HJNO Sep/Oct 2024

withGI disorders. Integration of these treatment modalities has been proven to benefit this pop- ulation by targeting thoughts, emotions, and behaviors as they relate to this disease, as well as learning specific mindfulness-based stress reduction techniques to manage the relation- ship between the brain and the gut. As a result, patients can experience improvements in their own self-efficacy in terms of disease manage- ment, acceptance of their diagnosis, improved medication adherence, and a more complete understanding of how this disease impacts more than just their GI tract. The Crohn’s and Colitis Center is working hard to create a space where patients feel heard, understood, and re- spected by their providers while they are con- comitantly being given the opportunity to bet- ter understand their disease — and ultimately themselves — through honest and intentional discussions, integration of specialized and in- formed providers, and shared decision making. Hartman Brunt, MD, MSHCM Incorporating Clinical Informatics in Managing Inflammatory Bowel Disease Like all chronic medical conditions, IBD re- quires ongoing monitoring to achieve effec- tive disease management and minimize dis- ability. Achieving successful outcomes means first intentionally measuring your outcomes, and that depends on the availability of so- phisticated tools and technology, including patient-centered electronic health records (EHRs), care pathways, and clinical decision support systems. In the modern healthcare landscape, clinical informatics plays a crucial role in enhancing care delivery by optimiz- ing how we manage and utilize health data. Effective management of IBD necessitates highly coordinated care, which is facilitated by the seamless exchange of health information enabled by robust informatics infrastructures. Interoperability — the ability of different data systems to exchange and use information co- hesively — determines how well clinical data is shared among patient care teams. Although the U.S. healthcare system is progressively adopt- ing interoperable data standards and our local health systems are increasingly utilizing unified EHR systems, challenges remain. Fragmented data storage still occurs, leading to inefficien- cies and incomplete care within regional health ecosystems. From our experience, one signifi- cant advantage of implementing interdisciplin- ary care as an integrated practice unit is the mitigation of data silos. Integrating specialties such as gastroenterology, primary care, colorec- tal surgery, mental health, and dietary services fosters the free flow of standardized data. To illustrate the importance of information flow in longitudinal monitoring, consider the treatment targets for IBD: patient-reported outcomes (PROs), biomarkers, and endoscopic scores. Each of these data points provides a critical piece of the puzzle in understand- ing a patient’s condition. PROs, which include measures of symptoms like bowel frequency, abdominal pain, and quality-of-life indicators such as depression (assessed by the PHQ-9) and anxiety (measured by the GAD-7), offer direct insights into the patient’s experience and the impact of IBD on their daily life. Bio- markers act as surrogates for the inflammatory burden within the body, providing objective data on the severity of the disease. Endoscopic scores, on the other hand, assess the visible extent of disease through direct visualization of the gastrointestinal tract. Capturing and analyzing these data points not only helps nar- rate each patient’s journey but also allows for adjustments to the disease trajectory, aiming for sustained improvements in quality of life. In a collaborative care model, gastroenter- ologists, primary care providers, and other specialists — such as clinical social work- ers and dietitians — use these data points to make well-rounded decisions. For instance, a gastroenterologist might analyze endoscopic scores and biomarkers to adjust treatment plans, while a primary care provider may use PROs to address related symptoms or co- morbidities. Clinical social workers, familiar with the psychological and social impacts of chronic illness, can interpret PROs to tailor “From our experience, one significant advantage of implementing interdisciplinary care as an integrated practice unit is the mitigation of data silos. Integrating specialties such as gastroenterology, primary care, colorectal surgery, mental health, and dietary services fosters the free flow of standardized data.”