What to Know About Telehealth for Crohn’s Disease

A combination of in-person and virtual visits may be helpful for some

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Telehealth services were not common before the COVID-19 pandemic. Now people who live with chronic conditions, including Crohn’s disease, have access to expanded forms of care via telehealth.

The relapsing/remitting nature of Crohn’s disease means that patients require care throughout their lives. While some routine parts of care—such as blood tests, colonoscopy, and medication infusions—will still need to be done in person, others can be done via telehealth.

Virtual visits can include nutritional consultations, mental health care, education about the disease or treatments, and going over lab work results or other tests. Members of the Crohn’s disease healthcare team that might be seen virtually include a primary care provider, dietitian, gastroenterologist, colorectal surgeon, or mental health professional.

patient talking to doctor on a video call on a laptop

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When to Use Telehealth for Crohn’s Disease

In-person appointments in the office, clinic, endoscopy center, infusion center, or hospital will still be needed for tests, procedures, medication administration, and some post-surgery checkups. However, there is a broad range of reasons that telehealth can be used to manage Crohn’s disease.

People who live in rural areas or don’t have an inflammatory bowel disease (IBD) center within a reasonable driving distance may be able to see providers that are far away via telehealth. Patients may have more communication and face-to-face visits with their providers because a virtual visit doesn’t require travel.

Lab Work Results

Lab work such as blood tests or fecal calprotectin will need to be done in person, or at least in the case of stool tests, a sample will often need to be dropped off at a lab. However, going over the results can be done via a telehealth appointment.

In this way, questions about what the results mean for future treatment or procedures can be answered without going into an office.

Nutritional Consultations

Managing nutrition is part of Crohn’s disease treatment. Dietary needs will change over time based on whether the disease is in remission or not and around any procedures or surgeries. For that reason, patients may need touchpoints with a dietitian to understand how best to tailor their diet for their disease.

A dietitian visit can be done via telehealth, which may offer some advantages to an in-person visit. The patient can show a provider around their kitchen and pantry, which might be helpful when recommending changes or different ways of preparing foods.

Prescription Refills or New Prescriptions

Many people who live with Crohn’s disease receive medication regularly. Refills on prescriptions are common and are sometimes a reason for a visit with a provider.

Discussing a refill of a current medication or a change in medication or dosage could be done via a telehealth appointment versus in the office. A provider can talk over any questions regarding new or changed medication schedules, including potential adverse effects, dosing, and administration.

Other Crohn’s-Related Issues

Crohn’s disease affects the whole person. It’s not only about how many bowel movements a patient is having and if they’re painful or bloody. People who live with Crohn’s disease also experience problems with sleep, mental health, joints, eyes, skin, and more.

With telehealth, there may be an opportunity to have more appointments and to see more specialists. With more ways to work with healthcare team members, all the issues that sometimes get put to the wayside because they’re not so critical can be discussed, and a plan can be put into place.

You May Need to Be Seen in Person If…

Crohn’s disease can sometimes be associated with complications. Reasons to seek care in person include:

Benefits and Challenges

Telehealth offers some significant advantages in managing Crohn’s disease, but there are also some challenges. Given that telehealth has become more mainstream during the pandemic, going forward it may be helpful for most patients to have a combination of in-person and telehealth appointments.

People with Crohn’s disease sometimes travel to see specialists. Telehealth can make these visits easier because there will not be a need to drive, park, walk, and deal with unfamiliar areas where there may or may not be bathrooms available.

In the pandemic, with so many businesses closed or only open on a limited basis, bathroom access has become even more challenging for people who live with Crohn’s disease.

For those people with Crohn’s disease who don’t have access to health insurance or are under-insured, telehealth might also be an option. This will be especially true for visits with, for instance, a primary care provider, mental health professional, or dietitian.

The cost will be a factor here because some patients who don’t have insurance coverage may need to pay for part or all of the visits. It’s worth exploring all options and discussing costs with providers to ensure that care is being received in the most efficient and affordable way.

The challenges to using telehealth can be technological in nature. As far as technology goes, there’s a need for some preparation before a telehealth appointment. Some healthcare systems use particular applications which will need to be downloaded and tested ahead of time.

There is also likely to be paperwork to be filled out ahead of time to opt in to a telehealth visit. A good Internet or cellular connection will also be needed to access the appointment.

