Virtual Multidisciplinary Gastrointestinal Care for Adults With Gastrointestinal Needs: Retrospective Cohort Study

Area of Science:

• Gastroenterology and Hepatology
• Digital Health and Telemedicine
• Integrated Care Models

Background:

• Gastrointestinal (GI) disorders are common, complex, and costly, necessitating multidisciplinary GI care (MGC).
• Access to traditional MGC is limited by specialist availability, highlighting the need for innovative care delivery models.
• The effectiveness and patient engagement in large-scale virtual MGC programs remain under-explored.

Purpose of the Study:

• To characterize patient demographics, engagement patterns, and outcomes within a large-scale virtual MGC program.
• To evaluate the mediating role of dietitian and behavioral health support in the relationship between medical engagement and symptom improvement.
• To assess the feasibility and effectiveness of delivering integrated GI care remotely.

Main Methods:

• Retrospective cohort study of 11,345 adult patients utilizing virtual MGC services.
• Interventions included virtual onboarding, synchronous telehealth, and asynchronous chat for medical, dietary, and behavioral support.
• Data analysis involved descriptive statistics, logistic regression, and path analysis across imputed datasets to assess outcomes like symptom control and improvement.

Main Results:

• The virtual MGC program served a diverse patient population, with Disorders of Gut-Brain Interaction and Gastroesophageal Reflux Disease being primary conditions.
• Increased utilization of GI provider, dietitian, and behavioral health services correlated significantly with improved symptom control and patient-reported outcomes.
• Path analysis confirmed that engagement with GI advanced practice providers (APPs) facilitated increased use of supportive services, leading to symptom improvement.

Conclusions:

• A virtual-first MGC model is feasible and effective for managing a wide range of GI conditions at scale.
• Integrated care, facilitated by medical engagement, enhances the utilization of nutritional and behavioral interventions, improving patient outcomes.
• This scalable virtual MGC model addresses specialist shortages, expanding access to high-quality GI care irrespective of patient location.