March 2013

HealthLinkBCBarb Leslie, Director

Dietitian Services

About HealthLink BC

HealthLink BC is a non-emergency health information service that

provides B.C. residents with 24-hour access to medically-

approved information and advice at any time from anywhere in

the Province, providing:

• Nursing Services

• Navigation Services

• Pharmacist Services

• Dietitian Services

2

HealthLink BC Public Services

3

Print:

• is a self-care manual that provides information on common health concerns.

Web:

• is an interactive website with information on many health topics and over the counter and prescription drugs, as well as, an interactive symptom checker.

Phone:

• is an easy-to-remember three digit number for 24/7 access to non-emergency health information and advice.

Application:

• The BC Health Service Locator App helps you find clinics, hospitals and other health services near you.

Dietitian Services at HealthLinkBC

4

• History:

• 1972: Dial-A-Dietitian opened in Greater Vancouver

• 1991: Province-wide

• 2002: Joined BC HealthGuide program

• 2008: Dietitian Services at HealthLinkBC

• 2010: HealthLink BC in the Ministry of Health

Dietitian Services Mon. to Thurs. 8 a.m.–8 p.m. and Fri. 8 a.m.–5p.m.

• Free of charge, up-to-date, evidence-based nutrition information, counselling and advice by telephone • General Contact Centre

• Telephone - 1972

• Client Email - 2011 • Specialty Area Services

• Allergy Nutrition - 2004• Oncology Nutrition - 2007• Pediatric Nutrition - 2011• Provincial Food Policy - 2008• Healthy Eating Promotion - 2011

• Resource Management Centre

5

General Contact Centre

• Mon. to Thurs. 8 a.m.–8 p.m. and Fri. 8 a.m.–5p.m. • Contact Centre registered dietitians (6.2 FTE) • Operations Manager (1 FTE)• Senior Dietitian, Practice Improvement (1 FTE)• Call 8-1-1 and ask to speak with

a registered dietitian• Email a HealthLink BC Dietitian

6

HealthLink BC Dietitian - Top 10 Categories

Telephone Service

1. Chronic Disease 2. Infant Feeding3. Gastrointestinal Concerns4. Healthy Eating5. Food6. Food Allergy and Intolerance7. Safe Food & Water8. Healthy Weight9. Nutrients and Supplements10.Cancer

Email Service

1. Healthy Eating2. Healthy Weight3. About Dietitians4. Nutrients and Supplements5. Digestive Concerns6. Babies and Children7. Food8. Diabetes9. Heart Disease10.Food Allergy and Intolerance

7

Clients - 2011

• How do clients find out about Dietitian Services?• Self-referral 60%

• Referred by Health Care Provider 21%

• Print or Website 5%

8

Nutrition Care Type - 2011

• Dietitian Defined Nutrition Care Type:• Nutrition Information: 54%

• In-depth Individualized Nutrition Information:28%

• Medical Nutrition Therapy: 18%

9

10

Dietitian Services – Performance - 2011

Outputs

Short Term

Outcomes (11-12)

Medium Term

Outcomes

General Service 17,857 calls & emails received

Interventions: 73% education 9% counselling3% care coordination

5% increase in calls/emails offered over prior year

98% of clients say they receive the help they ask for

Specialty Area Client

Encounters: 313 Pediatric, 573 Oncology, 576 Allergy

57% increase in specialty area client encounters

Nutrition Resources

105 consumer, 137 translated, 146 professional 22,710 nutrition resources downloaded, emailed, or mailed

CPEN evidenced based resources answer 91% of caller needs

Annecdotal Self-Reported Outcomes…..

• “….During the past 6 months I have phoned your office 4 times … I was given good advice and explanations on how to change and improve my diet … I have made a 33% reduction in triglycerides, a 12% reduction in cholesterol [sic] … I am 63 years old and I have a tradesmen's intellect and I was able to receive from your office that I describe as simple, easy to understand explanations of what appears to me to be a complicated subject. My doctor and myself are pleased with my progress and I really appreciate your help.”

