The evolution and utilization of telehealth in ambulatory nutrition practice

The term telehealth is often used interchangeably with telemedicine. Telemedicine involves the electronic exchange of medical information between two remote sites for the optimization of patient care, whereas telehealth is the application of all electronic communication and delivery systems in the provision of healthcare. Telehealth gives patients an opportunity to communicate with their healthcare providers and, overall, access ambulatory care that otherwise is not available in their area of residence. Several telehealth delivery systems are available for electronic communication. Telehealth and other communications technologies used in the delivery of healthcare services are regulated at both the federal and state levels. Coverage and payment policies vary among the different insurers (e.g., Medicare, Medicaid, and private plans), and policies may further be defined by state telehealth parity laws. Telenutrition involves the use of digital technology to provide nutrition care to patients and caregivers and shows potential to optimize nutrition care and outcomes. The coronavirus disease 2019 pandemic has contributed to sweeping legislative and regulatory changes that allowed the temporary expansion of telehealth delivery and reimbursement to maintain continuity of care for patients who were not able to come in for an in-person office visit with their healthcare provider. The purpose of this review is to introduce key concepts of telehealth delivery systems including policy, legal, and regulatory considerations for ambulatory care as well as the role of telenutrition in nutrition care, and highlight the evolving role of telehealth in optimizing patient and nutrition care during a pandemic and beyond.