Telenutrition helps patients with spinal cord injuries

Around 300,000 people are living with a spinal cord injury.

The condition can lead to a variety of health concerns including weight gain, chronic disease and depression.

However, a new hospital study is helping patients beat those odds, and it all begins with what’s on their plate.

Eric Raptosh is proud that he can make his way around the kitchen. It’s one of the many changes in his life since becoming recently paralyzed in a small plane crash.

“Broken cervical spine, broken thoracic spine and broken femur and broken ribs. Ninety-nine percent of the things that were in control before your injury are no longer in your control,” he says.

However, Eric still had control of his diet.

“Some of our patients live many, many hours away, five hours away for example, so then we couldn’t provide in-person nutrition counseling,” explains Kazuko Shem, MD, from Santa Clara Valley Medical Center.

Nutrition is key.

Studies show the mortality rate for cardiovascular disease is 228% higher in those with a spinal cord injury.

“It’s important for quality of life, mental health. It’s important for avoiding chronic disease,” says Shelley Wood, MPH, RDN, a clinical dietician at Santa Clara Valley Medical Center.

Patients in the study receive an iPad loaded with a photo app. For three months, they keep a food diary and have remote counseling sessions to develop an awareness of their habits.

“I look through all two weeks of their food that they’ve taken a picture of or their caregiver has, and we work together on optimizing their diet. I had a participant lose closer to 90 pounds,” Wood recalls.

Eric lost weight too, but more importantly, his quality of life improved.

“You have a lot of power over the decisions you make over your body, and they’re very important,” he says.

Anyone can create a photo food journal using an app such as “Ate.” It helps create an awareness to daily habits, no matter how big or small.

REPORT #2672

BACKGROUND: The expansion of telehealth services into the nutritional care arena is growing at a substantial rate. The Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services defines telehealth as “the use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, storeand-front imaging, streaming media, and terrestrial and wireless communications”. In other words, telehealth is the use of various technologies to provide people with virtual medical and/or nutrition counseling and education rather than in person. There are many benefits of telehealth and telenutrition including convenience, flexibility, quicker and more accessibility to your healthcare provider, private and confidential sessions, ongoing support, and reduced costs.

TELEMEDICINE IS CHANGING HEALTHCARE: One way telemedicine is changing healthcare is through direct-to-consumer products and services. While workflow solutions are now built into most telehealth apps, the next generation of products is beginning to emerge with some incorporating artificial intelligence into the process. These apps not only guide patients through a series of questions and collect data, but some can interpret those responses. By the time the patient connects with the provider, a huge amount of legwork is complete. Another area of growth for telemedicine is provider collaboration. This can enhance communication between nursing staff and physicians, as well as physician consultation with specialists. The last area is in space. It involves a shift in thinking with the idea that future patients can be treated at home, in the hospital, in nursing homes, in physician’s offices and other places. Space would be designed and configured to include placement of secure cabling, and any necessary equipment such as high-resolution cameras, speakers and monitors – similar to the way an eICU might be equipped today.

THE FUTURE OF TELEMEDICINE: The applications of telemedicine reveal its value to both patients and physicians who prescribe diet as part of the management of chronic conditions, according to Jonah Cohen, MD, who is a founder of the digital therapeutics company Nutrimedy, which created the platform for virtual nutritional counseling. “As gastroenterologists, we are experts in the function of the gastrointestinal tract but not necessarily in nutrition. Most physicians get very little training in this area,” said Dr. Cohen, who is a gastroenterologist affiliated with Harvard Medical School and Beth Israel Deaconess Medical Center in Boston. Helping patients develop an effective diet and implementation strategy to which they are willing to adhere is not a simple task. “Nutrimedy’s proprietary matching system connects patients to their ideal dietitian who will help establish a specific nutrition plan for their medical conditions through video visits, unlimited messaging, photo food logs, recipes, and biometric trackers,” Dr. Cohen continued. A new hospital study at the Rehabilitation Center at Santa Clara Valley Medical Center is helping spinal cord injury patients with health concerns beat the odds. They are beginning with what’s on their plate because nutrition is key. Patients in the study receive an Ipad loaded with a photo app to keep a three-month food diary and have remote counseling sessions to develop an awareness of their habits.

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