We are excited to feature an interview with Catherine Frederico, MS, RDN, LDN. Catherine Frederico is an industry leader in nutrition technology and has been at the forefront of innovation in the dietetics field for years. We discussed her journey in dietetics and using new technology.
Healthie: Tell us about your career as a dietitian.
I’ve had an exciting and varied dietetic career for nearly 40 years, so this may be a long story! I received my B.S. from Pennsylvania State University in Biological Health/Nutrition Science. I earned my M.S. in Home Economics/Foods and Nutrition from Arizona State University and I interned at Mesa Lutheran Hospital. Besides patient menu management and consults, part of my responsibilities included writing a monthly nutrition article for the hospital newsletter.
My first job out of college was as a part-time renal dietitian position in Pennsylvania. Shortly after, I accepted a full-time position with the same company in Boston. The company was a 24/6 dialysis unit with 400 patients. It was 1 of a few large dialysis units in the country and was also near the corporate headquarters and research offices. The facility serviced all the major Boston hospitals, so I knew all the local nephrologists and renal dietitians. It was common to have dietitians from around the country call for information.
For many years, I kept a staggered daily schedule to see every shift each week. After some time, the company agreed to hire 2 more part-time dietitians. This position as Director of Nutrition Services was instrumental in shaping my career skill set. Very early on, my mentor made sure that I joined the National Kidney Foundation’s Council on Renal Nutrition. She also advised me through submitting an abstract and speaking program every year. I became co-editor of the CRN Quarterly, and was awarded Renal Dietitian of the Year. I was local Chairperson when we collectively wrote a patient cookbook, patient handbook, and renal dietetic manual. I also served on the local chapter of the National Kidney Foundation and served as Treasurer of the federal ESRD Network #28. My renal experiences over those 11 years prepared me for careers in almost any direction I wanted to explore.
To my surprise, when it was eventually time to return to my full-time career after raising children, my former renal position was available. This time we charted with DOS programmed computers. I had to set up the structure for my notes for each patient. I stayed two more years, and then began consulting for a new large fitness center.
I became an adjunct professor at 4 colleges and began teaching a wide variety of courses, including Computer Applications in Nutrition. This course covered professional use of social media, apps, and more. To further develop my food science skills, I took an online Harvard edX MOOC course and also attended the free public lectures and demonstrations that featured talented and noted global chefs.
While at Regis College, administration received a grant to upgrade their communications infrastructure by 500%. In the fall they gave iPads to all students and faculty. I became part of their Innovators Group to help with training and also attended monthly weekend education sessions with Apple educators to learn more about their productivity applications.
I continue to speak nationally and internationally on nutrition technology, electronic health records (EHRs), telehealth, and apps and gadgets of interest to consumers and dietitians. I have written several tech-related eBooks and articles (available on my site AppyLiving.com, and continue to work in app development.
Most recently, I am creating a nutrition tech workshop/webinar series, updating a food science textbook chapter, writing texts on nutrition informatics for health professionals, an ebook on digital health for consumers, as well as consulting. I enjoy managing my websites NutritionVision.info and AppyLiving.com, reading daily news and blogs about digital health, keeping up with personal health tech devices, and adding to my personal collection.
Healthie: What role has technology played throughout your career?
The technology at the time included corded phones, electric typewriters, dictation recorders, printouts of blood lab values, fax machines, and special kinetic modeling calculators. I was a preceptor for many interns over the years, and I once partnered with an intern to write Hemodialysis Nutrition Trivia. We had a graphic artist lay out the book for us and have it printed. We sold and mailed them all over the world. For special projects, I had access to the one large computer machine in the facility. Charting, care plans, and discharge summaries were mostly handwritten.
In the mid 1980s, I realized that dietitians could reach a larger audience with health messages if they used television. I was terrified of being in front of the camera, but hoped if I learned how to film content, that I would overcome that fear. I spent time becoming cable television certified at the Wellesley, MA station and worked with classmates on set and on location to air a Nutrition Spotlight segment for the town’s news program. I created nutrition cellphone text alerts called Nutrition411 and Apronstrings to market nutrition materials and products to parents, teachers, and youth programs. During summers on Cape Cod, my 3 children, their friends, and I made nutrition public service announcements for the local cable television station. The collection became the start of my website, NutritionVision, and also a guide book.
