by RDBA Executive Director Annette Maggi, MS, RDN, LD, FAND
Today's sales climate has gone beyond traditional marketing and now requires the creation of a relationship with the shopper. Dietitians play a key role in creating this shopper relationship through programs, services, and meeting the shoppers' individual nutrition and health needs. For those shoppers with a health condition, the relationship may extend to helping them effectively manage the condition and live a healthier life through telehealth counseling.
Telehealth is emerging as an opportunity for retail dietitians to engage their shoppers outside the store environment by taking advantage of technology applications. Using telehealth, retail RDNs can reach consumers outside their geographic service area, a key benefit for regional or corporate dietitians or retailers with stores in rural locations. It also provides a way for retail RDNs to increase their ROI by securing insurance reimbursement and fees for services.
According to the Academy of Nutrition and Dietetics practice resources, "telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration." It can be conducted via the internet, video conferencing, email, fax or other methods of distance communications. "Telenutrition" is the term used to define RDN's use of electronic information and telecommunications to diagnose, counsel, and monitor clients in a remote location.
As you consider and delve into providing telehealth services, be aware that regulatory, licensure and reimbursement issues can be complicated. The Center for Connected Health Policy provides a comprehensive list of all state policies and issues for implementing telehealth. The Academy offers additional resources on state rules and policies in their library on telehealth services. For licensure, challenges arise when you interact with clients outside the state where you are currently licensed, and you must be licensed or certified in each state where you are practicing (based on client location).
Today's federal legislation does not require reimbursement by private payers for telehealth services, and states define policies. Many states are creating laws, requiring insurance companies to cover telehealth, but it is essential to understand the policies in all states where your services are or will be offered. Under Medicare, certain telehealth RDN services are covered, including individual and group MNT, diabetes, heart disease, and weight management counseling, and wellness visits. Medicaid rules are created state-by-state.
Preliminary data suggests telehealth can be impactful for improving key measures of health outcomes. The Academy of Nutrition and Dietetic's Evidence Analysis Project on telenutrition found that when these services are provided by a RDN as part of a healthcare team, significant improvements were seen in weight, BMI, A1C levels, blood pressure, and serum lipids. Additional limited research shows no significant differences between telehealth counseling and traditional in-person sessions.
Whether you currently offer nutrition counseling services for health management or are considering adding it to your programs, the Academy of Nutrition and Dietetics provides comprehensive resources on successfully implementing telehealth services, which are available here.