Telephone Encounters in Inflammatory Bowel Disease (IBD) Care: Burden, Risk Factors, and Opportunities for Intervention

Abstract

Telephone communication is an integral part of modern life in the USA, including health care. Telephone communication among patients, care providers, pharmacies, and insurers is now an established interchange in health care, and this is especially true for the care of chronic illness, including the inflammatory bowel diseases (IBDs). Telephone encounters in the care of patients with IBD have taken on further importance, in part due to the younger age demographic of this patient population and their comfort and familiarity with technology, as well as the acuity and severity of these diseases and their need to interact with health care. Telephone communication in IBD is multidirectional and involves patient contacting care providers with questions and clinical status updates as well as the background communication among the health-care providers, pharmacies, and payors (i.e., insurance companies) for authorization of prescriptions, diagnostic testing, and procedure scheduling. A comprehensive evaluation on the spectrum of telephone activity in IBD management was recently conducted by our center, and the findings indicate that the volume of telephone activity is double the number of clinic encounters. Furthermore, the record of telephone encounters embedded in the electronic medical record functioned as a robust indicator of clinical status. Stratification of IBD patients by patterns of annual telephone activity demonstrated that a subset of patients is responsible for the majority of telephone encounters, and these patients reflect a heterogeneous complexity of illness.