Nothing is more obvious than the importance of good nutrition in preventing and managing chronic disease. Paradoxically, nothing has been more difficult for many physicians to implement than comprehensive nutritional therapy.
Lack of adequate nutrition training, the time required for thorough consultations, the copious but often confusing evidence base, the dizzying array of nutraceuticals, and the outlandish marketing claims all combine to make this essential aspect of health care all but absent from most primary care practices.
The developers of NutriScan, a proprietary, computerized, office-based nutritional assessment and supplement management tool, hope to take the hassle and headache out of nutritional practice.
The brainchild of Paul Sullivan, a pharmacist and nutritional product formulator, NutriScan was designed in collaboration with a team of physicians and nutrition researchers, to address what its founders view as the very real roadblocks that limit physicians’ abilities to integrate patient-centered, nutrition-based health maintenance and disease prevention strategies. An early version of the system was launched in January 2001.
“After many decades of medical research, and the best efforts of thousands of our brightest minds, medical disabilities and chronic disease rates continue to soar,” said Mark Percival, ND, NutriScan’s medical director. “The associated prescriptions of drugs to manage these states of compromised health are increasing at a rate that cannot be maintained. The snowballing financial impact and devastating consequences of adverse drug effects all lead to the conclusion that there has to be a more effective, integrative approach.” He and his colleagues believe NutriScan provides such an approach.
Streamlining Nutrition with NutriLogic
Implementation of the NutriScan system is quite simple: after enrolling, a physician is given an individual access code, which he or she then conveys to patients, who log on to NutriScan’s website using this code. Once online, patients fill out a questionnaire comprised of 34 questions for males and 36 for females. The questionnaire, which takes roughly 20 minutes to complete, assesses a host of health parameters, including age, gender, geography, current health status, personal and family history, genetic predispositions, ethnic background, diet, lifestyle factors, current and past medication and supplement use, risk for common chronic diseases, and allergies.
A system of more than 4,000 evidence-driven rules, known collectively as NutriLogic, assays the patient’s responses and generates a Personalized Nutrition Profile for each patient, outlining key nutrient requirements. “All of our recommendations are science-based. We provide low and high-priority recommendations based on the best available data,” explained Richard Perryman, ND, a member of NutriScan’s clinical staff.
For each supplement recommended, NutriScan can provide physicians and patients with a comprehensive report on the specific indicators in the patient’s profile that triggered the recommendation, the expected benefits, literature citations and abstracts supporting the recommendation, and a review of that particular nutrient’s history in clinical use. The report also includes information on safety, specific dosing, scheduling, and potential interactions.
After review by the “referring” physician, and with consent of the patient, NutriScan will provide a customized monthly supplementation program carefully tailored to the patient’s core nutritional needs, while avoiding potential drug-nutrient or nutrient-interactions. NutriScan sends the supplements by mail within 48 hours of order, and the patient receives individualized, twice-daily, sealed packets. The packets are labeled “AM” and “PM,” indicating the optimal time to take each set of nutrients.
Precisely Timed Dosing
Chronobiology is a core principle for NutriScan. A growing body of data indicates that human metabolism is governed by multiple interlocking circadian and monthly cycles. This is especially true for women, the most obvious example being variance in iron requirements over the menstrual cycle. During the menstrual period, a woman loses a lot of iron and her need increases relative to other times of the month. It makes sense to tailor her intake by increasing the dose during menstruation, while lowering it before and after. Greg Kelly, ND, one of NutriScan’s scientific consultants, has been studying the chronobiology of nutrient metabolism for years, and has built these principles into the system.
The key to incorporating dose variations into NutriScan’s supplementation programs is the automated robot that prepares the daily packets. Designed for use in the pharmaceutical industry, the robot is controlled by the individualized data from each patient’s profile. Automation eliminates errors, and customization of the daily packets goes a long way toward preventing under- or over-dosing.
According to Dr. Perryman, inadvertent over-supplementation is a common problem, especially among patients who self-treat with multiple nutraceuticals. Using selenium as an example, he explained that, “It is not unusual to find selenium in multi-vitamin formulas, antioxidant formulas, thyroid support products, and eye formulas. An individual taking 4 such products can end up getting excessive amounts of selenium. Many supplements favorably impact physiologic function at one dose, but have either no added benefit or produce unwanted effects at higher doses.” By sticking to NutriScan’s daily program, patients avoid these potential risks and wastes.
Cost-Effective for Physicians, Patients
From an economic viewpoint, NutriScan is a win-win prospect for clinicians and patients alike. Start-up costs for physicians are essentially non-existent, and NutriScan returns 25% of all revenue from patient orders to the physician. It makes it easy for physicians who have been reluctant to dispense supplements to provide comprehensive nutritional interventions. For doctors who do dispense, it eliminates the cost, time, and space required to maintain an on-site formulary.
Patients pay a small administrative charge of $16.95 for processing the assessment questionnaire and generating the Nutrition Profile. NutriScan then credits this fee toward purchase of the individualized supplement program. The monthly cost to a patient will vary, depending on the individual’s nutritional needs and health status. But even an intensive program will still be cheaper than retail purchase of separate bottles of each recommended product.
Strict Quality Standards
NutriScan is an independent entity, not financially beholden to any one supplement manufacturer. Consequently, NutriScan’s clinical staff can select products from a wide range of manufacturers. “No one supplement company truly has uniform quality and efficacy across their entire product line. We are able to shop around and select the best product for each nutrient category,” Dr. Perryman told Holistic Primary Care.
The company’s quality and safety standards are stringent. NutriScan will only dispense products with strong evidence of clinical efficacy, clear track records for safety, and demonstrated adherence to the highest standards of good manufacture. “We do not maintain vast warehouses full of products that we then have to push onto the market. We can change the products we use very quickly, based on new evidence. So our system is constantly evolving.”
Likewise, the matrix of rules governing analysis of a patient’s nutritional needs can be rapidly revised based on emergence of new data. Dr. Perryman said future iterations of NutriScan will allow clinicians to submit clinical lab results, hormone profiles, and other objective biomarkers along with the patient’s responses to the questionnaire. Currently, they must make their own assessments of NutriScan’s recommendations in light of any lab work or clinical observations that might influence nutritional decisions.
Dr. Percival added that NutriScan is compliant with HIPAA guidelines. A patient’s personal health information is reviewed exclusively by NutriScan’s team of medical advisors and his or her own physician.
One of the many positive aspects of this system is that it provides a valuable tool for tracking the therapeutic impact of nutritional interventions. The personal nutrition profile provides baseline information; periodic re-testing and lab work can give insight into positive and negative health changes associated with the recommended interventions.
So far, NutriScan has been pilot tested for one year in approximately 450 clinical practices, and has had a 78% patient retention rate, indicating strong adherence. Dr. Perryman said this reflects the fact that NutriScan’s individualized packets make it easy for patients to follow. The company also provides a lot of patient education and support materials. Physicians and patients alike end up learning a lot about nutrition along the way to better health.
For more information about NutriScan, visit www.mynutriscan.com, or call 888-888-8565.
