Dr Horst recaps her presentation at the Advances in Inflammatory Bowel Disease meeting on the top 5 advances in the past 20 years in the delivery of team-based care for patients with IBD.

Sara Horst, MD, is a gastroenterologist with the Vanderbilt University Medical Center IBD Center.

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TRANSCRIPT:

Speaker 1:

Hi, I am Sarah Horst, a gastroenterologist at Vanderbilt University Medical Center, and I was really excited to come to AIBD and talk about advances in team-based care. And so what I really wanted to help people understand was, well, what is team-based care? Sort of the evolution of that over time. And I really think in the past five to 10 years, we've learned a lot about how to deliver care to patients with chronic disease. And there's also been some reviews about this now. And so when you think about inflammatory bowel disease and how to take care of patients within a team-based care model, a lot of the reviews suggest a gastroenterologist, a nurse, so integral into this, a mental health provider, a dietician and a surgeon, as well as thinking about things like a team coordinator to help try to move all of these players around. And then thinking about a pharmacist as well.

So putting all of these in place can be difficult, and it's really probably for a place with specialty centers, but it's increasing over time. And I think a lot of healthcare systems are understanding the value of a team-based care. In some of the reviews they suggest this can also decrease gastroenterologist burnout, which is so key and something we've been talking about a lot more in the provider world. And so I think the next thing I wanted to talk about was one of the advances of team-based care is how can we show value? Team-based care comes at a cost, and it comes at time and it comes with a team. And so one of the advances that we've done over the past five to 10 years is to try to show healthcare systems and payer systems the value to team-based care.

Dr. Ruggiero has been integral in this, and he showed that there was almost a 40% drop in ER visits and hospitalizations within one year of implementing a medical home that had a lot of the team members that I talked about earlier. At Vanderbilt we're very passionate about team-based care. And we have tried to show the value by looking at adherence. With our team-based care and a specialty pharmacist, we had almost a 15% higher adherence rate to subcutaneous biologics over the national average.

So these numbers add up, and although there is an initial cost and time and expenditure for team-based care on the backend patient quality of life improvement and healthcare cost improvement is really, I think over time we're going to continue to show this. And the last thing I talked about is what's the future? And I think one of the things that the COVID Pandemic has brought to the forefront is disruptive technology within healthcare. And so telehealth is probably the future for this so that we can give better access. Not everyone needs to have a medical home. So Dr. Ruggiero talked yesterday about making a medical neighborhood, so allowing the center to be the hub and then the spokes can hopefully get out farther to all of our patients through things like disruptive technology with telehealth. So thank you so much.

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