Author: Tameika Shaw, RD | TAIBU CHC
Posted: July 5, 2021
We can all agree that the covid-19 pandemic has impacted the way healthcare is delivered and that it will continue to change our future, including Dietetics. Dietitians have adapted, much like many other disciplines, as we were all forced to embrace new ways of providing care. This has been a huge adjustment not only for our patients but also for us: RDs.
My organization, a CHC in Scarborough, witnessed this transformation. The Centre: a usual hub of activity and people; became almost vacant as soon as the WHO declared a pandemic. Like many others, we quickly transitioned to virtual services and programs (defined as phone, video conferencing or secure messaging or emails). This emergency pivot, though laudable, was a reactive action and as such, attention must be given to the post-covid era.
What will the role virtual care and digital health tools play in the future of dietetics?
I realize that most primary care organizations had the tools to offer virtual services pre-pandemic; however, I would be curious to know how often these tools were utilized.
As a reference point, pre-pandemic, our Centre’s average virtual encounters across our team were less than 9% compared to now where we offer 50% of encounters as virtual visits. Almost 15 months later, multi-disciplinary primary care organizations are planning for expansion and resumption of services, with hints of maintaining a hybrid approach to care. Dietitians are likely to remain mostly virtual to allow space for our other colleagues who carry out their work with clients present.
Even when we can finally have free reign to resume in-person visits, we must acknowledge there is no going back to the way it was. One of the legacies of the covid-19 pandemic will be the accelerated growth in digital health. Kelly et al. (2021) uses the term: “digital disruption of dietetics” and asks the question, “are dietitians ready”?
Dietitians and clients can leverage virtual care and digital health, where virtual care can have the ability to address social determinants of health including:
Eliminating geography as a barrier to service
lower absenteeism or income loss related to missed time from work
increased access to cultural or translation tools using remote interpretation services or translation apps
access to specialized programs that may otherwise be off limits due to location
fostering collaboration with clients to play more active role in health through apps or wearable tech
However, as we plan to continue digital offerings in a post-covid era, consideration must still be given to those who have struggled due to lack of access to compatible devices, data services and those with less comfort and skills to navigate the virtual space.
When assessing this readiness we need to recognize that digital health literacy is a combination of both access and utilization among clients, providers, organizations and health systems (Conard, 2019). Are primary care dietitians and their organizations ready to integrate digital technologies and virtual care on a more permanent and seamless basis to provide high quality accessible care? I do not think anyone will disagree that phone appointments can be a poor substitute for in-person consults and that video visits, though a more feasible option, are not readily accessible or utilized by clients and providers alike. Phone appointments though convenient, serve best for wellness checks or monitoring after client’s have had assessments and nutrition education.
Videoconferencing has the most capability to replicate an in-person experience in terms of “meeting” our clients, improving communication and building trust. Video visits support visual assessments such as the SGA and are more supportive of providing nutrition education to all types of learners, especially visual learners.
This assessment of readiness highlights that employers need to be ready to support RDs in this next phase. If your organization has not already done so, challenge them to assist with the resources and technology needed to help improve virtual offerings. Look beyond the phones and assess how to improve video offerings. And when needed, advocating with your leadership team and organization for more on-site days will be just as critical to suit those clients who need in-person contact. An equitable approach to the way we do our work is needed now more than ever. It is important that we take a patient first approach.
Dietitians have a role in in the virtual and technology offerings in the post-covid shift and we should prepare ourselves to not only embrace the change but to also be influencers of the movement especially as it relates to the needs of our clients.
The College of Dietitians of Ontario has several documents and webinars on virtual care that are worth visiting if you have not already done so: College of Dietitians – Virtual Care, Social Media & Technology.
Digital disruption of dietetics: are we ready? by Kelly et al., 2021 is an interesting read for those interested in looking at digital health through an NCP lens.
Conard (2019) Best Practices in Digital Health Literacy. Int J Cardiology 292: 277-279 Kelly, Collins, McCamley et al. (2021) Digital disruption of dietetics : are we ready? Journal of Human Nutrition and Dietetics 34: 134-136