*Dartmouth Geisel School of Medicine, Hanover, New Hampshire; and †Dartmouth-Hitchcock Inflammatory Bowel Disease Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Inflamm Bowel Dis. 2017 Oct;23(10):1678-1681. doi: 10.1097/MIB.0000000000001210.
Patients with inflammatory bowel disease (IBD) require regular follow-up to manage their care, which requires significant amount of time and out-of-pocket costs. Telemedicine in the form of video virtual visits could serve as an alternative to in-office visits. The aim of this project was to understand if telemedicine can provide high value care (defined as quality/cost) to outpatients with IBD.
Patients who participated in the IBD telemedicine clinic in the second half of 2015 were included. Patient-reported survey data before and after the virtual visit were collected. A retrospective review was performed on the study cohort for quality outcome measures a year before and after starting the telemedicine clinic. Outcomes were analyzed using simple descriptive statistics. Differences in quality outcomes were compared using odds ratios.
Forty-eight patients were included in the analysis. Most patients travel more than 25 miles each way, take half a day off, and on average incur an additional out-of-pocket cost of $62 for an in-office visit. Most patients (98%) agreed that there was enough time spent with their physician, 91% agreed that they felt like the physician understood their disease state, and 78% reported that they clearly understood the follow-up plan after the visit. Analysis of quality outcome measures did not show any drop in the overall quality of care, after initiating the telemedicine program.
Telemedicine offers a low cost and convenient alternative for patients with IBD without compromising quality of care.
炎症性肠病（IBD）患者需要定期随访以管理其病情，这需要大量的时间和自付费用。视频虚拟就诊形式的远程医疗可以作为门诊就诊的替代方式。本项目旨在了解远程医疗是否可以为 IBD 门诊患者提供高价值的护理（定义为质量/成本）。
纳入 2015 年下半年参加 IBD 远程医疗诊所的患者。收集虚拟就诊前后患者报告的调查数据。对研究队列进行回顾性研究，以评估远程医疗诊所开设前后一年的质量结果指标。使用简单描述性统计分析结果。使用优势比比较质量结果的差异。
共纳入 48 例患者进行分析。大多数患者往返路程超过 25 英里，需要请半天假，并且每次门诊就诊的自付费用平均增加 62 美元。大多数患者（98%）认为与医生的交流时间足够，91%的患者认为医生了解他们的病情，78%的患者表示在就诊后清楚了解了随访计划。在启动远程医疗项目后，对质量结果指标的分析并未显示整体护理质量下降。
远程医疗为 IBD 患者提供了一种低成本、便捷的替代方式，同时不会降低护理质量。