Ultimately, when the iPhone’s App Store opened, I became seriously interested in tapping its power for nutrition purposes. I serendipitously heard about a 2010 USDA Nutrition Game Jam and decided to attend on a whim. It was like falling through a looking glass into a new world. A programmer and I created a second-place computer food game, and I soon met a young student who was willing to work on making it into an iPhone app. That led to three more apps, and then collaborating on three more. My apps include Food Focus: Fruits and Veggie Garden Palooza and Max’s Plate for MaxOnSnax. I continued to be a Nutrition Section Chair for GamesForHealth.org for five years.
As an early adopter of tech and a professor, I kept pace with new health apps, connected devices, telehealth, and EHR development. In response to many inquiries about my favorite apps, I wrote the eBooks An App A Day and An App A Day for Health Professionals.
In 2012, I took the AMIA/Academy’s 10×10 Biomedical Informatics graduate course and met other Academy members interested in technology and informatics. As a result of my growing informatics awareness, I wrote the eBook, HIA: Health Informatics Acronyms. Many 10×10 grads serve on the Academy’s Nutrition Informatics Committee (NIC) or Interoperability & Standards Committee (ISC) or Consumer Informatics Work Group (CHI). I joined CHI in 2013. My 3-year term (2 as Chair) on CHI (now part of NIC) ended in June 2016.
Healthie: What are some of your proudest accomplishments as a member of the Academy?
Many years ago, I chaired the Massachusetts Council on Practice, served on the Public Relations Committee, and Executive Board. I was elected a Young Dietitian of the Year. More recently, I very much enjoyed serving on the Academy’s CHI and NIC. It was fascinating work and an honor to work with so many brilliant dietitians who have selflessly committed years to advancing nutrition informatics for all Academy members. Serving gave me the opportunity of representing the Academy on several conference programs including FNCE, HIMSS, and an NDEP regional meeting, as well as writing articles for newsletters and blogs, and developing nutrition tech materials for members, and building awareness. I now have a clearer picture of the workings of the Academy, and appreciate my membership even more.
Healthie: How do you think the role of the dietitian is changing because of technology and new tools available?
Regardless of technology, the primary role of the dietitian was and still is helping individuals and the public at large achieve their best health by using scientific evidence to empower them to eat well. The new usage of technology in healthcare demands responsibilities of dietetic practitioners to stay current on relevant digital health products, functionalities, and methods and that affect our care and our clients.
In many conferences and articles I see that doctors and nurses do not have time to follow and comment on data other than outlier alerts. Data aggregators are trying to digitally streamline this process, but dietitians are well educated and trained to assess, explain, and act on parameters such as weight, blood pressure, and calorie expenditure data. Dietetic practitioners seeking to expand their practices can employ digital health strategies to expand their scope of client services and advertise them!
Healthie: Why do you think dietitians should embrace technology?
The power of technology in healthcare is tremendous and growing rapidly in all areas of practice: clinical, food & culinary, business management, and research, to name a few. Technology streamlines our work making it faster and more efficient, enabling us to provide better care, have a greater global reach, and hopefully see better outcomes. Rapid cellphone proliferation has provided a new space to reach clients near and far. Smartphone features and medical peripherals, as well as apps, trackers and sensors, have created a new industry of, businesses, organizations, and practitioners that center around health technologies. Which digital strategies work the best is just now beginning to be studied and realized and we will need to follow the science. Still, dietitians need to communicate with their clients in ways that are familiar, common, and ubiquitous. It is no longer a question of whether dietitians should embrace technology, but how.
Healthie: What advice do you have for dietitians just entering the field?
First, be a sponge. Read everything you can get your hands on about digital health, take a nutrition tech course, download a few health apps, or try a small digital health device. Get in the conversation and join the over 1100 members of the Academy’s Nutrition Informatics Community. Read the materials in the “Library.” The Academy is planning additional, exciting nutrition technology initiatives. Look for them at FNCE, online, and in publications. Follow their nutrition informatics blog, The Feed. Attend local and national digital health conferences. Write and speak at conferences and with consumer and regulatory groups when you can. Be inquisitive, be leaders, and support and inspire others. This is a career-long process.
Some health professionals are fearful that technology will make their jobs obsolete. I have been working in nutrition technology since 2010 and have found just the opposite to be true. Many dietitians are working for health tech companies or creating their own to develop and code apps or teach, do research, advise, or train others. Nutrition technology is opening up a world of opportunities. It is an exciting time to be a dietitian. Seize the day!
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