title: Potential use of telemedicine to provide outpatient care for inflammatory bowel disease.
abstract: OBJECTIVE
  Patients with inflammatory bowel disease (IBD) often experience barriers to subspecialty access. We applied telemedicine, using a new computerized system called Collaborative Imaging, to resolve these barriers. We studied patients' experience and satisfaction, and clinic throughput.
  
  
  METHODS
  We performed a prospective randomized controlled pilot study at a Veterans Affairs hospital, assigning patients into two groups: telemedicine encounter, with the IBD specialist remotely located, and standard encounter. We assessed patient experience and measured differences in satisfaction as well as clinic metrics such as appointment duration, wait time, and throughput.
  
  
  RESULTS
  We enrolled 34 patients with Crohn's disease and ulcerative colitis who underwent 57 encounters in 9 months. Patients were mostly Caucasian men, with a mean age of 61 years. The two groups similarly rated as excellent their clinic experience and the major clinical satisfaction indices of attention to patient concerns, bedside manner, and perceived skill level of the doctor. The total clinic duration, wait time, and median number of patients per clinic were also similar. The fellow and subspecialist highly rated the technical and informational quality of the telemedicine sessions.
  
  
  CONCLUSIONS
  IBD outpatient service may be delivered via a novel telemedicine system. In this pilot study, we observed a high level of patient satisfaction similar to that achieved with a direct clinical encounter.
authors.affiliation: Veterans Affairs Palo Alto, Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Krier
authors.forename: Tonya
authors.initials: T
authors.lastname: Kaltenbach
authors.forename: Kenneth
authors.initials: K
authors.lastname: McQuaid
authors.forename: Roy
authors.initials: R
authors.lastname: Soetikno
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D003093:Colitis, Ulcerative / Q000628:therapy*; D003299:Cooperative Behavior; D003424:Crohn Disease / Q000628:therapy*; D003952:Diagnostic Imaging; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011446:Prospective Studies; D017216:Telemedicine / Q000706:statistics & numerical data*; D013997:Time Factors