Telehealth During the COVID-19 Pandemic: A Cross-Sectional Survey of Registered Dietitian Nutritionists

Abstract

During the current coronavirus disease 2019 (COVID-19) pandemic, health care practices have shifted to minimize virus transmission, with unprecedented expansion of telehealth. This study describes self-reported changes in registered dietitian nutritionist (RDN) practice related to delivery of nutrition care via telehealth shortly after the onset of the COVID-19 pandemic in the United States. This cross-sectional, anonymous online survey was administered from mid-April to mid-May 2020 to RDNs in the United States providing face-to-face nutrition care prior to the COVID-19 pandemic. This survey included 54 questions about practitioner demographics and experience and current practices providing nutrition care via telehealth, including billing procedures, and was completed by 2016 RDNs with a median (interquartile range) of 15 (6-27) years of experience in dietetics practice. Although 37% of respondents reported that they provided nutrition care via telehealth prior to the COVID-19 pandemic, this proportion was 78% at the time of the survey. Respondents reported spending a median (interquartile range) of 30 (20-45) minutes in direct contact with the individual/group per telehealth session. The most frequently reported barriers to delivering nutrition care via telehealth were lack of client interest (29%) and Internet access (26%) and inability to conduct or evaluate typical nutrition assessment or monitoring/evaluation activities (28%). Frequently reported benefits included promoting compliance with social distancing (66%) and scheduling flexibility (50%). About half of RDNs or their employers sometimes or always bill for telehealth services, and of those, 61% are sometimes or always reimbursed. Based on RDN needs, the Academy of Nutrition and Dietetics continues to advocate and provide resources for providing effective telehealth and receiving reimbursement via appropriate coding and billing. Moving forward, it will be important for RDNs to participate fully in health care delivered by telehealth and telehealth research both during and after the COVID-19 public health emergency.

The effects of telenutrition in overweight and obese adults in a nutritional center in Lima, Peru.

“…In New Mexico, USA, telemedicine-related barriers were identified through a survey that included 2016 nutrition professionals. 5 In this study, 29% of the professionals reported lack of client interest, 26% reported not having internet access, and 28% mentioned not being able to perform client assessment or monitor activities by this modality. In regard to the benefits of telemedicine, 66% of the professionals stated that it contributed to social distancing compliance, while 50% acknowledged the flexibility in arranging appointments.…”

“…In regard to the benefits of telemedicine, 66% of the professionals stated that it contributed to social distancing compliance, while 50% acknowledged the flexibility in arranging appointments. 5 Australian nutrition professionals regard telehealth evaluations as profitable and well-received by patients. They report that this practice improved healthcare access for people with chronic diseases.…”

Practical considerations of developing and conducting a successful telehealth practice in response to COVID‐19

“…This crisis provides clinicians and administrators an opportunity to build new and innovative systems that break down patient barriers to care. Previous studies have suggested video conferencing is well accepted by most patients, clients, and nutrition professionals 17,21 . With this change, however, also comes an opportunity for additional stress and difficulty for both patients and care team members, as not all prefer this method of communication.…”

Changes in US Dialysis Dietitian Responsibilities and Patient Needs During the COVID-19 Pandemic

“…T HE COVID-19 PANDEMIC has been a period of rapid change in society and has particularly impacted healthcare 1 and health behaviors. 2 Even before COVID-19, dialysis patients had intensive nutrition needs, but these may be worsened during the pandemic.…”