Background: IBD affects 1.6 million people in the US and is associated with increased healthcare utilization. Telemedicine is an alternative healthcare delivery system which could improve outcomes and decrease costs. The objective of this study was to compare healthcare utilization 1 year before and after randomization among participants receiving TELE-IBD and standard care. Methods: The TELE-IBD study was a multicenter, randomized, controlled trial conducted over 1 year. Controls received standard care whereas TELE-IBD participants completed testing with TELE-IBD weekly (W) or every other week (EOW). Testing consisted of an assessment of symptoms, side effects, and weight, alerts to providers, action plans to participants, and educational messages. Healthcare utilization was assessed by review of the electronic medical record and categorized as office and emergency department visits, diagnostic tests, infusions, procedures and hospitalizations. Results: Total encounters increased in all groups after enrollment; increased utilization was due to significant increases in office visits, infusions, and telephone encounters (Table 1). There was no difference in total encounters between groups. Telephone calls increased significantly from baseline in TELE-IBD EOW and W; however, the difference was not significant between groups. IBD-related hospitalizations increased in controls (22 to 26) but decreased from 27 to 16 in TELE-IBD EOW and 27 to 11 in TELE-IBD W respectively (TELE-IBD W vs. controls, p <.05). Conclusion: Healthcare utilization increased in all groups and was not decreased with use of TELE-IBD. However, use of TELE-IBD W was associated with a significant decrease in IBD-related hospitalizations. Despite more frequent interactions with the care team in TELE-IBD groups, telephone and electronic communications were not increased compared to standard care. Further research is needed to determine if telemedicine can be used to decrease healthcare utilization.
