Overview of size, composition and role
Overview of group
|Description of profession||Dietitians are responsible for providing advice on diet and nutrition. The patient mix seen by dietitians is very diverse. It includes all types of diabetes, obesity, eating disorders, aged care menu reviews and malnutrition, liver and kidney failure, assisted and tube feeding, paediatric failure to thrive and HIV/AIDS.|
(2006 Census recorded 2,590)
|Gender mix||91% female, 9% male|
EXHIBIT 46 - Distribution by Age and State
EXHIBIT 47 - Overview of practice attributes
Education, registration and accreditation
- University degree required, either a four year under graduate Bachelor of Health Sciences Degree or a two-year postgraduate Masters degree in one of fifteen Universities accredited by the Australian Dietetics Council
- Successful completion of university study is followed by a provisional year practicing under supervision.
- In order to be eligible to register with Medicare, Dietitians must be registered as an Accredited Practicing Dietitian (APD) as recognised by the Dietitians Association of Australia (profession is not yet subject to national registration through AHPRA).
- To maintain this qualification it is necessary to undertake at least 30 hours of Continuing Professional Development annually.
Funding and referral system
- Outside the hospital sector ambulatory patients can access a dietitian by self-referral, or referral through a GP or medical specialist. In a private practice setting self-referred patients either pay full-fee for service, or if privately insured may obtain a rebate for the service from their health fund if they hold ancillary or ‘Extras’ cover.
- Eligible Dietitians can access Medicare on referral from a GP through the individual allied health items for people with a chronic or terminal medical condition and complex care needs (MBS items 10950-10970); the follow-up allied health items for people of Aboriginal or Torres Strait Islander descent (MBS items 81300-81360); and the group allied health items for people with type 2 diabetes (MBS items 81100-81125).
- GPs and hospital specialists can also refer patients to dietitians practising in publicly-funded Community Health Centres. Here the service is provided either free at the point of service or there is a nominal fee charged to help with compliance and attendance. In this setting, waiting lists to access dietitians can be very long as sessions are limited by the Centre’s budget.
Peak National Body
|Dietitians Association of Australia|
|Address||1/8 Phipps Close |
DEAKIN, ACT 2600
|Contact||T: 02 6163 5200 |
F: 02 6282 9888
T: 1800 812 942
DAA maintains a membership of approximately 4000 dietitians with an additional 450 student members. It retains responsibility for accrediting university curricula as well as CPD provision. The DAA also provides a pathway for international graduates to achieve recognition as Australian APDs, which involves examinations and a period of practice under supervision.
Dietitians and eHealth
Examples of relevant eHealth applicationsThe key uses of eHealth that dietitians will benefit from include:
- Use of electronic patient education resources from kilojoule-counting, to food-label interpretation – many of these programs are available as ‘apps’
- Electronic health records – must be shared to avoid serious errors involving allied health like missing food allergies and incorrectly transcribing the composition of tube feeds – this occurs already in public hospitals. Software should enable the dietitian to summarise their extensive notes and upload the summary to a shared record. A template should be created to better enable this approach containing the ‘nutrition diagnosis, issues for management and recommendations.
- Nutrition analysis software is currently available and this should be developed to directly interface with the electronic record to avoid duplication of data entry.
- A template for electronic referrals and doctor letter to automate care planning so that the dietitian can spend more time with the patient addressing actual problems rather than duplicating histories and data entry.
Current eHealth 'Position'Dietitians view themselves as technologically savvy and early adopters of technology. This is related to both their young age as most have grown up with computers, and the emphasis on calculations and analysis in their day-to-day work. They mostly use smartphones and many have iPADs in their personal lives, however those working in the public sector are very limited by the available infrastructure and software programs. Many public hospitals require that allied health practitioners share one computer between several people and the functions are limited. Dietitians also take extensive notes, particularly during the initial consultation and there is a lack of products available that meet this need. Those software products that have been developed for doctors do not take this requirement into account, which is a common problem faced by many allied health practitioners.
Key insights from eHealth readiness survey
- Dietetics is a young field, with 56% of practitioners under 35 years of age. 52% work in more than one practice location. 16% of dietitians reported they worked daily in rural or remote areas, while 75% suggested they never did.
- Educational needs lead the current uses of eHealth solutions for dietitians, with 72% accessing online clinical materials, and 68% utilising online CPD. A further 24% and 27% respectively would like to use these tools.
- Recording of patient notes is a clear need, with 49% of dietitians suggesting they do so after a consultation, and a further 46% who would like to. 43% view or record patient information during a consultation, with a further 43% who do not, but would like to.
- Collaboration is the leading unmet need for dietitians, for although 27% share health records with other practitioners electronically, a further 67% do not, but would like to. The educational role dietitians play is also evident, with 42% using computers to show patients health related information, and a further 44% wanting to. Just 12% currently share health records with patients electronically, while a further 55% would like to.
- Telehealth use amongst dietitians is above average (15% use), and 34% expect to be using telehealth solutions within 3 years. Although training (32% expect to be using within 3 years) and consultations with other practitioners (28%) are the leading desired uses, patient monitoring (23%) and consultations with patients (22%) also show significant interest.
- 29% of dietitians maintain all records in paper form, while 13% only use computers. Of the 71% storing some form of records electronically, 65% use an EHR. 81% of dietitians strongly agreed they would like access to a shared patient record. 80% strongly agree that the majority of their colleagues are using computers, while 78% strongly agreed that computer use is expected in their profession.
- Top perceived benefits of eHealth for dietitians include improving collaboration (67% strongly agree), improving continuity of care (62%) and improving practice efficiency (55%). Although dietitians also perceive strong benefits to the care delivery process (38%), patient safety (35%) and quality of care (33%), the extent to which this improves patient satisfaction (16%) and relationships (15%) is less clear to practitioners.
- Affordability is the leading adoption barrier for dietitians (43% strongly agree), followed by compatibility (31%) and connectivity (29%) concerns.
- Dietitians listed their top drivers of adoption as the influence of other practitioners in their network (56% strongly agree), financial incentives (55%) and the advice of their professional body (51%).
16 Dietetics Association of Australia, Annual Report 2009