uptake of telehealth technology has steadily increased across all use cases.

Borrowing Everett Rogers (1995) classic model of the technology adoption lifecycle, the authors suggest that “Tele-Visits” in particular, once of interest to a small minority of early adopters, are now in a late stage of adoption. In an appendix to the study, the cohort of physicians adopting this technology are labelled either “early” or “late majorities”, and physicians engaging with this technology in coming years, “laggards”. In other words: if the sample surveyed by the AMA is representative, over the past seven years, digital health tools have become mainstream.

Figure 2: Tele-Visit adoption on Rogers’ (1995) model of the technology adoption life cycle (AMA, 2022, p. 29).

Responding to this trend, the Professorship of Spiritual Care at the University of Zurich has begun to investigate the uptake of telehealth technology by chaplains, or “telechaplaincy”.

We began with a qualitative survey of chaplains at leading healthcare institutions on their use of digital technologies (Winiger, 2022). It suggested that, though chaplains are generally aware of the introduction of telehealth at their institution, healthcare settings in which they are fully integrated into telehealth infrastructure are rare and appear limited to a few technology-forward and faith-sensitive institutions such as Mercy Virtual, Ascension, and the Veteran’s Health Administration. A national survey of telechaplains conducted by Sprik et al. (2022) confirmed this finding: chaplains’ understanding of telehealth lags behind other disciplines, and are often left to discover and make up their best practices on the go. As one telechaplain recently stated, “I’m building the plane as I’m flying it”.

Returning to the technology adoption life cycle, telechaplains are thrust into the difficult situation of being, simultaneously, innovators by the standards of their own profession, and laggards, when viewed in context of the larger life cycle of telehealth technology. The development of telechaplaincy, though at times perceived to be on the cutting edge of the profession’s development, has thus fallen behind a fundamental transformation of healthcare which has been underway for decades.

We contend that this situation is highly problematic for two reasons. Firstly, it adds to the institutional marginalization of chaplains, who struggle to remain visible as clinical workflows move to telehealth platforms which they may not be prepared to use, and which may not include provisions for their routine inclusion in patient care. Secondly, being put in a position where chaplain interventions are adapted for digital care settings on the fly threatens to undermine the high professional standards aspired to by pastoral care workers, and even more so by specialized spiritual care providers working to establish themselves as valued and respected healthcare professionals.

In order to gain a clearer picture of these challenges, in collaboration with Petra Sprik (University of Alabama) and with the support of the Transforming Chaplaincy-initiative, we initiated a Community of Practice of self-described Telechaplains based at leading U.S-based healthcare institutions.

In October 2022, the conversation in this community culminated in a two-day online conference which to us confirmed both the interest of chaplains in engaging proactively with digital health tools, and the dearth of information and training on this topic. Of the 360 participants who registered for the conference, 77 filled out a post-conference evaluation. Two-thirds stated they had received “none” or “very little” telechaplaincy training prior to this conference; 91.8% found the event “very” or “extremely useful”. A deluge of emails and requests for certificates of attendance confirmed this.

Clearly, we are witnessing not a short-lived Coronavirus-related fad, but the early stage of what – for a lack of a better word – might be described as a “megatrend”. Physicians cite the improvement of clinical outcomes and work efficiency as their most important motivations in using digital tools, with reduction of stress and burnout factoring prominently. Early data and impressions from the conference suggest that telechaplains are similarly motivated by improved outcomes, efficiency and stress reduction. The tools, skills and professional competencies by virtue of which these advantages may be replicated by telechaplains, however, remain unclear. Similarly, lacking EHR integration and concerns over liability coverage and data privacy are barriers for physicians, which may also apply to telechaplains.

In order to assist spiritual care providers in navigating this development, we launched – an information portal aimed at connecting spiritual care providers, managers and researchers working in digital (health)care environments. It gathers an easily digestible introduction to telechaplaincy alongside (where available) current recommendations by professional associations, recent research, documentation of events such as the conference, and an open invitation for practitioners to join the Community of Practice.

The portal has a twofold aim: firstly, it hopes to bridge academic reflections on the “digital turn” in spiritual care with the professional reality of chaplains working in increasingly digital care settings. Secondly, it hopes to cast a bridge across the Atlantic, for North American developments, due to the relatively advanced development of telehealth, bear many lessons for our European colleagues. is an offer of support to the (tele)chaplaincy community and a next step towards a more digitally-forward, evidence-based practice of spiritual care which proactively and creatively seizes telehealth as an opportunity to improve how and where we serve our communities.

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AMA. (2022). AMA Digital Health Research—Physicians’ Motivations and Key Requirements for Adopting Digital Health Adoption and attitudinal shifts from 2016 to 2022. American Medical Association.

Rogers, E. M. (1995). Diffusion of innovations (Fourth ed.). Free Press.

Sprik, P. J., Janssen Keenan, A., Boselli, D., & Grossoehme, D. H. (2022). Chaplains and telechaplaincy: Best practices, strengths, weaknesses—a national study. Journal of Health Care Chaplaincy, 0(0), 1–23.

Winiger, F. (2022). The changing face of spiritual care: Current developments in telechaplaincy. Journal of Health Care Chaplaincy, 0(0), 1–18.

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