Telemedicine in the Management of Inflammatory Bowel Disease: An Update

Figures & data

Figure 1 Different models of telemedicine. (A) Communication between the patient and clinical care team using electronic technology, for example, mobile phone. (B) Telehealth visit with both the patient and provider using computers to interact. (C) Tele-consultation with providers utilizing electronic technology to communicate. Reprinted from Clin Gastroenterol Hepatol, 15, Cross RK, Kane S, Integration of telemedicine into clinical gastroenterology and hepatology practice, pages no:175–181, copyright (2017), with permission from Elsevier.⁸

Figure 2 Representation of myIBDcoach depicting monitoring, personal care plan, e-learning modules, and communication between the patient and provider. de Jong M, van der Meulen-de Jong A, Romberg-Camps M, et al. Development and feasibility study of a telemedicine tool for all patients with IBD: myIBDcoach. Inflamm Bowel Dis. 2017;23:485–493, by permission of Oxford University Press.²⁸

Table 1 Pros and Cons of Telemedicine in the Management of Inflammatory Bowel Disease

Pros	Cons
Cost savings for patients	Reticence amongst providers to use the new technology due to increased non-reimbursed work generated by enhanced monitoring
Improved efficiency for patients and providers	Inability to perform physical exam
Allows for disease monitoring between office/telehealth visits	Rapidly changing rules and regulations regarding use of telemedicine
Provides an additional mechanism for education and links to resources for patients	Potential for hardware or software failure during visits
Facilitates communication between patients and healthcare teams	Lack of integration for remote monitoring systems into most electronic medical records
Allows consultation between local providers and distant providers with expertise in IBD care	Privacy/cybersecurity concerns
Improves access to care for patients living in rural areas or locations without IBD specialty care	Need for informed consent
Can be used to integrate multidisciplinary IBD care	Requirement by many states for provider to be licensed in the state the patient resides in
Decreases perceived barriers between patients and the healthcare team	Inability to bill at equal levels for telehealth compared to office visit

Table 2 Main Applications of Telemedicine in Inflammatory Bowel Disease

Application	Article
Disease monitoring	1. At-home detection of fecal calprotectin (Heida, et al) 2. Telepathology (Odze, et al)
Remote monitoring	1. Project Sonar (Kosinski, et al) 2. GI Buddy (Ehrlick, et al) 3. HealthPROMISE (Atreja, et al) 4. Laptop and electronic scale (Cross and Finkelstein) 5. UC HAT (Cross, et al) 6. Constant Care (Elkjaer, et al) 7. TELE-IBD study (Cross, et al) 8. myIBDcoach (de Jong, et al)
Telehealth	1. VA study (Krier, et al) 2. Dartmouth-Hitchcock Medical Center (Li, et al) 3. Feasibility study (Cross and Kane)
Teleconsultation	1. IBD Live (Regueiro, et al)