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

https://doi.org/10.1016/j.jand.2021.01.009Get rights and content

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.

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M. Rozga is a nutrition researcher, Academy of Nutrition and Dietetics Evidence Analysis Center, Chicago, IL.

D. Handu is a senior scientific director, Academy of Nutrition and Dietetics Evidence Analysis Center, Chicago, IL.

K. Kelley is a nutrition researcher, Academy of Nutrition and Dietetics Nutrition Research Network, Chicago, IL.

E. Y. Jimenez is a director, Nutrition Research Network, Academy of Nutrition and Dietetics and Research Associate Professor, Departments of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Chicago, IL.

H. Martin is a director, Legislative and Government Affairs, Academy of Nutrition and Dietetics, Washington, DC.

M. Schofield is a senior director, Governance and Nutrition Services Coverage, Academy of Nutrition and Dietetics, Chicago, IL.

A. Steiber is a chief science officer, Academy of Nutrition and Dietetics Nutrition Research Network, Chicago, IL.

STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

FUNDING/SUPPORT This survey was conducted using the time of staff employed by the Academy of Nutrition and Dietetics.

AUTHOR CONTRIBUTIONS K. Kelley and E. Y. Jimenez led the design and distribution of the survey, with contributions from A. Steiber. M. Schofield and H. Martin were content experts on telehealth. M. Rozga conducted data analysis and M. Rozga, D. Handu, K. Kelley, E. Y. Jimenez, H. Martin, and M. Schofield drafted the initial manuscript. All authors reviewed, edited, and approved the final manuscript.

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