The Use of An EHR Patient Portal (Mychart-Epic) in Patients With Inflammatory Bowel Disease

Reich, Jason; Canakis, Andrew; Shankar, Divya; Harrington, Jill E.; Apte, Manisha; Weinberg, Janice; Jones, Eric A.; Noronha, Ansu; Wasan, Sharmeel K.; Farraye, Francis A.

doi:10.1093/crocol/otz039

Cited by 9 publications

(16 citation statements)

References 14 publications

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“…Three studies were based on one clinical trial; two of them were RCTs with two different objectives and sample sizes (Abutaleb et al, 2018; Cross et al, 2019), and the third study evaluated the telehealth intervention qualitatively (Reich et al, 2019). The quantitative studies examined the effectiveness of the following interventions: web‐guided intervention, IBD management through an electronic health record patient portal, home tele‐management, telemedicine, short message services (SMS) for remote monitoring, tele‐monitoring using a mobile application, monitoring of fecal calprotectin (an inflammatory biomarker) using a smartphone application, nurse‐led annual telephone monitoring, a secure web‐based program for medication monitoring, videoconference clinics, a decision support tool to customize self‐management, a web‐based application for monitoring disease activity, and telemedicine virtual visits.…”

Section: Resultsmentioning

confidence: 99%

“…The second qualitative study (Walsh et al, 2019) also evaluated a web‐based program that remotely assessed patient‐reported outcomes. The qualitative studies used a semi‐structured questionnaire to collect data through face‐to‐face interviews (Walsh et al, 2019) and telephone interviews (Reich et al, 2019). Both studies employed thematic analysis for the data analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The study by Bager (2014) only selected adults with IBD in remission. Disease activity characteristics were not detailed in one study (Vinding et al, 2016), whereas the study by Reich et al (2019) included participants with worsening IBD symptoms. Five of the studies focused on participants who were in a particular group of medications; aminosalicylates for adults with UC (Elkjaer et al, 2010); biologics, immunosuppressants and steroids for adults with IBD (Del Hoyo et al, 2018); infliximab for adults with CD (Pederson et al, 2012); mesalazine for adults with UC (Pederson et al, 2014); and golimumab for adults with UC (Sebastian et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…The first study (Walsh et al, 2019) evaluated the true colors ulcerative colitis web‐based program, which remotely monitored symptoms and assigned a traffic light color code based on the severity of the symptoms (green: mild symptoms, yellow: moderate symptoms, red: severe symptoms). The second study (Reich et al, 2019) evaluated the telemedicine for patients with IBD (TELE‐IBD) in which symptoms were monitored remotely, and educational text messages were provided every week or every other week. The semi‐structured questionnaire of Reich et al (2019) explored the benefits and challenges of telehealth and mHealth interventions for adults with IBD, whereas Walsh et al (2019) mainly addressed participants' perceptions about the benefits and did not include a question about the challenges of telehealth and mHealth interventions.…”

Section: Resultsmentioning

confidence: 99%

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Telehealth and mobile health interventions in adults with inflammatory bowel disease: A mixed‐methods systematic review

Davis

Ross

Adatorwovor

et al. 2020

Research in Nursing & Health

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Inflammatory bowel disease (IBD) is a chronic illness that is comprised of two major disorders: Crohn's disease and ulcerative colitis. Adults with IBD have adopted telehealth and mobile health (mHealth) interventions to improve their selfmanagement skills and symptom-monitoring. This systematic review aimed to evaluate the efficacy of telehealth and mHealth interventions and explore the benefits and challenges of these interventions in patients with IBD. This review used a convergent segregated approach to synthesize and integrate research findings, a methodology recommended by the Joanna Briggs Institute for mixed-methods systematic reviews. Databases searched included PubMed, CINAHL, Embase, Cochrane Controlled Trials Registry, and ClinicalTrials.gov. The search followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, which yielded sixteen quantitative and two qualitative articles. A narrative synthesis was performed to present the findings of quantitative and qualitative studies. Evidence from quantitative and qualitative studies was then integrated for a combined presentation. The results of quantitative analysis supported the efficacy of telehealth and mHealth interventions to improve patients' quality of life, medication adherence, disease activity, medication monitoring, disease-related knowledge and cost savings. While some participants in qualitative studies reported certain challenges of telehealth and mHealth interventions, most of the participants conferred the benefits of the interventions, including improved disease-related knowledge, communication between patients and providers, sense of reassurance, and appointment options. The evidence from quantitative and qualitative synthesis partially supported each other. 1 | INTRODUCTION Inflammatory bowel disease (IBD) is a chronic illness of the gastrointestinal (GI) tract that mainly encompasses two major disorders: Crohn's disease (CD) and ulcerative colitis (UC; Lee, Kwon, & Cho, 2018). Active inflammation of the GI tract is the key factor behind IBD (Stein & Shaker, 2015). The clinical presentation of IBD includes abdominal pain, diarrhea, bowel urgency, rectal bleeding, weight loss, nutritional deficiencies, and many other extraintestinal manifestations (Stein & Shaker, 2015). Additionally, other symptoms, such as anxiety, depression, sleep disturbances, and fatigue, are highly prevalent in adults with IBD (Conley et al., 2017). This symptom burden, coupled with the remitting-relapsing nature of the disease and many other factors, including low social and family support, female gender,

