Kim Ross
People are what they eat. This is especially true for seniors. Unintentional or involuntary weight loss is a common phenomenon among older adults, occurring in 15 to 20 percent of the population, according to research estimates.  Identifying the root cause often can be challenging. The clinical consequences can be quite dire.
In most long term care facilities and senior living communities, clinical and nutrition information about a resident is, at best, stored in disparate systems and, at worst, is on paper in different filing cabinets. In some cases, comprehensive nutrition information for residents doesn’t exist at all, and intake studies are often performed as a reaction to negative events such as unintentional weight loss.
Getting to the root of the problem is often a process of multiple conversations among the care team over the course of days, weeks, or months. However, speed is of the essence in identifying and treating the cause of unintentional weight loss. Studies show that residents who experience a weight loss of 10 percent have a significantly higher mortality rate in the six months after.

How EHRs Can Help

There are several ways in which an electronic health record (EHR) with integrated nutrition management can support the treatment of unintentional weight loss:

1. Early detection. The EHR can track and trend changes in vitals, including weight and nutrition intake, and alert the care team early on when the resident’s eating habits change and/or weight begins to decline unintentionally.

2. Facilitate an immediate, consistent, comprehensive resident assessment. Rather than performing a standard assessment, the EHR can guide the clinician through a comprehensive assessment designed to evaluate and detect the cause of unintentional weight loss.

3. List potential laboratory studies and imaging. These suggested tools could help identify the cause of unintentional weight loss.

4. Rule out potential root causes. Studies have identified the common causes of unintentional weight loss. For instance, medications with adverse effects that contribute to weight loss are well known. The EHR can review the resident’s electronic chart for common causes, medications, and nutrition changes and then highlight potential causes applicable to the resident.

5. Provide suggested updates to the resident’s care and nutrition plans. Based on the potential causes applicable to the resident, the EHR can present possible treatments that can then be selected by the clinician as updates to the resident’s care plan. It can also drive changes to the resident’s nutrition plan for consideration by the registered dietitian.

6. Monitor the results of the updated care plan. The EHR can continue to track and trend changes in weight and nutrition, and then alert the clinician and registered dietitian accordingly.

Dietitians More Proactive, Less Reactive

While an EHR can help identify and address unintentional weight loss, without integrated nutrition information the clinician only has half of the story. Without understanding the resident’s nutrition intake and preferences, working with the registered dietitian to determine a course of treatment is extremely difficult. Likewise, the registered dietitian is hamstrung without information on diagnoses and medications that can trigger weight loss.

An effective nutrition management system can help dietitians efficiently perform an accurate intake study, and bringing that information into the EHR enables them to be more proactive and less reactive. In addition, the ability to analyze and trend nutrition and clinical data at a facility and enterprise level can help corporate dietitians assess the impact of new menus and nutrition programs.

Integrated clinical and nutrition information in the EHR can truly help providers deliver superior care, resulting in better outcomes for seniors.
Kim Ross, MBA, is senior director of marketing at MatrixCare. She can be reached at Kim.Ross@Matrix or (952) 995-9904.