Integration of telemedicine into clinical practice for inflammatory bowel disease

Abstract

Purpose of review In the context of the rising incidence and complexity of inflammatory bowel disease (IBD), telehealth offers new ways to support remote and efficient delivery of healthcare services. The aim of this review is to assess the current status of telehealth services in the management of IBD and challenges to adopting telehealth in clinical practice. Recent findings Different modalities of telehealth such as virtual clinics and remote patient monitoring have been studied in many IBD centers. They are found to be associated with high patient acceptance, decreased healthcare costs, improved quality of life, treatment adherence, and disease knowledge among patients. The major challenges encountered in the integration of telemedicine into clinical practice include risks to patient privacy and confidentiality, requirement for informed consent, lack of uniform reimbursement policies, operational difficulties, provider acceptance, and licensing. Summary Telehealth is an effective, efficient, and low-cost intervention that can address increasingly complex care of patients with IBD. However, for telemedicine to be adopted widely, new policies and reforms need to reduce the burden of physician licensing in multiple states, allow for receipt of all telehealth services in the patient's home or office, and require reimbursement for services on par with an office visit.

Demographic Factors Associated With Successful Telehealth Visits in Inflammatory Bowel Disease Patients

“…[4][5][6] Key barriers historically limiting telecare have been regulatory and billing challenges, ensuring privacy and security, liability issues, and licensure and technology challenges. 2,7,8 The coronavirus disease 2019 (COVID-19) pandemic forced an accelerated shift from traditional in-person outpatient visits to telecare to promote social distancing and reduce exposure to vulnerable patients. Although past efforts with smaller populations have shown that telehealth for IBD can be cost-effective and high-quality, little is known about the effect of a systems-wide shift towards telehealth.…”

Trends in U.S. Health Care Spending on Inflammatory Bowel Diseases, 1996-2016

“…From a health systems perspective, accessing hospital-based services is also significantly costlier than ambulatory visits. [13][14][15] The relative spending on pharmaceuticals increased over the 2 decades of this study, accounting for ~20% of total spending in patients with IBD, particularly in younger adults and middle-aged adults with IBD. Although we are unable to directly attribute costs to biologic therapy, it is likely that the relative increase in pharmaceutical health care spending is attributed to biologics.…”

Telemedicine and Integrated Multidisciplinary Care for Pediatric IBD Patients: A Review

“…The last decade has shown increased efforts at implementing telemedicine for adult patients with IBD [ 41 ] as virtual services have the potential to reduce costs associated with managing this disease and increase the availability of specialty care [ 34 ]. Within this population, telemedicine is well-accepted and associated with efficient care delivery [ 41 ], decreased rates of hospitalizations, improved patient quality of life [ 42 ], and increased patient satisfaction, empowerment, and collaboration amongst multidisciplinary providers [ 43 , 44 ].…”

“…Although the terms are often used interchangeably, telemedicine refers to the use of information and communication technologies (ICTs) for remote health care delivery (without direct physical contact with the patient) [ 31 ]. In contrast, telehealth employs ICTs in a broader spectrum of clinical activities (e.g., provider-to-provider communications) [ 32 ] as well as non-clinical services (e.g., administrative meetings) [ 33 , 34 ].…”