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Telehealth and mobile health interventions in adults with inflammatory bowel disease: A mixed‐methods systematic review

Davis

Ross

Adatorwovor

et al. 2020

Research in Nursing & Health

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“…We attribute these data to our proactive approach to vaccinating patients with IBD managed in our practice with standard protocols to administer indicated vaccines during patient rooming, and high rates of communication of the importance of vaccination through our EMR patient portal. With 85.5% of our participants active on an online health system communication portal, they may have received immunization reminders, which has been shown to increase vaccine uptake in patients with IBD [38,39]. Uncertainty regarding who is responsible for providing necessary vaccinations, which patients require vaccination, and patient and provider misconceptions regarding safety of vaccinations in immunosuppressed patients may contribute to suboptimal immunization rates [27,40,41].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Self-Reported Vaccination Status in a Cohort of Patients with Inflammatory Bowel Disease

et al. 2020

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Background and Aims Prevention of vaccine-preventable diseases is important in the care of patients with inflammatory bowel disease (IBD). Thus, accurate immunization histories are critical. Many providers rely on patient self-report when assessing immunization status. The primary aim of our study was to determine the accuracy of self-reported influenza vaccination status in a cohort of patients with IBD. Methods We conducted a prospective study of patients with IBD who answered a vaccination status questionnaire and compared their responses to the Wisconsin Immunization Registry, a statewide electronic immunization information system. The primary outcome was the sensitivity and specificity of self-reported influenza vaccination status. A secondary outcome evaluated the sensitivity and specificity of pneumococcal vaccination status. Results A total of 200 patients with IBD were included in the study. Documented immunization rates were 74.5% for influenza vaccinations and 79.9% for pneumococcal vaccinations. Influenza vaccination self-report had a sensitivity of 98.7%, a specificity of 90.2%, a positive predictive value (PPV) of 96.7% and a negative predictive value (NPV) of 95.8%. In comparison, the sensitivity for pneumococcal vaccination was 83.5% with a specificity of 86.2%, PPV of 96.4%, and NPV of 54.3%. Conclusions Self-reported influenza immunization status is sensitive and specific in patients with IBD. Accuracy for pneumococcal vaccination is slightly lower, but responses were notable for a high PPV. Self-report is an effective way to determine influenza immunization status and provides useful information for receipt of pneumococcal vaccine in patients with IBD.

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Remote care through telehealth for people with inflammatory bowel disease

Gordon

Sinopoulou

Lakunina

et al. 2023

Cochrane Database of Systematic Reviews

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Background People with inflammatory bowel disease (IBD) require intensive follow‐up with frequent consultations after diagnosis. IBD telehealth management includes consulting by phone, instant messenger, video, text message, or web‐based services. Telehealth can be beneficial for people with IBD, but may have its own set of challenges. It is important to systematically review the evidence on the types of remote or telehealth approaches that can be deployed in IBD. This is particularly relevant following the coronavirus disease 2019 (COVID‐19) pandemic, which led to increased self‐ and remote‐management. Objectives To identify the communication technologies used to achieve remote healthcare for people with inflammatory bowel disease and to assess their effectiveness. Search methods On 13 January 2022, we searched CENTRAL, Embase, MEDLINE, three other databases, and three trials registries with no limitations on language, date, document type, or publication status. Selection criteria All published, unpublished, and ongoing randomised controlled trials (RCTs) that evaluated telehealth interventions targeted at people with IBD versus any other type of intervention or no intervention. We did not include studies based on digital patient information resources or education resources, unless they formed part of a wider package including an element of telehealth. We excluded studies where remote monitoring of blood or faecal tests was the only form of monitoring. Data collection and analysis Two review authors independently extracted data from the included studies and assessed their risk of bias. We analysed studies on adult and paediatric populations separately. We expressed the effects of dichotomous outcomes as risk ratios (RRs) and the effects of continuous outcomes as mean differences (MDs) or standardised mean differences (SMDs), each with their 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE methodology. Main results We included 19 RCTs with a total of 3489 randomised participants, aged eight to 95 years. Three studies examined only people with ulcerative colitis (UC), two studies examined only people with Crohn's disease (CD), and the remaining studies examined a mix of IBD patients. Studies considered a range of disease activity states. The length of the interventions ranged from six months to two years. The telehealth interventions were web‐based and telephone‐based. Web‐based monitoring versus usual care Twelve studies compared web‐based disease monitoring to usual care. Three studies, all in adults, provided data on disease activity. Web‐based disease monitoring (n = 254) is probably equivalent to usual care (n = 174) in reducing disease activity in people with IBD (SMD 0.09, 95% CI −0.11 to 0.29). The certainty of the evidence is moderate. ...

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The Use of An EHR Patient Portal (Mychart-Epic) in Patients With Inflammatory Bowel Disease

Cited by 9 publications

References 14 publications

Telehealth and mobile health interventions in adults with inflammatory bowel disease: A mixed‐methods systematic review

Telehealth and mobile health interventions in adults with inflammatory bowel disease: A mixed‐methods systematic review

Accuracy of Self-Reported Vaccination Status in a Cohort of Patients with Inflammatory Bowel Disease

Remote care through telehealth for people with inflammatory bowel disease

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