gastroendonews.com
The Independent Monthly Newspaper for Gastroenterologists
Volume 71, Number 8 • August 2020
Race, Social Status Linked to Disparities In IBD Care
Clinicians Now Have Solid Guidance on COVID-19 And IBD Management
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hen Maria Oliva-Hemker, MD, was training to be a pediatric gastroenterologist in the 1990s, the medical literature of the day indicated that inflammatory bowel disease overwhelmingly affected white patients. As she treated patients in Baltimore, however, it was clear to her a significant population of Black children had IBD, too. In fact, the incidence of IBD has been increasing in African American and Hispanic patients in recent decades. But it is harder for these patients, and Black patients in particular, to receive the care they need, experts say. Social and economic realities, including costly health insurance, low socioeconomic status, and a lack of medical services in minority neighborhoods, all likely contribute to inadequate care and worse outcomes. Experts say educating providers, diversifying the clinician community, and investing in research and initiatives to increase access to care are needed to improve care for everyone with IBD. “It is the time for us in IBD care to be looking at care in an inclusive, more multicultural way to our patients because that’s who they are,” Dr. Oliva-Hemker, the director of the Division of Pediatric Gastroenterology, Hepatology and Nutrition at the Johns Hopkins Children’s Center, in Baltimore, said.
s clinicians across the country continue to face alarming surges of COVID-19 cases, experts in inflammatory bowel disease say the gastroenterology community is now much more prepared for the care of IBD patients during the outbreak. “We have learned a ton since the pandemic started, and I feel confident in our management strategy for IBD in the COVID era,” Jordan Axelrad, MD, MPH, an assistant professor of medicine at the NYU Grossman School of Medicine and the IBD Center at NYU Langone Health, in New York City, said. “We now know what the risk factors are for severe outcomes of COVID-19 in IBD patients, and, importantly, we know that biologic and
small-molecule therapies are safe and likely do not increase the risk of COVID-19 acquisition or severe outcomes.” see Strategy, page 46
EHRs May Hold Keys to Practice Survival In the COVID Era
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see IBD Disparities, page 22
he development of ancillary services is a crucial consideration for gastroenterology practices thinking about diversifying, particularly in the trying times of the COVID-19 pandemic. What service line should you develop? The answer may lie in the contents of your electronic health records (EHRs). Although often bemoaned as a bane of modern medical practice, the EHR holds a gold mine of patient data that can help practices identify ancillary service lines tailored to their own patient
population. These data, properly used, also can potentially identify gaps in care and drive significant improvement in patient outcomes. “Most groups still really don’t understand that EHRs contain a tremendous repository of data that can be used to identify subsets of patients who would benefit from specific ancillary services,” Scott Fraser, MBA, the managing director of Fraser Healthcare LLC, in Malvern, Pa., said. see EHR, page 12
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REVIEW ARTICLE Cases From the Frontiers of Therapeutic Endoscopic Ultrasound in 2020
see insert at 24