JMIR Publications

ABSTRACT

Background:

Highly prevalent gastrointestinal (GI) disorders significantly decrease quality of life and are a considerable cost to the US health system. Multidisciplinary GI care (MGC) (i.e., team-based care with access to GI providers, registered dieticians, and behavioral health providers) has proven efficacious in clinical trials, but its effectiveness and ability to be scaled outside of controlled settings remain uncertain.

Objective:

The study describes the delivery of virtual MGC at scale. The objective is to demonstrate its effectiveness and describe patient characteristics, outcomes, and the relationship between patient engagement and symptom improvement.

Methods:

We conducted a retrospective cohort study of patients who received virtual MGC between April 2021 and August 2025. Inclusion criteria for this analysis were: provided intake data; completed onboarding appointment with a GI provider; and reported on symptom improvement and control after receiving virtual MGC. We collected data on patient demographics, engagement (e.g., time to visits, number and duration of visits, number and duration of calls greater than 5 minutes, number of patient-initiated messages), satisfaction, and symptom-related patient-reported outcomes. We used descriptive statistics, paired t-tests, and logistic regression models to analyze the data.

Results:

The study’s 9405 patients had a mean age of 43.45 (SD 12.34) years and were predominantly female (65.92%). The median time to first scheduled visit was 6 days (interquartile range [IQR]: 3-9). The median number of visits and calls to GI providers was 2 (IQR 1-3), while registered dietitians and behavioral health providers saw a median of 2 (IQR 1-3) and 1 (IQR 0-2) visits, respectively. On average, patients initiated 9.32 (SD 19.09) chat messages with their virtual MGC team. We found that 93.55% reported symptom control, and 91.06% of patients reported symptom improvement. Patient satisfaction with virtual MGC was high, with a mean score of 4.85 (SD 0.50) out of 5. In adjusted regression models, increased engagement with the care team was significantly associated with symptom improvement. Patients with four or more GI engagements had 3.57 times higher odds of symptom improvement compared to those with only one (95% Confidence Interval [CI] 2.29, 5.57). Patients with three or more behavioral health engagements had 2.09 times higher odds of improvement (95% CI: 1.37, 3.18), while those with three or more dietitian engagements had 11.34 times higher odds (95% CI: 7.45, 17.27) compared to those with no engagements with these providers.

Conclusions:

It is feasible and effective to deliver virtual MGC at scale.