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P564 Significant reduction of admission time at the IBD infusion unit by an e-health pre-admission assessment and order system for intravenous therapy

E. Hoefkens*1, L. Pouillon1, V. Verheyen2, M. Bronswijk1, A. Van Olmen1, S. Van Dessel3, N. Siborgs4, P. Bossuyt1,5

1Imelda general hospital, Department of gastroenterology, Bonheiden, Belgium, 2Imelda general hospital, Central hospital pharmacy, Bonheiden, Belgium, 3Imelda general hospital, IBD infusion unit, Bonheiden, Belgium, 4Imelda general hospital, IT department, Bonheiden, Belgium, 5University Hospitals Leuven, Catholic University of Leuven, Department of gastroenterology and hepatology, Leuven, Belgium

Background

The regularly administration of intravenous (IV) therapy negatively impacts on the work productivity and social functioning of patients with inflammatory bowel disease (IBD). The advent of new IV therapies leads to an increased workload at the IBD infusion unit and pharmacy, demanding a more efficient organisation. E-health tools may optimise patient time consumption and workflow at the IBD infusion unit and pharmacy. Our aim was to assess the feasibility, adoption and impact on time consumption of an automatic online pre-admission assessment and order system for patients with IBD.

Methods

We developed an online platform, directly linked to the electronic agenda of the IBD infusion unit, enabling a pre-admission order of IV therapy. This system sends an automated email to the patient the day before the admission. Using the secured link in this email, the patient is required to answer several red flag and open questions about their health status since the previous infusion. These answers are reviewed by the healthcare provider and, if approved, the IV therapy is ordered and prepared for subsequent administration at arrival on the infusion unit. All patients treated with IV therapy at the IBD clinic of our hospital were invited to participate in this program, which was GDPR (General Data Protection Regulation) approved. Time consumption was prospectively evaluated in patients with maintenance infliximab treatment (1 h infusion) before and after implementation in June 2018.

Results

In total 172 IBD patients (n = 77 male, n = 119/51 Crohn/ulcerative colitis, n = 112/60 infliximab/vedolizumab) were invited to the program, 150 (87%) of which accepted to participate and 22 (13%) declined. The most important reason to decline participation was the lack of email access, which can be attributed to the median age of this subgroup (median age 73 years (IQR 65–75) vs. 46 years (IQR 36–56); p ≤ 0.0001). Inclusion rates were not influenced by gender, disease type or treatment duration. The effective adoption of the e-health system (number of IV therapies ordered online) increased from 42% in the first month to 59% in the fifth month. The use of the e-health system reduced the median admission time at the infusion unit significantly from 169 min (IQR 153–192) to 108 min (IQR 101–122) (p < 0.0001) in infliximab-treated patients (Figure 1).

Conclusion

The use of an e-health pre-admission assessment and order system for IV therapy in IBD is feasible, well adopted and leads to a significant reduction in admission time.

Figure 1 Admission time at the day clinic before and after implementation of e-health tool.