Novel tool may improve follow-up in IBD patients
Click Here to Manage Email Alerts
Using a novel clinical pathway integrated into the electronic medical record, researchers were able to identify patients with inflammatory bowel disease who were overdue for medical follow-ups, according to data presented at the ACG Annual Scientific Meeting.
“Both the unpredictable relapsing nature of IBD as well as discordance between subjective symptoms and underlying levels of inflammation make patients less likely to attend routine office visits, and we may miss critical opportunities to improve disease control and avoid complications,” Matthew K. Schroeder, MD, a chief resident in internal medicine at UT Southwestern Medical Center, said during a virtual poster presentation. “We aimed to develop a tool in the EMR that can assist providers and clinic staff in identifying individuals who are overdue for follow-up based on individualized risk assessment.”
The researchers identified patients with IBD using SNOMED CT terminology for Crohn’s disease and ulcerative colitis who were being treated with least one disease-specific IBD therapy and enrolled them into a clinical pathway integrated into the EMR (Epic Hyperspace), which then identified patients overdue for a follow-up. New patients were automatically enrolled into the pathway as they were seen in the clinic and were immediately stratified into three categories — high-risk, medium-risk and low-risk — based on their current drug therapy treatments and prescriptions. Overdue follow-ups for each category were defined as 3 months for high-risk, 6 months for medium-risk and 12 months for low-risk patients.
According to the data, 925 patients with IBD (median age, 44 years; 58.3% with Crohn’s disease) were initially included on the pathway. Using the tool, the researchers found that 20.6% of the total study population was overdue for a follow-up. When broken down according to risk, 28.4% of high-risk patients, 16.5% of medium-risk patients and 29.5% of low-risk patients were overdue for a follow-up.
“The largest contributor of overdue follow-up came from our medium-risk group of patients who were on biologic or immunomodulator therapy,” Schroeder said.
Schroeder noted that a dynamic report generated by the clinical pathway can easily identify patients who are overdue for follow-up and can sort patients by risk group or length of overdue follow-up.
“Using this dynamic report, we plan to reduce the number of patients with overdue follow-up by direct contact or notification within the patient portal to reschedule clinic visits,” Schroeder said. “We plan to further expand the application of this integrated tool for drug safety monitoring, objective markers of inflammation and health maintenance goals.”
Collapse
Schroeder M.K, et al. Automated clinical pathway utilizing custom risk stratification identifies substantial rates of overdue follow up and facilitates population health interventions Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).
Click Here to Manage Email Alerts