42 - Evaluating the Use of an On-Demand Telehealth Platform as a Mechanism to Prevent Emergency Department (ED) Visits for Patients Presenting With Gastrointestinal (GI) Symptoms

Russ R. Arjal, MD¹, Chad Ellimoottil, MD, MS², Jason Sugar, MD³, Fred B. Rosenberg, MD¹, David R. Beswick, MD¹, Naresh T. Gunaratnam, MD^4
1WovenX Medical Group, Chicago, IL; ²University of Michigan, Ann Arbor, MI; ³Washington Gastroenterology, Bellevue, WA; ⁴MNGI Digestive Health, Ann Arbor, MI

Introduction: Gastrointestinal (GI) disorders represent the leading cause of treat-and-release visits from emergency departments (ED) across the US, resulting in significant healthcare expenditures. More than 15 million patients present to the ED annually with GI ailments, however, < 20% of these cases require admission. We assessed the feasibility of diverting patients with GI concerns to more appropriate sites of service using an on-demand virtual platform.

Methods: Established patients of a community-based single-specialty GI group were included in the study and given access to an on-demand virtual platform staffed by GI-trained advanced practice providers from January 24 through April 12, 2024. Using the platform data, we retrospectively assessed user demographics and visit characteristics. Using a post-visit survey of patients and providers, we assessed patient experience and which alternative sites of service patients would have selected if the on-demand service had not been available, and analyzed provider recommendations.

Results: During the study period, 501 patients accessed the on-demand service. Median wait time for a visit was 5.8 minutes with a median visit length of 21 minutes. Median age was 53 y (range, 18-90 y) and 65.9% were female. The most common primary clinical indications were abdominal pain, GERD/dyspepsia, dysphagia/odynophagia, diarrhea, and inflammatory bowel disease (Figure 1). 97.8% of visits were deemed appropriate for an initial telehealth encounter by a supervising board-certified gastroenterologist. The most common referral sources were the practice call center (42.4%), practice website (24.2%), and practice triage nurse (21.2%). Visits resulted in blood work (27.9%), imaging (17%), and endoscopic procedures (30.1%). 47.5% of patients received a recommendation for ongoing GI care.

14% of patients responded to a post-visit survey. Of patients who responded to the survey, 44.3% reported they would have considered using an ED or urgent care, yet only 2% of all patients were directed to do so at the conclusion of the visit. 35.7% of patients reported they would have consulted with their PCP, and 18.6% reported they would have sought appointments with other GI groups had this service not been available.The Net Promoter Score from surveyed patients was 94/100.

Discussion: Our findings suggest that using an on-demand telehealth platform for patients with GI symptoms can redirect patients from the ED and urgent care while promoting patient satisfaction.



Disclosures:


Russ R. Arjal, MD¹, Chad Ellimoottil, MD, MS², Jason Sugar, MD³, Fred B. Rosenberg, MD¹, David R. Beswick, MD¹, Naresh T. Gunaratnam, MD⁴, 42, Evaluating the Use of an On-Demand Telehealth Platform as a Mechanism to Prevent Emergency Department (ED) Visits for Patients Presenting With Gastrointestinal (GI) Symptoms, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.