No matter where a patient lives, it is essential that they can access their healthcare team. Early disease detection and timely IBD care can improve overall quality of life, and reduce the need for invasive and expensive surgeries. However, there is significant disparity in access to specialized IBD care between urban and rural communities across Canada. IMAGINE Network’s partner, Crohn’s and Colitis Canada has embarked on an innovative project to improve access to quality IBD care for individuals living in rural and remote communities throughout Ontario. As a participant site within the Promoting Access and Care through Centres of Excellence (PACE) network, Mount Sinai Hospital (led by Dr. Geoff Nguyen) is conducting eVisits through the newly launched telemedicine program for adult patients living with Crohn’s disease and Ulcerative Colitis who reside in underserviced locations throughout Ontario. Eligible individuals:
- Have a diagnosis or Crohn’s disease or ulcerative colitis;
- Live at least 100 km outside of Toronto; and
- Require, but are not currently receiving, care from an IBD specialist OR are currently a patient at the IBD Centre of Excellence at Mount Sinai Hospital.
Patients in the IBD telemedicine program have access to real-time medical consultations from Gastroenterologists who specialize in IBD management. Telemedicine essentially involves a health care specialist speaking to a patient through videoconferencing technology similar to Skype or FaceTime, but within a secured computer network. A telemedicine eVisit is similar to a regular office visit. The only difference is the doctor sees and talks to his or her patient through a television or computer screen. These eVisits allow people with Crohn’s or colitis to receive consultations and follow-up appointments without the need to leave their communities. Through the use of this technology, this program endeavors to minimize the disruption, stress and cost that can be associated with travel to Toronto for IBD-related medical appointments.
In the past year, researchers increased the number of IBD patients accessing telemedicine from 50 to 128, and increased the number of IBD Ontario Telemedicine Network (OTN) locations from 33 to 55. The PACE telemedicine program has also enabled new IBD consultations to be scheduled within approximately 17 days of referral, and 83% of patients with active IBD symptoms are seen within 2 weeks.
Since the program’s launch, the telemedicine team has connected patients with specialists in over 70 host sites across Ontario. Whether it is providing a student away from home with access to their medication, or helping a senior with limited mobility in a rural community, the program ensures patients receive care that they might not otherwise be able to access. Through Ontario Telemedicine Network centres, these patients met with specialty care teams including gastroenterologists, colorectal surgeons, nurses, and dietitians. In some cases, patients have been able to receive specialty care within a week, which is considerably less than the two-to-three-month wait period many patients face.
The success of the Telemedicine Program over the past two years has been remarkable, and is growing. The program has recently begun facilitating easy, at-home video conferencing. Led by Dr. Vivian Huang, and designed particularly for high-risk pregnancies, it is a novel and welcome approach to providing specialty services. The adoption of a digital self-monitoring app in IBD care within the Telemedicine Program is also an exciting new development. The app allows patients to regularly track their symptoms and communicate them back to their IBD team. The IBD Telemedicine Program recently expanded to the Thunder Bay area via Dr. Petros Zezos, a gastroenterologist and hepatologist with a long-term interest in IBD. Dr. Zezos and Registered Nurse Shelley Bouchard met with people in the community who are impacted by IBD, with the support of the Thunder Bay Chapter of Crohn’s and Colitis Canada to field questions from the audience about treatment options, research directions, nutrition, and medicinal marijuana and helped researchers learn more about the needs of patients in Thunder Bay.
Given the tremendous success of the Telemedicine Program, Dr. Nguyen and Ms. Bouchard are now working with other PACE Centres of Excellence to make similar programs available to IBD patients across the country. A clinical trial evaluating telemedicine offerings is underway in Ontario with a view to expand the program across the country. The Telemedicine Program is one way that IMAGINE Network and CCC’s PACE projects making strides in improving IBD patient outcomes.
