Perspectives of Registered Dietitian Nutritionists on Adoption of Telehealth for Nutrition Care during the COVID-19 Pandemic

Abstract

Widespread transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has resulted in a global coronavirus disease 2019 (COVID-19) pandemic that is straining medical resources worldwide. In the United States (US), hospitals and clinics are challenged to accommodate surging patient populations and care needs while preventing further infection spread. Under such conditions, meeting with patients via telehealth technology is a practical way to help maintain meaningful contact while mitigating SARS-CoV-2 transmission. The application of telehealth to nutrition care can, in turn, contribute to better outcomes and lower burdens on healthcare resources. To identify trends in telehealth nutrition care before and during the pandemic, we emailed a 20-question, qualitative structured survey to approximately 200 registered dietitian nutritionists (RDNs) from hospitals and clinics that have participated in the Malnutrition Quality Improvement Initiative (MQii). RDN respondents reported increased use of telehealth-based care for nutritionally at-risk patients during the pandemic. They suggested that use of such telehealth nutrition programs supported positive patient outcomes, and some of their sites planned to continue the telehealth-based nutrition visits in post-pandemic care. Nutrition care by telehealth technology has the potential to improve care provided by practicing RDNs, such as by reducing no-show rates and increasing retention as well as improving health outcomes for patients. Therefore, we call on healthcare professionals and legislative leaders to implement policy and funding changes that will support improved access to nutrition care via telehealth.

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“…A 20-question survey emailed by the Academy of Nutrition and Dietetics (ADA) between 24 August and 11 September 2020 collected responses from 22 registered dietician nutritionists (RDNs) [138]. The responses showed that, prior to the pandemic, 15 hospitals had not provided nutritional care via telemedicine.…”

“…The questionnaire revealed that mainly telephone calls were used during COVID-19, along with videoconferencing and remote patient monitoring. The RDNs reported that it was difficult to conduct nutritional focused physical exams (NFPEs); on the other hand, they could manage to have a longer assessment time and to look at the patient's home environment and nutrition habits [138].…”