Communication & Technology

Communication and technology play pivotal roles in the ever-changing environment of healthcare, including dietetics. Whether used to reduce error, track progress or promote behavior change, communication and technology tools are constantly being refined. With innovative technology tools, dietitians strive to:

• More effectively gather healthcare information,
• Improve quality of care and
• Provide greater access and safety for the patient.

As adoption of technology continues to spread, collaboration between patient and providers is promoted, resulting in improved transparency and, hopefully, better patient health outcomes across the continuum of care.

---

---

---

Frederick County Farm to School is working to incorporate locally grown produce into the public school system. They also aim to provide students, and their families, the knowledge and skills necessary to enjoy these foods! Interns have the opportunity to create education videos for Frederick County Farm to School. Check out the video below about bell peppers that an intern created.

---

---

Flu Tracker Tool

This activity was designed to teach dietetic interns of tools available online to monitor influenza rates across the country. Flu season is a scary time of year in the world go healthcare as it brings very sick patients into hospitals and if employees also contract the flu, there is a limited staff to treat patients. Using CDC’s flu tracker tool is a helpful way to stay up-to-date on flu prevalence in your area.

Flu Tracker Date Range: February 11 – March 30, 2018

I chose to track influenza rates in the state of New York because my brother goes to school in upstate New York and was infected with the Flu in late February. I chose to start at February 11, 2018 on CDC’s website in order to track four weeks of data.

Relevant Data:

Week One: February 11 – February 17

• 18, 258 laboratory confirmed influenza cases
• 61 counties reported cases this week
• Patients hospitalized with laboratory confirmed influenza: 2, 160 persons

Week Two: February 18 – February 24

• 13,703 laboratory confirmed influenza cases
• 61 counties confirmed cases this week
• Patients hospitalized with laboratory confirmed influenza: 1,702 persons

Week Three: February 25 – March 3

• 6,414 laboratory confirmed influenza cases
• 61 counties confirmed cases this week
• Patients hospitalized with laboratory confirmed influenza: 1026 persons

Week Four: March 4 – March 10

• 3,692 laboratory confirmed influenza cases
• 62 Counties confirmed cases this week
• Patients hospitalized with laboratory confirmed influenza: 694 persons

Summary:

Although the focus of this task was on tracking influenza between February 19 and March 24, I was curious to see when the flu was at its peak. In New York State, the flu changed from sporadic to local at the end of the week of November 25, 2018. The flu went from local to regional at the end of the week of December 2, 2018. Finally, the flu went from regional to widespread at the end of the week of December 9, 2018. The flu rates/prevalence remained widespread in New York State for 14 consecutive weeks (up until the last week with data provided – week ending at March 10). At its peak, the week of February 11-February 17, 18,258 people were reported to have laboratory confirmed influenza. As depicted by my chart above, the rates have been steadily decreasing since that time.

---

Low FODMAP Diet: Symptom Management for Irritable Bowel Syndrom (IBS)

---

Clinical Decision Support Tools: The Importance of Computerized Decision Making in the Clinical Setting

Gastroesophageal Reflux Disease, or GERD, is a digestive condition where the contents of the stomach readily flow back into the esophagus due to the inappropriate relaxation of the lower esophageal sphincter, causing irritation and possibly decay of the intestinal lining.(1) Many dietary and lifestyle choices contribute to the inappropriate relaxation of the lower esophageal sphincter. This includes obesity, tobacco use, hiatal hernias, and the consumption of caffeine, peppermint, chocolate, high fat foods, and alcohol. Over 60 million, or 20%, Americans are affected by this disease at least once a month, and over 15 million are affected daily.(1)

Treatment options range from dietary modifications to surgery, depending on the severity of the condition. Lifestyle modifications that are strongly encouraged include: losing weight, wearing loose-fitting clothing around the abdomen, sitting upright 3 hours after a meal, sleeping at an angle, and smoking cessation.(2)

We chose to analyze the process for diagnosing and treating GERD because we believe the Registered Dietitian plays a crucial role in the treatment and, more importantly, the prevention of this disease. Recognizing the initial signs and symptoms of GERD and consulting a Dietitian for early intervention strategies can lead to improved health outcomes, decreased risk of complications, and lowered costs incurred by the patient and healthcare system.

Clinical Decision Support Tools and Algorithms are increasingly being integrated into electronic health records to provide clinicians insight into timely and appropriate next steps in the clinical workflow. Computerization tools such as these, in theory, help expedite or reduce manmade errors during clinical processes.

The information used to create our Clinical Decision Support flowchart was pulled from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality website.(3) We chose to reference these evidence-based guidelines to create our flowchart because we believe the information provided a comprehensive medical approach to the diagnosis and treatment of GERD but was lacking in the Registered Dietitian’s role in the treatment and future prevention of this disease. With the help of a Registered Dietitian, the patient can gain lifestyle habits that can help prevent or manage the progression of painful symptoms related to GERD.

1. WebMD. (2018). Get the Facts About Gastroesophageal Reflux Disease (GERD). [online] Available at: https://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1#2-4 [Accessed 25 Feb. 2018].
2. National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Eating, Diet, & Nutrition for GER & GERD | NIDDK. [online] Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/eating-diet-nutrition [Accessed 25 Feb. 2018].
3. Guidelines.gov. (2018). Diagnosis and Treatment of Gastroesophageal Reflux Disease (GERD) | National Guideline Clearinghouse. [online] Available at: https://guidelines.gov/syntheses/synthesis/50025 [Accessed 25 Feb. 2018].

