Improving pediatric Inflammatory Bowel Disease (IBD) follow-up

Area of Science:

• Pediatric Gastroenterology
• Health Services Research
• Digital Health

Background:

• Standardized Inflammatory Bowel Disease (IBD) care via the ImproveCareNow (ICN) Network has improved pediatric outcomes, but progress has plateaued.
• Current ICN guidelines recommend biannual health supervision visits, yet gaps exist in timely follow-up, especially after disease flares or interventions.
• Telemedicine offers a potential solution to address these care gaps in pediatric IBD management, despite limited prior use.

Purpose of the Study:

• To implement and evaluate a multi-step telemedicine approach for pediatric IBD follow-up care.
• To improve timely reassessment of patients with active disease and enhance routine follow-up scheduling.
• To assess the impact of telemedicine on patient access, care quality, and resource utilization.

Main Methods:

• Utilized the Plan-Do-Study-Act (PDSA) model for improvement.
• Implemented a pilot program offering e-visits and e-messaging for pediatric IBD patients.
• Tracked key metrics including follow-up completion rates, e-visit/e-messaging volume, patient portal adoption, and adverse events.

Main Results:

• Patient portal adoption increased from 20% to 70% median within six months.
• E-messaging use grew from 5 to 76 messages/month, and 32 e-visits replaced traditional appointments.
• Telemedicine effectively managed medications, nutrition, and disease activity, with no increase in unplanned visits or emergency department encounters.

Conclusions:

• Telemedicine, including e-visits and e-messaging, successfully enhanced access and care delivery for pediatric IBD patients.
• This novel approach maintained care standards, improved patient convenience by enabling home-based visits, and demonstrated cost-effectiveness.
• Continued use of telemedicine in pediatric IBD is anticipated to improve remission rates and patient-reported outcomes through timely treatment adjustments.