Influence of Telemedicine-first Intervention on Patient Visit Choice, Postvisit Care, and Patient Satisfaction in Gastroenterology

Munroe, Craig A.; Lin, Teresa; Rouillard, Smita; Fox, Jeffrey H.; Lee, Jeffrey K.; Corley, Douglas A.

doi:10.1053/j.gastro.2020.10.020

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…A cohort study of 48 patients with IBD analyzed the quality outcome and did not show any drop in the overall quality of care after initiating the telemedicine program [23]. Finally, a recent cross-over study of 4890 patients with IBD found no changes in outcomes or care use related to medical decision-making, time to appointment or patient satisfaction [24]. Our study did not assessed the quality of care.…”

Section: Discussionmentioning

confidence: 76%

French experience with telemedicine in inflammatory bowel disease: a patients and physicians survey

Guillo

Bonnaud

Nahon

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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Background and aims The use of telemedicine dramatically increased during the COVID-19 pandemic. We collected patients and physicians experience on telemedicine in the field of inflammatory bowel disease (IBD). Methods We conducted a nationwide survey between September 2020 and January 2021. A self-administered questionnaire was sent to participants through mailing lists of the national patients' association and IBD expert groups. Results Overall, 300 patients and 110 gastroenterologists filled out the survey. On a 10 points scale of satisfaction with telemedicine, 60% of patients noted a score ≥8 and 52.7% of physicians ≥7. Patients and gastroenterologists felt that the duration of teleconsultations appeared to be shorter than in-person visits in 57.5 and 55.1% of cases, respectively. All participants agreed that telemedicine is appropriate in dedicated situations and not for flare-up consultations. For 55.1% of patients, quality of care was the same via telemedicine, whereas 51.4% of gastroenterologists believed they managed less well their patients. Lack of clinical examination being pointed out as the main limitation of telemedicine. Three-quarters of patients and gastroenterologists would agree to use telemedicine more often in the future. Conclusion Patients and gastroenterologists were satisfied with telemedicine and would be willing to use it in the future. However, telemedicine does not replace in-person visits and should be discussed on a case-by-case basis.

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Section: Discussionmentioning

confidence: 76%

French experience with telemedicine in inflammatory bowel disease: a patients and physicians survey

Guillo

Bonnaud

Nahon

et al. 2021

European Journal of Gastroenterology &Amp; Hepatology

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“…Patients not previously seen by surgery were provided the opportunity for consultation for LHM. After the first 4 POEM procedures in January of 2019, subsequent patients were offered telehealth consultations for pre-procedural and post-procedural ambulatory encounters; thereby facilitating care when patients would otherwise need to travel long distances [ 20 ]. With the declaration of the coronavirus disease 2019 pandemic (COVID-19) in March of 2020, telemedicine was utilized exclusively for outpatient care.…”

Section: Methodsmentioning

confidence: 99%

Successful Design and Implementation of a POEM Program for Achalasia in an Integrated Healthcare System

et al. 2023

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Background Per Oral Endoscopic Myotomy (POEM) is a minimally invasive treatment for achalasia with results comparable to laparoscopic Heller myotomy (LHM). Studies have described the development of proficiency for endoscopists learning to perform POEM, and societies have defined educational and technical objectives for advanced endoscopy fellows in training. However, there is limited guidance on the organizational strategy and educational plan necessary to develop an achalasia service with POEM expertise. Aims We aim to outline the steps for design and implementation of a successful POEM program. Methods We reported our experience developing a multi-disciplinary clinical program for POEM and the steps taken to achieve procedural proficiency. We also reported our technical success (successful tunneling into the gastric cardia and myotomy of LES muscle fibers) and clinical success (post-procedure Eckardt score ≤ 3) at 3–6 months and 12 months post-procedure. Adverse events were classified per the ASGE lexicon for endoscopic adverse events. Results After creating a multi-disciplinary clinical program for achalasia and completing procedural proficiency for POEM, our technical success rate was 100% and clinical success rate 90% for the first 41 patients. One adverse event (2.4%) occurred, moderate in severity per the American Society of Gastrointestinal Endoscopy (ASGE) lexicon for adverse endoscopic events. Conclusion In this study, we outlined the steps involved to establish a POEM service in a large integrated healthcare system. Prior competency in interventional endoscopy, procedural training models, POEM observation and education, proctorship, and interdisciplinary patient care are recommended.

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“…Participation rates, quality of life and 90-d hospital re-admission rates were compared, with lower re-admission rates at 90 d (28% vs 58%, P = 0.004) and improved quality of life with regards to physical function and general health in the telemedicine group. Munroe et al [ 87 ] designed a single-arm, crossover study during the COVID-19 pandemic. A telemedicine consult, via phone or video call, was offered to patients referred to the practice; patients could accept a virtual consult or request a review in person.…”

Section: The Effect Of Covid-19 On Gastroenterology and Hepatology Servicesmentioning

confidence: 99%

COVID-19: Effect on gastroenterology and hepatology service provision and training: Lessons learnt and planning for the future

Anjum¹,

Chalmers²,

Hamid³

et al. 2021

WJG

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In late 2019, reports arose of a new respiratory disease in China, identified as a novel coronavirus, severe acute respiratory syndrome coronavirus 2. The World Health Organisation named the disease caused by the virus ‘coronavirus disease 2019 (COVID-19)’. It was declared a pandemic in early 2020, after the disease rapidly spread across the world. COVID-19 has not only resulted in substantial morbidity and mortality but also significantly impacted healthcare service provision and training across all medical specialties with gastroenterology and Hepatology services being no exception. Internationally, most, if not all ‘non-urgent’ services have been placed on hold during surges of infections. As a result there have been delayed diagnoses, procedures, and surgeries which will undoubtedly result in increased morbidity and mortality. Outpatient services have been converted to remote consultations where possible in many countries. Trainees have been redeployed to help care for COVID-19 patients in other settings, resulting in disruption to their training - particularly endoscopy and outpatient clinics. This has led to significant anxiety amongst trainees, and risks prolongation of training. It is of the utmost importance to develop strategies that continue to support COVID-19-related service provision, whilst also supporting existing and future gastroenterology and Hepatology services and training. Changes to healthcare provision during the pandemic have generated new and improved frameworks of service and training delivery, which can be adopted in the post-COVID-19 world, leading to enhanced patient care.

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Influence of Telemedicine-first Intervention on Patient Visit Choice, Postvisit Care, and Patient Satisfaction in Gastroenterology

Cited by 3 publications

References 8 publications

French experience with telemedicine in inflammatory bowel disease: a patients and physicians survey

French experience with telemedicine in inflammatory bowel disease: a patients and physicians survey

Successful Design and Implementation of a POEM Program for Achalasia in an Integrated Healthcare System

COVID-19: Effect on gastroenterology and hepatology service provision and training: Lessons learnt and planning for the future

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