New UF Health Initiative Seeks to Broaden Access to IBD Care
Modern treatment plans for inflammatory bowel disease, or IBD, are complex and rapidly evolving.
However, one thing has remained consistent: Early access to care improves outcomes.
“If patients are able to see an IBD-trained gastroenterologist early in the course of their disease, it can change everything,” said Angela Pham, MD, a digestive disease specialist and an assistant professor in the division of gastroenterology, hepatology, and nutrition.
Currently, UF Health Shands Hospital takes care of approximately 3,000 IBD patients yearly, receiving referrals throughout Florida and southern Georgia. These patients are otherwise unable to receive the subspecialty care needed for their IBD, Pham said.
Typically, lack of access to specialists can significantly delay patients undergoing the appropriate procedure, diagnosis, initiation of treatment and/or surgery, and ultimately impede induction of remission, leading to significant morbidity and mortality.
Although community gastroenterologists see patients with IBD in their practices, these patients are outnumbered by those with irritable bowel syndrome, reflux disease and other more common GI conditions, Pham said.
This, and other barriers — like practices being dominated by colonoscopies — has made widespread patient access to IBD specialists difficult.
Now, Pham and the dedicated IBD team are developing a solution.
“(The University of Florida) is an IBD center of excellence, which means we have a close relationship with our referring physicians and see many of their patients in consultation at our Gainesville campus,” Pham said. “However, many patients are not able to travel to our site and their insurance status often is a limiting factor. Therefore, we would like to leverage existing communication and patient advocacy resources that have been developed and utilized for diabetes care, to help our referring GI physicians care for IBD patients.”
The team is adopting the Project Extension for Community Healthcare Outcomes, or ECHO, model to address gaps in IBD care, an approach that will ensure high-quality treatment for IBD can be delivered to underserved and/or geographically remote regions.
"We would like to leverage existing communication and patient advocacy resources that have been developed and utilized for diabetes care, to help our referring GI physicians care for IBD patients." - Angela Pham, MD
This will enable gastroenterologists practicing in a rural setting to access the tools they need, like core knowledge and access to IBD specialists, to provide quality care to the IBD patients in their practices.
Pham and her team will lead 10 sessions over a 10-month period with physicians in 10 different sites in northern Florida and southern Georgia to share the IBD Core Curriculum. Each session provides a case-based discussion of the principles of modern IBD care. An IBD health coach will also act as a health care liaison to link patients with their hometown gastroenterologist and UF gastroenterologist, enhancing healthcare delivery to IBD patients who live in rural or underserved areas.
“Our goal is to increase the capacity of general gastroenterologists and clinics to empower and safely and effectively manage underserved patients with IBD who do not receive routine specialty care,” Pham said. “Project ECHO also connects patients to health coaches to help equip them with the skills needed to navigate the health care system and manage chronic disease, which we hope will contribute to better overall health.”