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The Dietitian's Role in Telehealth
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As telehealth becomes more widely used, the role dietitians play in multidisciplinary teams for the treatment of allergy has increased.
Alexia Beauregard, MS, RD, CSP, LD
The utilization of telehealth in medicine has become a valuable tool in recent years, especially in rural areas. When it comes to collaborative treatment of patients with food allergies, it seems that also rings true—but the role that the dietitian plays has been less clear.
In a presentation at the 2018 American Academy of Allergy, Asthma, and Immunology (AAAAI)/World Allergy Organization (WAO) Joint Congress in Orlando, Florida, Alexia Beauregard, MS, RD, CSP, LD, detailed how and when dietitians can utilize their opportunities to consult about food-allergy related nutrition via telehealth.
While there are roughly 89,000 registered dietitians in the United States, according to the Commission on Dietetic Registration (CDR), dietitians specializing in food allergy are rare—only 10 members of the AAAAI are listed as dietitians. This paves the way for knowledge gaps among dietitians, which can lead to confusing “or even dangerous advice,” Beauregard said.
The utilization of telehealth allows for those gaps to be filled, as other health care providers that are part of multidisciplinary teams can connect with dietitians that are qualified to handle the subtleties of food allergy. It also allows for those dietitians to reach patients that are living either in remote areas or distances too far to travel for care.
Beauregard has already seen the impact. She told MD Magazine that she currently is working with patients “from coast to coast,” and has a patient she connects with via telecommunication in Long Beach, California, from her South Carolina practice.
For successful dietitian-led telehealth appointments, in combined efforts with an allergist, telehealth appointments can be scheduled after an allergy diagnosis is confirmed, and then discuss dietary management and reinforce education that was received during the in-office visit. Afterward, routine telehealth appointments as needed for support can be scheduled.
Additionally, dietitians can partner with the primary care provider or school clinic for follow-up appointments in order to obtain height and weight data, discuss any accidental exposures and the barriers to effective management, as well as reinforce diet education.
“Approximately 75% of healthcare expenditures are on chronic disease management,” Beauregard, a member of the Gastroenterology Associates, the Ellyn Satter Institute, and Seagrass Nutrition and Therapy, said. “Studies have been done in diabetes, stroke, congestive heart failure, diabetic retinopathy, and asthma, and have shown telehealth produces benefits for the providers. They’ve reduced no-show appointments, increased patient engagement in disease or condition management, and increased patient satisfaction.”
Beauregard added that while the data on the expense of telehealth has been controversial, the savings for the patients and families are noteworthy. Reportedly, they have saved 200 school or work days, and an estimated $58,000 on travel.
“Telehealth can reduce geographic barriers for those in rural areas and small cities that do not attract specialists, and for those without reliable access to transportation or those that have a required use of medical equipment,” Beauregard said. It also allows for a multidisciplinary team to patients to “schedule follow-up appointments during an exacerbation, rather than at arbitrary times based on the provider’s availability.”
As of 2015, an estimated 15 million Americans had received some form of care through telecommunication. It is anticipated that by 2020, that number will jump upward of 158 million, underscoring the importance of understanding and implementing the strategy properly and effectively.
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