Tufts Medical Center to pilot nutrition screening in EHR

By creating food and nutrition insecurity screening within Tufts Medicine’s Epic electronic health record and patient engagement system, the new Tufts University Food is Medicine Institute in Boston and its team of medical, scientific, technology and health policy collaborators hope to advance the science of food and medicine.

They also want to figure out how we can address food and nutrition accessibility within the healthcare system.

Proponents say food-based interventions can address one aspect of the social determinants of health and improve health equity, while also addressing chronic diseases.

At the international level, the World Health Organization focuses on food security and other challenges to address global health equity. As part of the National Center for Chronic Disease Prevention and Health Promotion, the US Division of Nutrition, Physical Activity and Obesity, the Centers for Disease Control and Prevention also focuses on food and nutrition security as one of the five social determinants of health.

Dr. Dariush Mozaffarian, a cardiologist and the Jean Mayer Professor of Nutrition at the Friedman School and a driving force behind the study of food in medicine at Tufts, said the institute will approach this as “food-based nutritional interventions integrated into health care to treat diseases and promotes health care equity with supportive policies and programs at the population level.”

“But the core focus is: how do we actually get food into healthcare?”

In addition to her efforts to collaborate with the team embedding food safety screening tools into Tufts Medical Center’s EHR, Ronit Ridberg, research assistant professor at the Friedman School, said her research also focuses on food is medicine as a way to support mother and child. health equity by looking at how people use prescription programs.

“We want to test strategies to increase participation, engagement and use of benefits, just the way people want to use these programs,” she said before introducing a panel on cross-sector collaboration.

When Mike Dandorf, president and CEO of Tufts Medicine, was asked why Tufts created a food institute, he explained that a number of things need to happen to include food as part of point-of-care care.

“What I’m trying to do is pave the way for a different trajectory for health care,” he said.

“And at Tufts Medicine, we really try to be a key player in what we want health care to look like.”

Dandorf acknowledged that as a medical company, Tufts and others provide excellent medical care in the U.S., “but we are really falling short when it comes to healthcare.”

According to the Implementing Food and Nutrition Security Screening in EPIC and Clinical Care at Tufts project websitethe process will be based on:

• Identifying best practices for streamlining clinical workflow to include screeners.
• Expanding these successful screening practices across departments and practices, such as general medicine, maternal and paediatrics, paediatrics and cardiology, etc.
• Collecting reliable data for research that can examine associations between positive screenings and health outcomes, health care use, and costs.
• Improving nutritional status and health of patients through resource referrals and related research.
• Identifying departments within Tufts Medicine to replicate these efforts.

While screening can add to providers’ digital burden during appointments, point-of-care tools that effectively capture and use SDOH data can also help providers advance healthcare equity, said Mohamed Humaidi, senior vice president of data and analysis at New York University. Florida-based health coordinator CareAbout.

EHRs “often lack the ability to easily integrate or exchange data with various sources, even between EHRs from the same vendor,” Humaidi shared. Healthcare IT news in June.

Healthcare SDOH interventions require multiple partners

Many moving parts and partners are needed to address food and nutrition insecure patients in the healthcare system, in addition to technologies that integrate with EHRs.

At the institute’s launch event last week in Boston, the speaker list included healthcare leaders, medical scientists, policy makers, food safety organization founders, patients and partners from the technology and life insurance industries who have worked to advance food-based interventions in the healthcare.

Many joined the event virtually – including World Central Kitchen founder Jose Andres, Senators Cory Booker (D-New Jersey) and Ed Markey (D-Massachusetts), US Secretary of Agriculture Tom Vilsack, Congressman Jim McGovern (D-Massachusetts) and others. .

Mozaffarian noted in his overview that food insecurity, “which is not exactly the same as poor nutrition,” has the highest rate of diet-related diseases. A map he shared showed an overlap between food insecurity and diabetes.

Policymakers reiterated the lack of access to food and nutrition as a barrier to advancing healthcare equity and also noted that the cost of Food insecurity adds billions to healthcare costs every year.

“Right now, we live in a world where healthcare providers are writing more and more prescriptions, while researchers tell us that prescribing fresh fruits or vegetables can often help as well,” said McGovern, who works in the healthcare field. House Rules Committee and is a senior member of the House Agriculture Committee.

“We need a paradigm change,” he said.

In previous years, the USDA has funded food equity programs through Medicare and Medicaid. Vilsack spoke about a number of initiatives, noting that the Gus Schumacher Nutrition Incentive Programwhich ends in 2023, funds fruit and vegetable purchases by SNAP participants and has a produce prescription program.

Pam Schwartz, Kaiser Permanente’s executive director of community health, discussed four medically tailored meal studies to support disease management and wellness, which are based on the presence of both a specific health condition and social needs.

She reported positive results for diabetes patients from a study in which Instacart delivered curated boxes of product prescriptions to Medicaid patients with diabetes or pre-diabetes for six months.

The work will be presented soon, said Schwartz, who leads the organization’s national food security strategy and ensures that social health interventions are integrated into Kaiser’s care and services provided to Medicaid members.

Kaiser researchers “see lower rates of A1C in a very difficult-to-serve, high-risk population,” she said.

“Our physicians are very excited about this. Our patients are very excited about this.”

Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.