Care Coordination Tool Cuts Crohn's Disease Hospitalizations, Costs

New research suggests patients with Crohn’s disease are less likely to need hospitalization and emergency care when they use a care coordination tool that frequently collects data through digital check-ins.

The findings, based on two years of tracking patients, represent how technology can enable value-based care. In the study, patients with Crohn’s disease reduced their medical costs by an average of $6,500 per patient when they used SonarMD’s care coordination platform. The study involved 176 Crohn’s disease patients within Blue Cross and Blue Shield of Illinois’ network, comparing them to a matched cohort of patients who didn’t use the tool.

Lawrence R. Kosinksi, M.D., a gastroenterologist and co-founder of SonarMD, said this type of tool can be particularly meaningful for Crohn’s disease, because it’s often difficult or impossible for patients to distinguish when symptoms begin to get worse.

“Unlike other diseases like hypertension, obesity, liver disease and even many diabetics, patients with Crohn’s disease have frequent symptoms: diarrhea, abdominal pain, joint pains, etc.,” he told Inside Digital Health™. “They get accustomed to being symptomatic and live in a ‘new normal,’ which is a symptomatic one.”

The results can be quite serious. The United States spends $6 billion per year treating patients within the broader category of irritable bowel disease. More than half of that money funds hospitalizations, some of which can be avoided. As with some other conditions, a subset of patients (25-30%) account for some 80% of the healthcare spending.

SonarMD works by regularly collecting data between physician visits. The technology uses those data to ascertain changes in patient health that might otherwise go undetected.

Kosinski said SonarMD can detect changes that the patient cannot. Those changes can lead to complications like bowel obstructions, fistulas, abscesses, gastrointestinal bleeding and infections.

“As the condition worsens, the likelihood that it will lead to hospitalization or need to be treated with high-cost therapeutics increases,” he said.

In the study, patients enrolled in the program regularly received “pings” via phone, email or text which inquired about their symptoms. Most patients, across age groups, opted to use text messages, the company said. The patients’ responses were then tracked and used to create a “Sonar Score.” Patients with high scores were targeted for earlier interventions, often resulting in the avoidance of hospitalization.

The study was based on an earlier version of SonarMD. The company has since updated the program, releasing version 2.0.

Tami Speten, a patient with Crohn’s disease who uses SonarMD, recounted her experience in a press release for the company.

“I was once called into my gastroenterologist’s office because of my Sonar Score,” she said. “We quickly learned my blood and iron counts were dangerously low. I had no idea I was so sick.”

Without the intervention, Speten her condition would likely have deteriorated to the point where she needed hospitalization. She said the technology has also resulted in a closer doctor-patient relationship.

The study was presented earlier this month at the Digestive Disease Week conference, in San Diego.

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