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Appl Clin Inform 2023; 14(05): 855-865
DOI: 10.1055/a-2154-9172
Research Article

A Digital Health Intervention to Improve the Clinical Care of Inflammatory Bowel Disease Patients

Rishika Chugh
1   Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, United States
,
Andrew W. Liu
2   Center for Digital Health Innovation, University of California San Francisco, California, United States
,
Yelena Idomsky
1   Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, United States
,
Olivia Bigazzi
2   Center for Digital Health Innovation, University of California San Francisco, California, United States
,
Ali Maiorano
2   Center for Digital Health Innovation, University of California San Francisco, California, United States
,
Eli Medina
2   Center for Digital Health Innovation, University of California San Francisco, California, United States
,
Logan Pierce
2   Center for Digital Health Innovation, University of California San Francisco, California, United States
3   Department of Medicine, University of California San Francisco, San Francisco, California, United States
,
Anobel Y. Odisho
2   Center for Digital Health Innovation, University of California San Francisco, California, United States
4   Department of Urology, University of California San Francisco, San Francisco, California, United States
,
Uma Mahadevan
1   Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, California, United States
› Author Affiliations
Funding This study was funded by the University of California San Francisco Digital Patient Experience Program.
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Abstract

Background Inflammatory bowel disease (IBD) is a chronic condition that requires close monitoring. Digital health virtual care platforms can enable self-monitoring and allow providers to remotely surveil patients and efficiently identify those with active disease.

Objectives The primary aim was to design and implement an IBD remote monitoring program, identify predictors of patient engagement, and determine who found the chat to be a valuable tool.

Methods We developed the IBD Virtual Care Chat, an electronic health record (EHR)-integrated chat to monitor electronic patient reported outcomes (ePROs), medication changes, and disease activity, and subsequently report concerning findings to providers via the EHR. All patients in the IBD practice over age 18 with a clinical encounter in the preceding 12 months were eligible to be enrolled. The primary aim was to identify predictors of patient engagement and determine who found the chat to be a valuable tool.

Results Between May 2021 and March 2022, 2,934 patients were enrolled. A total of 1,160 engaged at least once and 687 (23.4%) continually engaged, submitting at least three ePROs. Disease severity (based on Harvey–Bradshaw Index or Simple Clinical Colitis Activity Index) did not impact ePRO submissions. Patients were significantly more likely to be continually engaged if they self-reported the presence of extraintestinal manifestations (7%, 95% confidence interval: 0.01–0.14; p = 0.04). Patient satisfaction remained moderately high with a median score of 8 (interquartile range: 5–10) on a scale of 1 (poor) to 10 (good).

Conclusion Our program demonstrates the potential for EHR-integrated digital health as part of routine IBD care to achieve sustained engagement with high patient satisfaction.

Keywords

inflammatory bowel disease - digital health - remote patient monitoring - telemedicine

Protection of Human and Animal Subjects

This study was approved by the institutional review board.


Authors' Contributions

R.C.: Conceptualization, data curation, formal analysis, investigation, writing—original draft, writing—review and editing; A.W.L.: project administration, data curation, formal analysis, investigation, writing—original draft, writing—review and editing; Y.I.: data curation, resources; O.B.: funding acquisition, conceptualization, methodology, project administration; A.M.: conceptualization, investigation, visualization; E.M.: funding acquisition, project administration; L.P.: data curation, formal analysis, review and editing; A.Y.O.: funding acquisition, resources, conceptualization, methodology, investigation, formal analysis, writing—review and editing, supervision; U.M.: conceptualization, methodology, investigation, writing—review and editing, supervision.


Supplementary Material



Publication History

Received: 08 February 2023

Accepted: 14 August 2023

Accepted Manuscript online:
16 August 2023

Article published online:
25 October 2023

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