N23 Volume and Impact of Text Communications with an IBD Nurse– A Large Tertiary Center Experience
Authors: Haj Natour O , Talan Asher A , Levartovsky A , Goshen G , Goren M , Ben-Yehuda Y , Kopylov U , Ben-Horin S 
Published: January 2025

Background

Patients with inflammatory bowel diseases (IBD) face a range of medical and psychosocial challenges . Coping is facilitated by the support of IBD nurse that plays a pivotal role in addressing a large variety of disease related issues and logistical hurdles associated with a long-term disease. Accessibility and easy of contact with an IBD nurse is significant. Text communication is a preferable mode of communication for IBD patients. However, there are scant data about the work-load and the implications of establishing mobile-phone text communication route between patients and IBD nurses.

Objective

To Characterize volume, time distribution and topics text communications between an IBD nurse and patients treated in IBD unit

Methods

Text communications were carried out using WhatsApp application. WhatsApp messages between September 2020 and September 2024 were extracted. A series of messages exchanged within a three-day period continuously , was defined as a 'conversation'. Communication that followed a break of more than one day was considered a new 'conversation'. The analysis framework process chat text data that extracted and underwent conversation segmentation based on temporal gaps (&gt;1 days), feature extraction including message types, timestamps and participant roles. The system employed model for conversation classification across six pre defined categories (medical problems, medical instructions, administrative guidance, general administrative, scheduling and other) with severity scoring (1-10) and handling multilingual content (Hebrew, Arabic, English)..

Results

Between September 2020 –September 2024 (1476 days) a total of 3,927 patients had at least 1 visit to our IBD unit, 1,623 (49.2%) received at least 1 advanced therapy. 2,173 (55.3%) contacted an IBD nurse at least once during the study period. 15,962 conversations were conducted , with 174,814 messages, average of 118 messages per day. Median response time was 1.9minutes (36 sec-19.3min). Most of the conversations occurred in weekdays (92.4%) , in office hours (8am-4pm, 60.5%). Main topics of communication were administrative scheduling , administrative guidance (26.4%, 20.5% respectively), medical – problem 15.8%, medical instruction 12.8%, administrative general 9.9%, other 14.6%. Conversation severity levels were defined as acute (grades 7-10; 2.1%), non-severe(grads 1-3; 50.1%) and intermediate (grades 4-6; 25.6%)

Conclusion

High volume and efficiency of communication, combined with the nurses' quick response times, contribute to faster treatment and potentially prevent complications. However, their workload might benefit from utilizing AI tools like chatbots for routine tasks, allowing nurses to focus on more complex aspects of care.

References

Rosso, C.; Aaron, A.A.; Armandi, A.; Caviglia, G.P.; Vernero, M.; Saracco, G.M.; Astegiano, M.; Bugianesi, E.; Ribaldone, D.G. Inflammatory Bowel Disease Nurse—Practical Messages. Nurs. Rep. 2021, 11, 229–241.

Chang S, Hamilton M, Lees C, Atreja A. Mobile Health in IBD: Enhancing Care, One Phone at a Time. Inflamm Bowel Dis. 2020 Jan 6;26(2):163-166. doi: 10.1093/ibd/izz262. PMID: 31675058

Bernstein, K.I., Promislow, S., Carr, R., Rawsthorne, P., Walker, J.R., Bernstein, C.N. (2011) Information needs and preferences of recently diagnosed patients with inflammatory bowel disease. Inflamm Bowel Dis 17: 590–598.

Sturm, A., & White, L. (Eds.), Inflammatory Bowel Disease Nursing Manual (1 ed., pp. 417-422). Springer Cham.