How Telemedicine Can Be Effective If You Have IBD

Seeing a practitioner via video call can helpful for people with IBD

Telehealth appointments are an increasingly popular way to interact with medical specialists, including those that treat chronic illnesses such as inflammatory bowel disease (IBD), Crohn’s disease, or ulcerative colitis.

How to Make the Most of Telehealth IBD Appointments
Verywell / Julie Bang

What Is Telemedicine?

Telemedicine is a broad term that encompasses the use of various forms of telecommunication—including telephone, video calls, texts, email, patient portals, and social media—for health care. There are a variety of tools available where you and your provider can see and hear each other over video or send real-time messages back and forth.

Healthcare providers may use a telehealth appointment to follow up after an in-person office visit, for example, which helps you avoid travel time or taking time off from work. Some practitioners may decide to use telehealth only in certain circumstances or may require a certain ratio of in-person to online visits.

2:04

What is Telemedicine?

If you require therapeutic monitoring for your IBD, such as bloodwork or a stool sample or urine sample, you will need to go to your healthcare provider's office or a testing facility.

How Telemedicine Can Help People With IBD

Telehealth may be cost-effective for people who have specific medical needs. For example, IBD can be challenging to treat, and people with the condition usually see their healthcare providers often for the prevention of flare-ups and when coping with a flare-up.

Healthcare systems may find that more frequent check-ins with people who live with chronic illnesses, such as IBD, could prevent the need for more extensive treatments.

Telemedicine may be especially useful for those who live in rural areas. In some regions, not only are there no local IBD specialists or centers, but it may require a long drive just to see a gastroenterologist. In this situation, bringing an IBD specialist into the team via telemedicine can offer some much-needed expertise.

Tips to Make the Most of Telehealth Appointments

Even people who have had a lot of medical care in person might not be familiar with the process of a telehealth visit.

Here are some ways to help the visit go smoothly:

  • Fill out all the necessary paperwork: Just as there is paperwork to be completed at every in-person visit, paperwork or online forms must be completed before a telehealth visit. If all the necessary forms aren’t completed before the visit, there’s a risk of not being able to have the appointment or having difficulties with insurance coverage.
  • Contact the insurance company: Before a telehealth appointment, especially if it is with a new practitioner, call your insurance company to find out if there are any costs that you're responsible for. Copay, coinsurance, and deductible structures may be different for telehealth visits.
  • Practice with the telehealth tool prior to the appointment: It may be necessary to download some software or a plug-in. Doing this before the visit will help you navigate technical problems in advance. Call the practitioner’s office or insurance provider if you have any questions about how to use the technology.
  • Create the right space for the visit: A quiet room with privacy and minimal distractions is ideal for your telehealth visit.
  • Prepare as if it is an in-person visit: Be on time for your appointment and have notes and questions on hand. Bring your medications to show your provider so your refills will be processed in a timely way.

The main difference between an in-person and a telehealth visit is that a practitioner can’t conduct a hands-on physical exam during a telehealth appointment.

You can also use our downloadable Doctor Discussion Guide below, which can help you prepare by teaching you relevant terminology, suggesting questions to ask your healthcare provider, and more.

IBD Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

The Evidence Supporting Telemedicine in IBD

One of the first studies done on telemedicine in IBD was a year-long pilot trial that included people with ulcerative colitis. While some patients did find telemedicine helpful and reported an improvement in their quality of life, the system was difficult to manage for some patients. Overall, the researchers concluded that there was potential for telehealth to be used in the treatment of IBD.

Another trial done in Spain investigated a specialized web-based system called Telemonitoring of Crohn’s Disease and Ulcerative Colitis [TECCU]. Sixty-three patients were recruited and randomized to either using TECCU, receiving nursing care over the phone, or continuing their usual care protocol in a clinic. Researchers found that the use of TECCU offered both improved care and cost reduction. They acknowledged, however, that a larger study is needed before the methods can be deployed on a wider scale.

