Telehealth During the COVID-19 Pandemic: A Cross-Sectional Survey of Registered Dietitian Nutritionists

Rozga, Mary; Handu, Deepa; Kelley, Kathryn; Jimenez, Elizabeth Yakes; Martin, Hannah; Schofield, Marsha; Steiber, Alison

Background During the current COVID-19 pandemic, health care practices are shifting to minimize virus transmission, with unprecedented expansion of telehealth. Objective To describe self-reported changes in registered dietitian nutritionist (RDN) practice related to delivery of nutrition care via telehealth shortly after the onset of the COVID-19 pandemic in the United States. Design This cross-sectional, anonymous online survey was administered from mid-April to mid-May 2020. Participants This survey was administered to RDNs in the United States providing face-to-face nutrition care prior to the COVID-19 pandemic. Outcomes This survey included 54 questions about practitioner demographics and experience and current practices providing nutrition care via telehealth, including billing procedures. Results The COVID-19 telehealth survey was completed by 2,016 RDNs with a median (IQR) of 15 (6, 27) years of experience in dietetics practice. While 37% of respondents reported that they provided nutrition care via telehealth prior to the COVID-19 pandemic, this proportion was 78% at the time of the survey. Respondents reported spending a median (IQR) of 30 (20, 45) minutes in direct contact with the individual/group per telehealth session. The most frequently reported barriers to delivering nutrition care via telehealth were lack of client interest (29%) and internet access (26%) and inability to conduct or evaluate typical nutrition assessment or monitoring/evaluation activities (28%). Frequently reported benefits included promoting compliance with social distancing (66%) and scheduling flexibility (50%). About half of RDNs or their employers sometimes or always bill for telehealth services, and of those, 61% are sometimes or always reimbursed. Conclusion Based on RDN needs, the Academy continues to advocate and provide resources for providing effective telehealth and receiving reimbursement via appropriate coding and billing. Moving forward, it will be important for RDNs to participate fully in healthcare delivered by telehealth and telehealth research both during and after the COVID-19 public health emergency.