With the evolving technologies at our fingertips, and now with the world-wide COVID-19 pandemic, use of Telehealth and communications has come to the forefront of helping serve our residents and is more valuable than ever. Registered/Licensed Dietitians are a vital part of the interdisciplinary team and during this COVID-19 pandemic we may not able to be onsite due to facility restrictions. However, we can provide the same nutritional care remotely with some different tools and communications methods.
Telehealth is a collection of means or methods for enhancing health care, public health and health education delivery and support using telecommunications technologies per the Center for Connected Health Policy. Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of means to enhance care and education delivery.
One area within Telehealth is Telenutrition, which according to the Academy of Nutrition and Dietetics, involves the interactive use, by Registered/Licensed Dietitians, of electronic information and telecommunications technologies to implement the Nutrition Care Process (nutrition assessment, nutrition diagnosis, nutrition intervention/plan of care, and nutrition monitoring and evaluation) with residents/patients at a remote location, within the provisions of their state licensure as applicable. Registered/Licensed Dietitians are able to utilize a number of technologies, in real time, to communicate with other health care providers, patients and their families, to address a number of concerns including diet education, referrals for high risk patients, and other areas of compliances and documentation health care facilities need. The use of Telenutrition and Telehealth is beneficial for residents in every level of health care to continue to provide comprehensive service and care.
Registered/Licensed Dietitians can use methods such as phone or video communication with facility staff, residents, and families, faxed information/communication, assessments forms, email communications, and the benefit of remote charting with the use of electronic health and medical records for each building and client. Dietitians gather data needed to complete assessments through continued communication with clients and provide our expertise and recommendations needed using the electronic health records and return communication with facilities and staff. The dietitian can also be involved with care plans via phone or video to provide valuable input. Medicare is allowing temporary use of non-public facing communications technology to provide services via telehealth. Effective immediately, the Department of Health and Human Services Office for Civil Rights will temporarily waive penalties for HIPAA violations against health care providers that serve patients in good faith through every day non-public facing communications technologies during the emergency per the Academy of Nutrition and Dietetics. Under Medicare, RDN/LDNs may temporarily use popular applications that allow for video chats.
A multitude of options are currently available for live video chatting, conference calls, resident interviews or clinical/sanitation reviews with Medicare’s temporary approval of non-public facing communications technology, to provide services via Telehealth, including the following:
- Apple FaceTime
- Facebook Messenger video chat
- Google Hangouts video
- WhatsApp video chat
Communication between the RDN/LDN and facility staff remains an extremely important piece for complete and beneficial assessments for our residents, as nutritional status is a vital part of everyday resident care and outcomes. The dietitian provides assistance and insight into continuing the Nutrition at Risk meetings with key staff via phone or video conferences, establishing best forms of communication between key staff and the RDN/LDN, especially if obtaining additional information not available in the electronic health or medical record, continuing to set dates for remote/virtual visits, resident interviews and education with continued monitoring available, or coordinate of care plan information and meeting times with staff. With the assistance of staff communication and additional information available, the dietitian can also continue to provide documentation, and interventions, needed for review of malnutrition risk for utilization in PDPM reimbursement.
Telehealth and Telenutrition can allow for the seamless continuation of RDN/LDN services even when onsite visits are not possible due to a temporary crisis like COVID-19. Knowing your RDN/LDN can continue to support you and your residents virtually can put your mind at ease while remaining in touch with other interdisciplinary team members. Keeping residents/patients safe and healthy is the most important goal for all facilities and use of Telehealth and Telenutrition by your dietitian allows for a continuum of care without even being in the same room.
About Telehealth. (n.d.). Retrieved March 2020, from https://www.cchpca.org/about/about-telehealth
Practicing Telehealth. (n.d.). Retrieved from https://www.eatrightpro.org/practice/practice-resources/telehealth
Telehealth Quick Guide for RDNs. (n.d.). Retrieved from https://www.eatrightpro.org/practice/practice-resources/telehealth#quickGuide