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Mount Sinai Uses Telehealth to Improve Care Management for IBD Patients

August 06, 2019

New York's Mount Sinai Health System is using a telehealth platform to boost care management for patients at its IBD medical home, giving both them and their care providers more opportunities to collaborate.

In late 2016, the hospital’s IBD medical home, which treats roughly 7,000 people dealing with chronic conditions like ulcerative colitis and Crohn’s disease, launched a connected health platform developed by MediSprout. The audio-visual telemedicine service enables patients to connect with care providers when needed, instead of waiting for an in-person appointment every six months.

That’s a huge benefit for the hospital’s patients, many of which are young and active, unsure of how to manage care for a health condition that can be suddenly very debilitating, and in need of guidance on everything from nutrition to mental health care.

“These are young patients who need a lot of help navigating the healthcare system,” says Laurie Keefer, an academic health psychologist and the director for psychobehavioral research within Mount Sinai’s Division of Gastroenterology who works at the IBD medical home. “We have to provide a lot of self-management training, even assertive training.”

Telehealth is a vital tool for care management of the health system’s IBD patients, Keefer says, because it’s on-demand. A patient suddenly stricken with urgent diarrhea can connect with a care provider for treatment options and medication advice rather than going to the nearest emergency room or urgent care clinic.

The platform also allows providers to manage patients over the long term, developing a care plan that might reduce flare-ups and improve health and wellness. And unlike the hurried, unscheduled phone calls that the center used to get, the mHealth sessions are billable.

“You’re working with them,” Keefer says. “Seeing them every six months in person isn’t really moving the needle.”

But when in-person visits are combined with virtual visits, Keefer says, providers can manage care over time, rather than in small episodes, and gain insight into a patient’s home environment, and how that might figure into treatment. They can also loop in other members of the care team, such as nutritionists and social workers.

Keefer says the telehealth platform also enables care providers to schedule and manage more meetings with patients, giving them the opportunity to connect with more people more often while fine-tuning the daily workflow.

“I can also see patients when I want,” she adds, noting she’ll schedule video sessions on Wednesdays when she works from home.

Going forward, Keefer wants to “keep pushing the envelope” on care management, giving patients and their care providers new opportunities to improve treatment. She’s starting to look at hypnosis, and there are studies underway focusing on how mHealth wearables might be used to gather data and track symptoms.

They might also – someday – integrate the telemedicine platform with other records platforms, such as the electronic health record. For now, the service is a stand-alone one, accessible through an app that can be a little clunky at times, especially for new patients.

“It’s more about finding the right fit for us right now,” Keefer says.

And taking gradual steps toward better care management for a group of patients that could use a little help beyond the phone call.

 

By Eric Wicklund