04/12/2021 - The COVID-19 pandemic and its impact on the health and daily lives of Americans brought telehealth policies and practices to the forefront for registered dietitian nutritionists, the Academy and many other health care provider types and organizations. To equip the Academy and RDNs to support strong telehealth policies at the state and federal levels, the Academy Board of Directors has voted for the adoption of the following stance on telehealth policy. The five-part stance was developed by the Telehealth Task Force under the oversight of the Legislative and Public Policy Committee:
- Nutrition care services are critical to comprehensive health care delivery systems and should be covered when provided via telehealth under the same coverage and payment policies as in-person care.
- Patients should have coverage for telehealth delivered via audio-only if they cannot effectively access or utilize audio-visual technologies.
- In declared emergency situations when access to qualified providers is otherwise severely impacted, the modification of certain consumer protection policies such as licensure and HIPAA requirements may be appropriate.
- Public funding and support for broadband internet, technology, digital literacy education and language services are necessary to address racial, economic and geographic health disparities and to address disabilities.
- Publicly funded research on telehealth should be nationally representative and include a wide variety of services and providers, including nutrition care services provided by registered dietitian nutritionists and nutrition and dietetics technicians, registered.
The Academy began to examine telehealth and its impact on members over 30 years ago. In more recent years, a staff collaborative collected and developed practice resources, articles and communications to assist members with current practices. In 2015, a telehealth survey was launched to better understand how telehealth was being used by the profession. These results were published in the Journal of the Academy of Nutrition and Dietetics and guided the Academy's work to update and produce new telehealth guidance for members.
In light of the continued expansion of telehealth and growing policy conversations at the state and federal levels and within the private sector, the Academy convened the Telehealth Task Force to develop a formal policy stance as part of its strategy to increase access to MNT and foster the visibility of its members who provide services in this format. Academy members appointed to serve on the task force included: Meg Rowe, MS, RD, LDN, FADA, FAND (task force chair); Robyn Smith Brown, MBA, RD, LD; Charla Burill, JD, RD; Darlene Dougherty, MS, RD, FAND; Ingrid Knight, RD, LD; Melissa Ventura Marra, PhD, RDN; Leslye Rauth, MPH, RDN, LMNT, FAND; and Regina Saxton, RDN, LD, CLT.
The task force launched shortly after the start of the COVID-19 public health emergency and conducted an environmental scan on issues related to telehealth policy. This included an assessment of current and pre-pandemic federal and state telehealth laws, regulations and policy proposals; research on utilization and patient experiences; and practice and quality considerations. In addition, updates from the Academy’s in-progress research study on the impact of the COVID-19 public health emergency on telehealth practice by US-based registered dietitian nutritionists were considered. The task force reviewed policy positions and research from other US-based health care professional associations, dietetics associations based in other countries, US government agencies and advisory bodies, think tanks and other academic sources. An article outlining the stance, findings and recommendations of the task force will be published later this year in the Journal of the Academy of Nutrition and Dietetics.
More information and resources on telehealth, including the Telehealth Quick Guide for RDNs, are available on the Academy's website. The Academy also recently launched a Telehealth Discussion Board for members in all areas of practice and practice settings to network around delivering nutrition related services via all telehealth modalities. The Academy will continue to create and update materials on telehealth and provide educational opportunities, including at FNCE® 2021.