Sara Horst, MD, MPH: Telehealth’s Impact on Patient Retention in IBD

Presented at the 2024 Crohn’s and Colitis Congress in Las Vegas this weekend, findings from a recent study are reinforcing the viability of telehealth for patient retention, specifically for those with inflammatory bowel disease (IBD).

Although the COVID-19 pandemic necessitated the implementation of telehealth across many healthcare settings, the option to receive remote care is still offered at various institutions in the post-COVID era, prompting speculation about its impact on patient care.

A team of investigators led by Sara Horst, MD, MPH, ​​associate professor in the division of gastroenterology, hepatology, and nutrition at Vanderbilt University Medical Center, sought to examine the use of telehealth among patients with IBD at a single tertiary care center from January 2018 to March 2020 and August 2020 to January 2023, excluding individuals seen between March 2020 and July 2020 due to institution-mandated telehealth visitation.

“I am in a center where we have a really large catchment area, so we have a lot of patients who are living 2 or 3 or even 4 hours away, and they're sick, and they are on chronic immunosuppressive or immuno-modulating medications. We need to see them frequently,” Horst said in an interview with HCPLive, explaining the importance of finding ways to continue to offer care to these patients and increase retention rates.

Data was obtained from patients’ electronic medical records, only including office visits for those seen by an MD or APP. Drive time in minutes was established based on patient addresses using Esri geographic information systems data, services, and software.

A total of 7040 patients were included in the analysis. The majority of participants were female (56%), White (89%), and had commercial health insurance (76%).

New patients seen in the post-COVID period had shorter drive times than those seen in the pre-COVID period. Patients who had ≥ 1 year of follow-up were more likely to be seen as a return visit in the post-COVID period (84%) versus the pre-COVID period (76%; P <.05). In the post-COVID period, 62% of patients had return IBD care by their MD or APP team delivered via telehealth.

Investigators highlighted significantly longer drive times among patients seen in telehealth (56.3 minutes; Interquartile range [IQR], 93.3) compared to in-clinic-only patients (47.9 minutes; IQR, 89.7; P <.001), noting this trend was observed for both the telehealth patients who had been seen in-clinic in the pre-COVID period as well as patients who were seen only in the post-COVID period.

Additionally, patients who continued care only with in-clinic visits in the post-COVID period had significantly shorter drive times than patients who were seen in-clinic pre-COVID (38.8 minutes; IQR, 60 vs 54.2 minutes; IQR, 89.9; P <.001).

The editorial team of HCPLive Gastroenterology sat down with Horst to discuss the study’s design, important takeaways from this research, and current limitations hindering the wider implementation of telehealth.

Reference:

Olson J, Beaulieu D, Bennett A, et al. Telehealth Enhances Retention of Patients With Inflammatory Bowel Disease Within A Tertiary Care Inflammatory Bowel Disease Center. Presented at: Crohn’s and Colitis Congress. Las Vegas, NV. January 25-27, 2024.