Quality in Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) causes significant distress to patients and their families from a health and economic perspective and should be ideally managed by a multidisciplinary team. Given the complexity of the disease, patients with IBD are subject to variability in care and at risk of developing disease or medication-related complications as well as high expenses due to direct and indirect costs of the disease. Variability of care has been considered a surrogate of poor quality of care leading to overuse, underuse, and misuse of healthcare resources. These characteristics make IBD a disease suitable for quality improvement. To assess and quantify quality of care, quality measures and indicators must be evaluated. Different organizations have created multiple initiatives to define quality care in patients with IBD which include the International Consortium for Health Outcomes Measurement (ICHOM) outcome measures, American Gastroenterological Association (AGA) Physician Quality Reporting System (PQRS) performance measures, and the Crohn’s & Colitis Foundation’s process and outcome measures, while others like ImproveCareNow and IBD Qorus have centered their efforts on the development of learning health systems and the University of Pittsburgh Medical Center (UPMC) and Project Sonar have implemented specialty patient-centered IBD medical homes. While there is still room for improvement on adherence to quality measure, learning health systems and specialty-centered IBD medical homes have demonstrated significant improvement in patient outcomes. This shows that collaborative quality improvement efforts are effective in improving quality of care.