Embody diet remedy if telemedicine protection is expended in RI

Laura Kilcline is a registered nutritionist, private practice owner, and president of the Rhode Island Academy of Nutrition & Dietetics.

If telemedicine persists in RI, medical nutritional therapy should be included. The COVID-19 pandemic has devastated many aspects of our healthcare system, but it has also sparked some positive changes.

One of the most noticeable was former Governor Raimondo’s order to expand access to telemedicine services to all Rhode Islanders and to ensure “equal pay” for providers. This means that a doctor, nutritionist, or other licensed professional performing telemedicine visits must receive the same amount as if the appointment had taken place in person. This was not the case before the pandemic. Permanent parity for telemedicine is currently being reviewed by the Rhode Island General Assembly, but in different forms.

Telemedicine has made sure the pandemic doesn’t stop the Rhode Islanders from getting the medical care they need. An important part of this care is nutritional medical therapy services provided by Registered Nutritionists (RDNs). When the public health emergency ends, these rules expire. If they do, some of our state’s most vulnerable residents will find it harder to get the care they need.

Many people benefit from telemedicine: parents with young children, people with mobility issues (including many older adults), people without transportation, and people with inflexible work schedules. It is time to stop standing in the way of these barriers to quality health care. With the technology available today, you should be able to schedule medical appointments during your toddler’s lunchtime without worrying about wheelchair access, bus routes, or a drive, and without having to sacrifice your limited vacation time for medical appointments.

Registered nutritionists provide nutritional advice and education to help people eat better, feel better, and prevent and treat diseases such as diabetes, heart disease, eating disorders, and kidney disease. Because ambulatory dietitians typically don’t perform physical exams, most dietary visits over the phone or video chat are equally effective. In some cases, telemedicine improves the patient experience by giving the RDN insight into the home food environment (e.g. checking food in a patient’s pantry) and using technology to teach patients important nutritional issues related to their health. When more Rhode Islanders can access RDNs through telemedicine, we can continue to improve public health through preventive measures in a cost-effective manner.

Consider the case of Gladys, who has been struggling to meet appointments with her health care provider for months because she was so sick that it was difficult for her to leave her home. However, through telemedicine, Gladys was able to meet with her dietitian for most of the weeks to seek help in finding ways to improve her diet. During the meeting with her nutritionist, she was able to eat more and gain strength and, thanks to her telemedical appointments, can now go for walks and visit her daughter and granddaughters more often.

A change in the law is required and we encourage our state parliament to include medical nutritional therapy in the telemedicine bills under consideration. The Senate version of this bill would provide coverage and equal pay only to primary care physicians and behavioral health care providers, which while an important step forward, skips the important work dietitians do. However, the House version of this legislation (which RIAND supports) is much broader and more powerful.

Telemedicine is not just technology; It’s about making sure everyone gets the health care they need. We urge the Rhode Island General Assembly to include nutritional therapy as an eligible telemedicine treatment in the final version of the Telemedicine Act.