{
  "abstract": "Introduction Chronic management of Inflammatory Bowel Disease (IBD) in the NHS has traditionally relied on routine, time-based consultant and nurse-led follow-ups. This drives high follow-up-to-new ratios, long waits and limited ability to prioritise those at greatest risk of deterioration. Clinic capacity can be tied up in low-value, largely reassurance-based reviews, while patients do not consistently receive care aligned to their disease activity.Methods At University Hospitals Birmingham (UHB), a digitally enabled IBD pathway underpinned by the Big Picture Medical (BPM) platform was introduced to replace face-to-face follow-ups with structured remote monitoring and PROMS and fecal cal algorithm recall. Patients complete regular digital check-ins capturing symptoms, flares, treatment tolerance and quality of life. We incorporated validated PROMS within the digital check-ins to ensure the patient voice was systematically captured and to assist with the risk stratification algorithm. These inputs are triaged using clearly defined clinical rules so that only those with worsening control or complex needs are brought into the clinic, while stable patients are safely managed virtually. Clinicians access a single view of the IBD cohort, supporting outreach and more meaningful use of consultant and specialist nurse time.Results For UHB, this redesigned model delivers core outcomes. First, substantial avoidance of traditional outpatient appointments, with around 35% of planned follow-up visits no longer required because issues are safely managed through remote monitoring. Second, freed consultant and nurse capacity is repurposed into new referrals and high-risk follow-ups, improving access and enabling earlier intervention for those who most need in-person care. Third, independent analysis by the Healthcare Innovation Consortium has externally validated the economic impact of these changes, estimating approximately £448,000 in annual financial savings from avoided appointments and released capacity, alongside reduced backlogs and clearer evidence of waiting-time impact.Over time, the shift to, risk-stratified monitoring has supported better long-term disease control, with a reduction in steroid-dependent flares through earlier preventative intervention. The majority of patients are now managed in community settings rather than in acute care, reserving specialist capacity for complex cases.Conclusions A digitally enabled, risk-stratified IBD pathway at UHB has therefore converted remote monitoring and virtual review into substantial, independently validated cost savings and enabled greater clinic capacity. The pathway provides a scalable template for other long-term disease clinics needing to move from routine face to face based review to digitally risk-stratified, virtual care creating further efficiencies and financial savings.",
  "authors": [
    {
      "affiliations": [
        "Big Picture Medical, London, United Kingdom"
      ],
      "name": "Angus Forth"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham, Birmingham, United Kingdom"
      ],
      "name": "Rachel Cooney"
    }
  ],
  "title": "P186 Remote, digitally enabled IBD monitoring at university hospitals Birmingham: fewer visits, better prioritisation",
  "uid": "d6cf932f-dd93-5247-9ffa-0485c2dc867d"
}