---

Food Allergy Awareness Social Media Toolkit

Social media toolkits are used in many different industries by businesses and organizations. The toolkits are designed around a specific topic, theme or event and filled with a variety of sample messages and graphic. Employees, partners or the public can then access and share these messages on their own pages to spread word or promote an event. As part of an internship project, we were tasked with creating a mock social media toolkit.

I designed my mock toolkit to promote food allergy awareness. I came up with a variety of different hashtags, social media posts, and graphics. Take a look at some of the graphics I designed to be shared on social media pages below.

---

An experience in myth busting with the International Food Information Council

IFIC is a company based in professionals. They cover topics such as food safety, food science, dietetics, Washington DC that focuses on promoting accurate and science backed food and nutrition information for both the general public, and health and health data trends. They gather and sponsor relevant and factual information through social media and technology platforms. They present information in easy to read/understand formats for the everyday reader, as well as data driven analysis for health institutions and related companies in the field.

Food for Thought this Healthy aging month -Adam Sachs
This article examines food and health trends of the portion of the population who are 65 and older, as well as their nutritional needs and if they are being met

A Clearer Look at Lutein -Julia Werth
Lutein is a phytochemical found in orange foods like carrots and pumpkins. This article separates the facts from fiction about Lutein in your diet

Chocolate Milk: Can a Childhood Fav be Fitness Fuel -Adam Sachs & Julia Werth
Written by runners, for runners. This article shows how top sports nutrition professionals are looking to chocolate milk as a recovery drink for long distance runs

Sugar Alcohols in Gum: A Wad Full of Benefits -Julia Werth
This article explodes the science of Sugar alcohols used in many sugar free chewing gums, and how they react in your body

Food Fad Friday: Apple Cider Vinegar – Julia Werth
Apple cider vinegar is being marketed as a nutritional and health powerhouse. This article takes on those claims so you can know the facts

A “Basic” Examination of the Alkaline Diet -Adam Sachs
Another fad diet that produces so-called miraculous results. This article tells you what the alkaline diet is, and if there’s any reasonable evidence supporting it

---

An Experience in Corporate Wellness with WCS

---

Learning to Manage Team Nutrition Training Grants at the Food and Nutrition Service

Dozens of spreadsheets, conference calls, constantly rethinking the best way to do something and when you’re at a loss and feeling exhausted an email shows up with photos of preschool children learning to love fruits and vegetables from the garden all the way to their plate makes it all worth it.

At the Nutrition Education, Training and Technical Assistance branch of the Food and Nutrition Service at the USDA I worked with Team Nutrition on managing their grants given in 2015, 2016 and 2017. These are 2-3 year grants given to a state to fund research-based project to aid students and staff involved nutrition education and food service at day cares and k-12 schools.

To feature some of the great work that comes out of all the efforts both in the national office and in the state I wrote three blogs on the Team Nutrition Training Grants blog.

---

Tracking Nutrition with Tech

There are lots of reasons to keep a record of what you eat. It might be to help manage a nutrition-related disease, to improve athletic performance or even to identify a food intolerance or allergen. The most common reason people keep food journals is in an effort to lose weight. Sometimes food journals are encouraged by physicians or dietitians who are counseling patients. It can help the healthcare provider gain insight into the patient’s habits, behaviors and preferences. Even without healthcare intervention, keeping a food journal has been shown in some studies to aid weight loss efforts.

Food journals have historically been written with pen and paper, but there are now many other ways to track nutrition with technology. Many new tech companies are rushing to develop and sell tools and devices for nutrition tracking and analysis. One device called SCiO is a small handheld molecular scanner that claims to analyze the food on your plate, with the caveat that the food must be homogenous. NutriRay3D is another gadget for analyzing the food in front of you. You input what the food is, and it 3D maps it to tell you how much is in the portion you have. These and other devices and wearables are interesting tech concepts, but are all prohibitively expensive and have no independent research on their accuracy or efficacy.

The most common route is through smartphone applications. There are countless different apps for nutrition tracking, but they typically share many of the same features:

• Providing estimates on nutrition needs based on personal data
• Tracking user-entered food info and calculating nutrition
• Supplying large databases of food and beverage nutrition information

The variation between apps is largely in their presentation and design. Some offer ways to streamline the process of entering food, like barcode scanning or storing and recalling previously entered recipes. Apps also often employ methods to increase engagement with the app, like push notifications, tie-ins to social media or making the app more game-like. The goal here is twofold: to encourage users to comply with keeping a food journal and to increase revenue through advertisements and in-app purchases.

The other commonality between nutrition tracking apps is a lack of peer-reviewed literature examining their efficacy. Almost no research has been done on nutrition tracking smartphone apps and their efficacy with weight loss or any other outcome. Given the fact that millions of people use these apps, more research needs to be done to see which apps or which features may be beneficial.

---

Advancement of Renal Care Through Technology

---

Informational Flyer on Mindful Eating

While working with Wellness Corporate Solutions, one of their initiatives for the month of march was to develop resources to educate clients on mindful eating. To kick off the month of march, the materials and resources on mindful eating were to be included on a weekly newsletter. I developed an informational handout, as well as a link to a mindful eating video. The handout was given to clients at various informational sessions, but also posted on the client portal for any member to take advantage of.

---