Email from W. D.

• After 18 years on blood pressure medication I called your service and, since following your diet, I have lost 40 lbs. And am now off my medication. No, I love moving more than before.”

BC Caller

11

Specialty Area Services

• All Specialty Area Nutrition Services provide:• Contact Centre services, professional support, and resource

development services

• Specialty Area Nutrition Services:• also develop Nutrition care plans

where nutrition services do not exist in a community

• Allergy (1 FTE) – 9:00 - 4:30 M-F

• Oncology (1 FTE) – 9:00 – 4:30 M-F

• Pediatrics (1.5 FTE) – 9:00 – 4:30 M-F 12

Provincial Food Policy Service

• The Provincial Food Policy Service at Dietitian Services supports provincial healthy eating initiatives:• Guidelines for Food and Beverage Sales in BC Schools and

the Brand Name Food List• BC regulation restricting trans fat in

food service establishments • Informed Dining - a voluntary program

where participating restaurants provide nutrition information on all their standard menu items.

13

Healthy Eating Promotion Service

• The Healthy Eating Promotion Service was established in spring 2011 as the “public face of healthy eating initiatives in B.C.” to:• Support public outreach promotional campaigns and

initiatives of the Ministry of Health Prevention Strategy, and

• Increase awareness and facilitate education about healthy eating in British Columbia.

• A current key area of focus is to support HealthyFamiliesBC initiatives http://healthyfamiliesbc.ca

14

Healthy Eating Promotion Service

• http://healthyfamiliesbc.ca• Blogs!

15

Dietitian Services Resource Management Centre

• Development of accessible, evidence-based resources, professional counselling tools and website content

• Resources for consumers and professionals

• Ministry of Health nutrition resources:• HealthLinkBC Files• BC HealthGuide Book and www.bchealthguide.org• Resources for specialty groups

• Website access to resources for consumers and professionals at www.healthlinkbc.ca/dietitian

16

Resource Management

• Mon. to Thurs. 8 a.m.–8 p.m. and Fri. 8 a.m.–5p.m. • Registered dietitians (1.8 FTE) • Manager Resource Coordination• Web Officer

• Supports the Dietitian Services Contact Centre• Maintains a web-based nutrition database customized for

use by Dietitian Services at HealthLink BC (CPEN) in partnership with Dietitians of Canada

• Prepares responses on “hot topics” – nutrition or food safety issues that are in the media

17

• DAD collaborated in the development of CPEN with Dietitians of Canada in 2005-2006

• CPEN is a call centre “portal” of DC’s PEN knowledge base• Eat Right Ontario (ERO) uses a call centre tool called OPEN.• DAD Assisted Ontario in setting up their nutrition call centre pilot

project in 2006-2007

• PEN partners participate in Annual Strategy Meetings and in PEN Product Steering Committee Meetings• Technical enhancements• Collaboration on content

18

Customized Practice Based Evidence in Nutrition (CPEN)

Why did we customize PEN?

• CPEN allows for • Quick, efficient information retrieval by dietitians

• Customization of resources for a call centre • Call Centre Resources for Dietitians

Standardized Responses (STDRES) Counselling Guidelines Topic Pages

• Consumer Resources Nutrition Fact Sheets

• CPEN provides guidance for answering over 90% of callers’ inquiries

• CPEN Feedback supports quality improvement 19

CPEN

20

A codified documentation tool at HealthLink BC: First Contact Dietitian - February 2011Purpose: To introduce a Dietitian Electronic Documentation

Tool as part of the HLBC electronic health record software application to facilitate:

• A consistent approach to nutrition care - NCP/IDNT• Documentation of the client/dietitian encounter• Collection of business metrics via standard reports• Communication with other health care providers• Service evaluation

21

FC Dietitian Telehealth Record

22

FC Dietitian Telehealth Record

23