Patient education is a potential advantage of telemedicine. IBD is complex and many patients face a steep learning curve at diagnosis. One small study of 21 patients diagnosed with ulcerative colitis measured how well patients fared through the use of a web-based treatment program as compared to a patient education center over the course of six months. The results showed that knowledge of IBD was “significantly" increased with the use of the web-based program.

A larger trial of web-based learning included 95 patients with mild to moderate ulcerative colitis. Patients were receiving mesalazine to treat ulcerative colitis and were monitored for fecal calprotectin (a marker of inflammation) once a week. An online survey, called the simple clinical colitis activity index (SCCAI), measured the severity of disease by asking patients five questions about their ulcerative colitis symptoms. The higher the score, the more disease activity. Eighty-six percent of the patients completed the program for three months. Researchers noted that there were lower SCCAI scores and fecal calprotectin in patients over the span of the study.

Barriers to Telemedicine

Even though telemedicine is shown to be effective in some situations, there are barriers to its use.

Logistics

Most medical practices are structured for in-person appointments. Setting up a way to work with patients remotely requires time, energy, and money. Some of these barriers have been overcome out of necessity in the era of the novel coronavirus (SARS-CoV-2) and physical distancing.

Billing

Another common barrier is billing. Billing for medical care via telehealth was not set up for many institutions, which hindered its use. Now, both Medicare and Medicaid can be billed for telehealth services. Some practices may work with insurance for telehealth visit reimbursement (many of the large payers now will pay for telehealth) or they may offer it on a cash basis.

Since billing and coverage are variable between practices and health insurance plans, you should check with your provider and your insurance company before scheduling a telehealth visit.

Privacy

A major hurdle for telehealth regards compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

During a national public health emergency, such as the COVID-19 pandemic, the Office for Civil Rights at the Department of Health and Human Services, which is responsible for overseeing HIPAA compliance, does not enforce penalties for noncompliance. In other words, when providers are, in good faith, using their best judgment and discretion to care for patients via telehealth, some flexibility is granted.

Going forward, it remains to be seen how HIPAA will be viewed, enforced, or even amended to accommodate the sudden expansion of telehealth services. 

IBD and Patient Adherence

One important area where telehealth may help people with IBD manage their condition is medication adherence (sometimes referred to as compliance by healthcare professionals).

People who have IBD sometimes take several medications; taking them all on time and as directed may be a challenge. Having frequent check-ins with a healthcare provider about medications and issues such as side effects can help keep you on track.

A World From Verywell

Telehealth can’t replace all appointments, as IBD diagnosis and monitoring require in-person tests. If you have IBD, ask your provider about the availability of telehealth. Be sure to contact your insurance company about their policies regarding telemedicine coverage before your appointment.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cross RK, Cheevers N, Rustgi A, Langenberg P, Finkelstein J. Randomized, controlled trial of home telemanagement in patients with ulcerative colitis (UC HAT)Inflamm Bowel Dis. 2012;18(6):1018‐1025. doi:10.1002/ibd.21795

  2. Del Hoyo J, Nos P, Bastida G, et al. Telemonitoring of crohn's disease and ulcerative colitis (TECCU): cost-effectiveness analysis. J Med Internet Res. 2019;21:e15505. doi:10.2196/15505 

  3. Elkjaer M, Burisch J, Avnstrøm S, Lynge E, Munkholm P. Development of a Web-based concept for patients with ulcerative colitis and 5-aminosalicylic acid treatment. Eur J Gastroenterol Hepatol. 2010;22:695-704. doi:10.1097/MEG.0b013e32832e0a18

  4. Pedersen N, Thielsen P, Martinsen L, et al. eHealth: individualization of mesalazine treatment through a self-managed web-based solution in mild-to-moderate ulcerative colitis. Inflamm Bowel Dis. 2014;20:2276-2285. doi:10.1097/MIB.0000000000000199 

Additional Reading

By Amber J. Tresca
Amber J. Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.