Does This EHR Make Me Look Fat? Lindsey Hoggle, MS, RD, PMP and Nancy Collins, PhD, RD, LD/N, FAPWCA

Transcription

1 Does This EHR Make Me Look Fat? Lindsey Hoggle, MS, RD, PMP and Nancy Collins, PhD, RD, LD/N, FAPWCA DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2 Conflict of Interest Disclosure Ms. Lindsey Hoggle reports that she is an employee of the Academy of Nutrition and Dietetics (formerly the American Dietetic Association). Dr. Nancy Collins has no real or apparent conflicts of interest to report HIMSS

3 Learning Objectives Discuss the role of proper and timely nutrition monitoring as part of the treatment plan for the global obesity and diabetes crises. Explain how traditional nutrition counseling tools, such as food diaries and calorie trackers, are translated and used in online based tools. Show specific examples of current technology that can be used to facilitate the care of patients.

4 Fast Food Facts A survey by the Pew Research Center (2006) reports that almost 20% of Americans eat fast food at least twice a week.

5 Before most children can speak they can recognize McDonald's McDonald's feeds more than 46 million people a day - more than the entire population of Spain

6 In 1972, we spent $3 billion a year on fast food in 2008, we spent more than $110 billion 5.6% of the average American s income goes to fast food!

7 Consequences of Poor Nutrition: Diabetes Diabetes affects 25.8 million people in the United States 8.3% of the population In 2009, diabetes was the 7 th leading cause of death

8 Consequences of Poor Nutrition: Heart Disease In 2010, 27.1 million people were diagnosed with heart disease Cardiovascular diseases, including heart disease and stroke, were the number one cause of death in

9 Consequences of Poor Nutrition: Obesity 1/3 of adults in the United States are obese 33.8% of the US population Obesity increases one s risk for developing heart disease, diabetes, cancer, high blood pressure, sleep apnea, joint problems to name a few.

10 Registered Dietitians (RD) The nutrition expert who is trained to provide nutrition assessments, monitoring and counseling services.

11 RD Services The RD may perform: 24 hour food recall discuss what the client has eaten in the past 24 hours. 3-Day or 7-Day Diet Record Food Frequency Questionnaire Carbohydrate counting education calculate how many carbohydrates the client needs to keep their diabetes under control. Calorie estimation determine how many calories per day the client should consume to meet their weight goals.

12 Nutrition Care Process A consistent, systematic process describing how nutrition professionals provide care to patients/clients. An Individualized Approach Uses Evidence-Based Science Not the same plan for all

13 Nutrition Care Process Four Steps Involved Nutrition Assessment Diagnosis Intervention Monitoring and Evaluation

14 Technology s role in nutrition Nutrient Databases- Nutrient Analysis Body Fat Calculation-Bioelectrical Impedance Weight Tracking Physical Activity Tracking Body Mass Index (BMI) Calculation

15 Consumers and Technology USDA MyPlate SuperTracker allows people to plan, analyze and track their diet and exercise.

16 Consumers and Technology FitDay offers a free diet and weight loss journal

17 Consumers and Technology LIVESTRONG.com provides a calorie counter, calorie tracker and food journal app

18 Consumers and Technology Lifescan OneTouch Glucose Meter automatically collects and organizes blood sugar results into graphs that can be downloaded into one s computer.

19 Consumer Access to Online Nutrition Information Information Age Attention Age Disruption Age? Internet Search Engines Google Social Media Twitter Pt View & Download Personal Data

20 Nutrition Monitoring Standardized Data Re-use of Data Right Data, Right Patient, Right Time

21 Nutrition is a Data-rich Field USDA compiling nutrition data for >115 years National Nutrient Data Bank 146 nutrients 7900 foods Dietary Supplements Database

22 Standardized Nutrition Data Nutrition Care Process HL7 Nutrition Initiatives International Dietetics & Nutrition Terminology (In process of Submission to SNOMED-CT) Standard Nutrition Terms Included in S&I Framework s Clinical Element Data Dictionary.

23 Nutrition Data Re-Use To Evaluate Progress & Outcomes Over Time To Screen for Obesity & Diabetes risk factors To Determine Trends for Patient Use To Evaluate Geographical and Cultural Trends

24 HITECH Related Changes In EHRs NQF Measure Number & PQRI Implementation Number NQF 0013 NQF 0028 Clinical Quality Measure Title Hypertension: Blood Pressure Measurement Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment b) Tobacco Cessation Intervention NQF 0421 PQRI 128 NQF 0024 NQF 0041 PQRI 110 NQF 0038 Adult Weight Screening and Follow-up Alternate Core Measures Weight Assessment and Counseling for Children and Adolescents Preventive Care and Screening: Influenza Immunization for Patients 50 Years Old or Older Childhood Immunization Status Federal Register Final Rule: EHR Incentive Program July 13, 2010

25 Right Patient Right Data Right Time? Information Overload? OR

26 Digital Transformation Bringing Patient generated content together with Provider generated content.

27 Nutrition Screening Used with Permission: Department of Clinical Nutrition National Institutes of Health

28 Nutrition Assessment: Anthropometric Measures

29 Pertinent Nutrition Labs

30 Nutrition Assessment & Plan

31 Nutrition Diagnosis: Nutrition Intervention

32 Leveraging New Tools Consumer/Patient Generated Data (Mobile Monitoring Devices) Standard Data in EHRs The DIRECT Protocol (Secure bidirectional exchange) Continuity of Care Document equality Measures

33 Continuity of Care Document (CCD)

34 Data Follows the Patient- Using Direct Nutrition Care Plan Electronic Process Provider Dietitian Patient s PHR

35 Health Care Costs by BMI

36 Potential for Improved Nutrition

37 Contact Info Lindsey Hoggle, MS, RD, PMP Nancy Collins, PhD, RD, LD/N, FAPWCA RD411.com