Another difficulty is with privacy concerns. Patients will need to work with staff to ensure that the apps being used to access appointments are private and secure.

Patients will need to find a time and space where they can privately attend their appointment. This can be challenging when other family members are home or if it’s necessary to use public equipment (such as at a library).

How to Prepare for a Telehealth Visit for Crohn’s Disease

Treating Crohn’s disease might require different types of doctors, but the physician that is usually the main point of contact is a gastroenterologist. If a telehealth appointment isn’t offered, it’s worth asking if any providers are now scheduling them.

One of the first steps is filling out paperwork. This might be done electronically via a patient portal or a document-signing site. It could also mean emailing, scanning, or faxing documents. It’s important to find out what’s needed from the staff in the doctor’s office because everything will need to be finished by the appointment time.

Downloading and learning how to use the software for telehealth appointments will also be helpful. This would ideally be done before the appointment, at a time that’s convenient to practice with it.

If help is needed, patients can reach out to tech support for the app or talk to someone on staff at the physician’s office. At the very least, taking 10 or 15 minutes before the appointment to get set up and familiar with the app or program will be needed. This will all help in preventing being late or not being able to attend the appointment.

Interacting with healthcare professionals over telehealth is different than in an office setting. This might mean putting some thought into the appointment beforehand—for instance, having prescription bottles on hand to discuss medications and dosages, or showing a rash or a problem with a stoma.

Sending pictures ahead of time via the patient portal or other options offered may be helpful. Using the best camera to which there is access and bright lighting during the appointment may also be helpful. Headphones can be useful to keep a visit more private.

Will Insurance Cover Telehealth for Crohn’s Disease?

Telehealth for chronic conditions such as Crohn’s disease has become more common and more accessible during the pandemic. Insurance coverage has expanded, but all carriers may not cover telehealth or may not cover it fully.

Further, coverage may change as the status of the public health emergency changes. Patients should keep checking with their insurance companies and stay informed about legislation around telehealth access.

What Happens During the Visit

The first step in the telehealth visit will be to log into the app or the software and ensure that the patient and the physician can see and hear one another. After that, the appointment may be quite similar to the visit that takes place in the office.

The provider might have more information on hand about the visit and what the patient is looking to accomplish, especially if there has been some back and forth in the patient portal before the appointment. 

The appointment may start with a staff member who takes information such as a history and preferred pharmacy, similar to a typical office visit. Other information such as an email address and a cell phone might be needed to send the visit report or for scheduling.

There may also be a touchpoint with a staff member after the appointment to hand over an electronic visit report and set up the next steps (such as follow-up appointments). Providers may also ask for verbal or electronic consent to be given at some point to have the visit.

One difference between in-person and virtual visits is the physical exam. The provider can’t do a physical exam over telehealth. For that reason, it might be necessary for the patient to, for instance, take their own temperature and weight or look at their own abdomen to see if there are tender spots or hard areas.

Because Crohn’s disease can be associated with fevers and unintentional weight loss, these measures can be an important part of the visit. Patients may also need to use the camera to show the provider any problem areas, such as bloating or skin problems.

Before signing off the visit, a plan should be put in place. This can include scheduling the next appointment, noting any labs or procedures that need to be done, and updating prescriptions. Any follow-up care or referrals to other specialists should also be done at this time.

Having an appointment from home is a new experience for many patients. Most people with Crohn’s disease have had many touchpoints with their healthcare team over the phone.

In the past, that was usually how important information was conveyed, but these usually weren’t formal “appointments.” They were often a stopgap between in-person appointments and used to convey a small amount of important information. With video visits that are covered by insurance, more topics can be discussed in depth.

While it’s important to try to have an appointment in a quiet place with few interruptions, providers understand that children and pets are part of their patients’ lives. If a little one or a furry friend makes themselves known, or other unforeseen things happen, a healthcare professional will understand.

A Word From Verywell

Telehealth was not commonly used for Crohn’s disease before the COVID-19 pandemic. It’s new territory for both physicians and patients. However, it’s truly exciting because it can offer people who live with Crohn’s disease more access to inflammatory bowel disease (IBD) specialists.

A major barrier to telehealth in previous years was in receiving reimbursement from insurance companies. That has changed under the public health emergency, and the status is still evolving. However, it does seem that telehealth will continue, in some form, into the future.

Patients will want to stay in touch with their healthcare professionals and their insurance company to understand telehealth’s availability and cost.

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