IDA workshop – Nutrition Diagnostic Language
I’m attending the Fall 2007 Illinois Dietetic Association Workshop at Illinois State University. Me, Scott Blank (Peoria), Mike (Peoria), and Calvin (Bloomington) are the three men in a room of 100 women. Pardon me while I ramp up my testosterone levels to compensate. I live in a house with my wife and three girls, so I’m used to this environment.
The featured speaker is Annalynn Skipper Ph.D., R.D., FADA, and the Editor-In-Chief of ADA’s online Nutrition Care Manual. Today’s topic: An Overview of the Standardized Language for Nutrition Care.
The leaning tower of Babel:
I write software and design systems for dieticians, and I have seen the vast regional differences in dietetic and food service terminology. The most basic example is the word used to describe the food that the patient will receive if they were not available able to choose food:
- House Diet
- Pot Luck
- Default Items
- Non-Select
So, imagine the differences in the clinical realm, and how these differences can hinder the portability of relevant clinical information from region to region. Several organizations (citations needed) are working to standardize the language of nutritional diagnoses, interventions, and outcomes for several reasons, including:
- to facilitate electronic medical record storage
- to increase the portability of information
- to ease interdisciplinary collaboration
Differences in the diagnostic process go even deeper than the terminology; institutions around the world implement different formats for documenting: PIE, SOAP, ADIME, etc.
The lowe$t common denomination
Hospital administrators take note: You should drive your dietary departments to adopt the new standardization, because it will save you money.
According to Ms. Skipper, The US Congress in 1999 approved medicare reimbursement for clinical dietician services for patients with two diagnoses; Diabetic, and Renal. No other dietary diagnoses are reimbursable by Medicare. The reason for the decision: the lack of measurability of the other diagnoses. Apparently, the supporting literature attached to the legislation only demonstrated measurability and evidence-based outcomes for those two diagnoses, and the literature for the other diagnoses/treatment types did not.
Mrs. Smith Goes to Washington… again?
Are efforts already underway to correct that shortcoming? Given the current war on obesity, I’m assuming that the Medicare billing situation for obesity and many other dietary services will change. Obesity is just one very small part of the dietitians’ client portfolio, but the other dietetic services (that demonstrate evidence-based outcomes) will likely get rolled into a Medicare billing legislation if the argument is properly made and well-formed. I agree with Annalynn Skipper: Standardization and evidence-based treatment plans are key to garnering increased respect from other medical disciplines, and building legislative support for reimbursement the next time around.
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