In the shift from illness to health, the reduction of healthcare costs and the growing attention for prevention, dietetics plays a very important role. E-health is becoming increasingly important in this. But separate apps will not provide the solution, according to Bianca Rootsaert of the Dutch Association of Dietitians.
Nutritional advice has become a market. Nowadays, anyone can call themselves a nutrition coach or diet coach. But dieticians are the experts. They are the only ones with a protected professional title. In the new vision that the Dutch Association for Dieticians drew up, the profession and the challenges are clearly described. And a direction is given for the coming years.
Bianca Rootsaert, director of the Dutch Association of Dietitians: “Healthy food is for and by everyone. It is great that the subject is getting so much attention. Even Albert Heijn has a lifestyle coach these days.”
“The dietician does much more than give nutritional advice, the dietician treats. He translates the scientific insights in the field of nutrition to the patient. And helps a patient to achieve the optimal nutritional status. That prevents further care. Take a patient with cancer. He often avoids food. You have to watch out for malnutrition. When you are ill, standard advice is no longer sufficient. Then you need a dietician.”
Three hours per year
A dietician receives three hours per year per patient from the basic insurance in primary care. In addition, sometimes more is possible from chain care and integrated care pathways. Three hours is sometimes enough, but very often not. “For example, if it concerns children or complex illnesses, then it is very tight. It would be nice if the reimbursement were provided flexibly based on the care intensity.”
Watch out for overgrowth
The dietician is becoming increasingly important in a time where prevention and reducing health care costs are central. Here too, e-health is playing an increasingly important role. Rootsaert sees an important role for remote care, but wants to guard against a proliferation of separate apps. “They are often no alternative to contact with the dietician. They focus too often on partial solutions and lose sight of the bigger picture. The relationship between people and food is more complex than focusing on products that you should or should not eat. This approach is too narrow.”
“In the coming years, we need to look at the long term. Digitizing is much more than building an app. If you do it, you need to do it sustainably. That is why, in addition to a vision on the profession, we also developed a Vision on Digital Care in the paramedical practice last November. We need to separate the wheat from the chaff.”
“Separate apps and algorithms that focus on one part of a disease, such as HBA in diabetes, will not provide the solution, it is really too complex for that.”
Rootsaert likes to connect based on content. In addition to being the director of the NVD, she is the chair of the Paramedisch Platform Nederland, a collaborative network of six paramedical organizations. She is also a board member of the Dutch Diabetes Federation and the Platform Overgewicht Nederland.
Open innovation platform
The vision on the profession and on digital care is also clear about this: “In 2030, dietitians will share knowledge, insights, tools, data, methods and techniques with each other on an open innovation platform. Think of research results, informative videos, facts about wearables and monitoring, digital consultation techniques, group program designs and more. With the innovation consortium that we are building, we are accelerating the development and modernization of the profession and increasing the impact of dietetics. The wheel only needs to be invented once.”
To be there by 2030, Rootsaert believes it is time to start building bridges now. “Is what is technically possible also good? There are four worlds that need to meet. I am thinking of ICT, care, dieticians and other care providers. Together we need to build that bridge and work on sustainable solutions.”
Smart applications
These sustainable solutions lie in e-health, but also in smart digital applications to facilitate the work of dieticians. Johan de Ridder of Evry is pleased with the vision. “It will really help to strengthen the position of dieticians. I have been surprised for years that only three hours per patient per year are reimbursed. Other paramedics, such as occupational therapy and speech therapy, have many more hours. Especially in a time when prevention is receiving so much attention, those three hours of dietetics are very few.
Save time
Evry helps dieticians use their time as efficiently as possible, according to him. “Take our app, for example, with which the employee can easily view the agenda on his or her phone and quickly call a client or scan a document. Or photograph a referral letter and add it to the file. They will definitely save time with that.”
Or the client portal where clients can log in themselves and send messages, plan a consultation themselves or, for example, pass on all kinds of measurements. So they can, so to speak, stand on the scale every day and pass on their weight, or their glucose level, heart rate or blood pressure. With this we hope that the client can do a bit more themselves and that the three hours can be spent optimally.”
Connect and implement
Rootsaert: “In the coming period, it will be important that we connect and implement everything that is technically possible and available in a proper way, while also paying attention to the costs that dieticians have to make. Many of these applications have their own licensing model and that is becoming untenable for individual paramedical practices.”
Healthy food is central during Zorg & food. This event will take place from 9 to 11 April at Jaarbeurs. Come to Utrecht for innovations and inspiration about sustainable, healthy and tasty food.g.