The American Gastroenterological Association and the American College of Gastroenterology recently signaled their support for whole-person multidisciplinary digestive healthcare delivered via a hybrid collaborative model offered by the virtual GI care clinic Oshi Health. The investment in Oshi Health by these GI specialty societies is aimed at helping gastroenterologists provide guideline-recommended dietary and behavioral health services, without placing additional burdens on practices.

Oshi Health, launched in 2020, uses evidence-based, high-touch protocols that are clinically validated and recommended by the ACG and AGA, said company co-founder and Chief Medical Officer Sameer K. Berry, MD, MBA, a gastroenterologist and clinical assistant professor at New York University, in New York City. Its services, delivered via telehealth, range from limited to extensive. They can be accessed by patients through gastroenterology practices or individually via their website (oshihealth.com).

“Some of the practices we work with have committed resources to measuring and improving their outcomes through a formal partnership that involves EMR [electronic medical record] integration, co-branding and data sharing,” Dr. Berry told Gastroenterology & Endoscopy News. “We also work with hundreds of GI practices with a simpler approach of bi-directional referrals and no up-front integration.” Either way, practices that work with Oshi pay nothing for its services.

Support From Major Societies

Both the ACG and AGA have made strategic financial investments in Oshi Health, which their representatives said help promote the societies’ mission.

“AGA has been committed to advancing innovation in GI for over a decade through its GI Innovation and Technology Center. We expanded our effort in 2022, by creating the GI Innovation Fund, which provides funding to fast-growing, early-stage companies like Oshi to speed innovations from concept to clinic,” said Thomas J. Serena, the CEO of the AGA. “We think that Oshi’s innovative solution aligns with our goals to improve patient outcomes, reduce the burden on providers and lower cost.”

William Chey, MD, the treasurer and incoming vice president of the ACG, told Gastroenterology & Endoscopy News: “The ACG wants to empower gastroenterologists to embrace the science supporting multidisciplinary, integrated care and adopt this care model into their own practices.” Dr. Chey is the H. Marvin Pollard Professor of Gastroenterology, a professor of nutrition sciences and the chief of the Division of Gastroenterology and Hepatology at Michigan Medicine, in Ann Arbor.

Oshi Health is the only startup that has been funded by both of these professional entities, Dr. Berry noted, adding that “leadership at both these organizations realize that the biggest missing piece in digestive care is getting patients access to all the services they need.”

Need for Such Services

Dr. Berry said he first recognized the need for an improved multidisciplinary care model working with Dr. Chey, his mentor during his GI fellowship. “The need has only intensified. The vast majority of GI doctors realize these services are necessary, but practices are completely overwhelmed—whether they are an independent physician group, a large private equity–backed practice, or a faculty group practice at an academic medical center,” Dr. Berry said.

“The challenge is that traditionally, dietary and behavioral services are not reimbursed. These services are also most effective when delivered with frequent touch points, which is much easier to achieve with a scaled national workforce using telehealth,” he added. “It would not be feasible for each and every GI practice to reinvent the wheel and build this technology from scratch. In a world where we have to do more with less, using virtual care to augment the in-person relationship is a win for everyone.”

Oshi’s ability to obtain reimbursement for services not traditionally covered by insurance is a result of its “commitment to measuring patient outcomes and investing in resources to improve guideline-driven care,” Dr. Berry said. Currently, reimbursement does not extend to Medicare and Medicaid, but he said this is expected to change.

Study Confirms Benefits

A prospective study appears to back up Oshi’s claims. Dr. Berry presented results from a trial evaluating the effect of Oshi’s care model on outcomes and cost at the 2023 annual meeting of the American Telemedicine Association (abstract 0-1). This study (funded by the University of California, San Francisco and Optum Labs) showed statistically significant reductions in healthcare costs and a significant improvement in health outcomes in patients with inflammatory bowel disease and disorders of gut–brain interaction, and in subjects with undiagnosed GI complaints.

Survey results showed that 98% of the patients were satisfied with the program, 89% had improved quality of life, and 92% became less symptomatic. Patients also reported 1.3 fewer missed workdays per month and significant improvements in GI health literacy.

Furthermore, a comparison of healthcare costs between patients enrolled in Oshi’s program for six months and propensity-matched controls, conducted by a third party, found a reduction in per-patient GI-related costs of $6,723 (P<0.0001) and all-cause healthcare costs of $10,292 (P<0.001). These savings were driven predominantly by a 64% reduction in avoidable GI-related emergency room visits (P<0.0001) and a 57% reduction in avoidable GI-related imaging (P<0.001).

Perhaps the ‘Wave of the Future’

Brian E. Lacy, PhD, MD, a professor of medicine and the program director of the GI fellowship at Mayo Clinic in Jacksonville, Fla., found these results, and Oshi’s concept, interesting. He noted that patients with disorders of gut–brain interaction pose management challenges to clinicians, also have dietary issues and frequently struggle with psychological distress.

“Multidisciplinary care—essentially a team approach involving healthcare providers, dietitians and psychologists—has been shown to lead to greater improvements in symptoms and quality of life compared to stand-alone therapy provided by a gastroenterologist. The data provided by Oshi Health (in abstract form only) is impressive, showing significant reductions in symptoms and healthcare costs, with an improvement in quality of life. The wave of the future should be this coordinated, team care approach,” Dr. Lacy said, “and I look forward to seeing further data from this innovative group.”

—Caroline Helwick

Dr. Berry is a cofounder of Oshi Health. Drs. Chey, Lacy and Serena reported no relevant financial disclosures.