Successful Distancing: Telemedicine in Gastroenterology and Hepatology During the COVID-19 Pandemic

Abstract

Telemedicine involves delivering healthcare and preventative care services to patients without the need for in-person encounters. Traditionally, telemedicine has been used for acute events (e.g., stroke, used to relay essential information to the emergency department) and chronic disease management (e.g., diabetes and chronic kidney disease management). Though the utilization of telemedicine in gastroenterology and hepatology has been modest at best, especially for inflammatory bowel diseases and chronic liver disease management, since the onset of coronavirus disease 2019 (COVID-19) pandemic, utilization of telemedicine in gastroenterology increased by 4000% in the first two weeks, equivalent to the last six years of growth before the pandemic. The Center for Medicare and Medicaid (CMS) relaxed rules for the use of telemedicine with easing restrictions on reimbursements, location, licensing requirements (across state lines), and the need for a prior provider-patient relationship. These changes increased the use of telemedicine in inpatient and outpatient settings for gastroenterology-related referrals. The use of inpatient telephonic or video consults helps provide timely care during the pandemic while conserving personal protective equipment and decreasing provider and patient exposure. Nevertheless, telehealth use comes at the cost of no direct patient contact and lesser reimbursements. The appropriate use of technology and equipment, training of healthcare providers, use of platforms that can be integrated into the electronic health record while protecting the privacy and the flow of information are essential components of telemedicine. Furthermore, encouraging patients to seek medical care remotely with the proper equipment and improving digital literacy without the need for physical examinations is a challenge, further compounded in elderly or hard-of-hearing patients and in patients who are more comfortable with in-person visits. The authors will systematically review and discuss how telemedicine can be integrated into the practice of gastroenterology and hepatology, with emphasis placed on discussing barriers to success and the ways they can be mitigated.

Evaluating IBD Patient-Initiated Electronic Communication During the SARS-CoV-2 Pandemic: A Single-Center Study

“…The authors showed significantly low use of e-communication among African-Americans (17%) compared to White (71.7%) patients with IBD. These findings are in concordance with other studies on telemedicine use [1]. Interestingly, Rao et al study also finds that patients' age and IBD subtype (Crohn's or ulcerative colitis) did not predict the electronic communication response.…”

“…We thank Rao S and Borum ML for their interest in our article "Successful Distancing: Telemedicine in Gastroenterology and Hepatology during the COVID-19 Pandemic [1]." In their correspondence, the authors provide their findings on using electronic communication patterns via portal messaging in inflammatory bowel disease (IBD) patients during the COVID-19 pandemic.…”

“…To the Editor, It is with great interest that we read the article by Perisetti and Goyal, entitled "Successful Distancing: Telemedicine in Gastroenterology and Hepatology during the COVID-19 Pandemic," which discussed the importance of integrating telemedicine platforms with gastroenterology care in the context of limited interactions between inflammatory bowel disease (IBD) patients and their care providers [1]. While the paper discussed an increase in IBD patients' use of telemedicine modalities, such as online applications, it also shed light on barriers to electronic communication during this vulnerable time, citing low acceptability of telemedicine use among Black and elderly patients.…”

Optimizing Healthcare Through Digital Health and Wellness Solutions to Meet the Needs of Patients With Chronic Disease During the COVID-19 Era

“…The increased demand for remote health services due to COVID-19 spurred the largest and fastest implementation and utilization of telemedicine and digital health solutions in the US healthcare system. For example, in fields like hepatology and gastroenterology, telemedicine usage increased by 4,000% ( 11 ). Although telemedicine and digital solutions cannot completely replace all components of the healthcare experience, there are some unique advantages, such as convenience of care, face-to-face interaction, and increased access to care, which was crucial for some medical fields like mental health services ( 12 , 13 ).…”

COVID-19 and beyond: development of a comprehensive telemedical diagnostic framework

“…First of all, telediagnostic currently has more implications than teleoperation. Thus, it enables physicians to monitor patients suffering from chronic disease or even in orthopedics [ 4 , 5 ].…”