A POPULATION-BASED APPROACH TO DIGITAL OUTREACH, TRIAGE, AND MONITORING OF IBD PATIENTS DURING THE COVID-19 PANDEMIC

Atreja, Ashish; Fasihuddin, Farah; Garge, Shashank; Davidoff, Liana; Rubin, Jonathan; Kakkar, Sarthak; Wedel, Nicole; Madisetty, Divya; Singhania, Rohit; Jain, Charu Madhwani; Kurra, Sravya; Sands, Bruce

BACKGROUND: In March 2020, the Mount Sinai Health System Inflammatory Bowel Disease (IBD) center reported an increase in telephone call volume, with many IBD patients expressing anxiety about being on immunosuppressive agents during the COVID-19 pandemic. Consistent with GI society and CDC recommendations, we leveraged the Rx.Universe platform (Rx.Health, New York, NY) to rapidly design and deliver a population-based digital navigation program (DNP) to provide outreach, remote COVID-19 symptom monitoring, triage, and Telehealth to IBD patients. METHODS: After identifying all IBD patients seen in our IBD center from Electronic Health Records (Epic Systems), we “bulk prescribed” the DNP (Rx.Health, New York NY) to 6100 patients’ smartphones. Patients were asked to reply to the prompt if they had new or worsening COVID-19 symptoms and opted-in to regular digital monitoring through an electronic patient reported outcome (ePRO) instrument. Patient data was screened by our clinical coordinators, who directly contacted patients via phone calls and scheduled testing and Telehealth visits with IBD practitioners when appropriate. RESULTS: Of the 6100 patients who were sent the DNP, 1829 patients opted-in to be regularly monitored using text-based electronic patient reported outcome (ePRO) instruments. Of those who responded affirmatively, 145 patients were identified requiring additional medical attention and were triaged using Telehealth visits. Compared to patients who chose not to opt-in, patients who opted-in were more likely to be female, white, married, on biologics, and had high inflammatory markers (Table 1). CONCLUSION: As demonstrated by the 30% of patients who opted-in to regular COVID-19 symptom monitoring, a digital navigation program population approach is an effective and efficient approach to provide continuity of care and to mitigate COVID-19 exposure in a high-risk, immunosuppressed IBD population. This scalable approach serves as a model for providing high quality, remote monitoring to patients during COVID-19 and beyond, as well as achieving “Treat to Target” goals. [Image: see text]