Transforming Gastroenterology Care With Telemedicine

Abstract Healthcare is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective and, importantly, high-quality methods to care for patients. We teach medial students that optimal patient care requires face to face interactions, to collect information on patients’ history, and the physical examination. However, management of many patients—especially those with chronic diseases—does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push towards efficiency and value, but also requires the belief that excellent patient care is not always provided in person. Telemedicine can include a variety of aspects of patient care adapted to be performed remotely, such as telemonitoring, tele-education, teleconsulting, and telecare. All of these have been evaluated in gastroenterology practice and have demonstrated feasibility and patient preference, but have produced mixed results regarding patient outcomes. By combining telemedicine tools and new care models, we can redesign chronic disease management to include fewer in-person visits when patients are well, yet increase access for patients who need to be seen. This change could lead to higher-value care, by improving the experience of care, decreasing costs, and improving health of the population. Barriers include reimbursement, licensing, and fear of litigation. However, if we hope to meet the needs of patients within our changing healthcare system, telemedicine should be incorporated into our strategy.