Knowledge of intensive care medicine and skills in critical care has seen a tremendous growth in India in the last 30 years. Medical technology impacts many aspects of healthcare, particularly critical care and encourages innovative ways for data collection,analysis and prediction of treatment and nutrition.

Keeping in line with the growth in medical technology, DocMode has introduced it’s own innovation to approach nutrition therapy in scientific and objective manner. The innovation has been getting great exposure on various platforms. Recently we have been published in the Principles in Critical Care Nutrition 2018 edition by ISCCM Pune.

Role of iNutriMon in the Planning and Delivery of Feeding :

Formulation and delivery of nutrition in India is more difficult than the west where liquid based nutrition is the norm. Indian ICU deals with powder based scientific feeding formulae which makes the formulation very complex and difficult, more so with large variety of products available in the scientific feeding formula segment. A web based innovative tool to approach nutrition therapy in a scientific and objective manner is iNutriMon.

It is designed to to improve acumen and manage nutrition prescriptions to improve the workflow efficiency of nutrition. It is capable of identifying patients that are at risk of malnutrition based on the analysis of the data that is provided to the software which includes co-morbidities, weight, height, dietary history, APACHE score, SOFA score etc. with the utilization of validated formulae like the NRS 2002 and the NUTRIC score. The software suggests the calories and protein requirements as per simple predictive equation and also gives the option of using multipliers in the form of stress factors.

The software also judges the number of scoops of scientific feeding formula with the amount of water that would be required as per the recommendations of the supplement used. The prescription further details the rate of delivery in ml/hr. The software also helps in the exact prescription of total parenteral nutrition (TPN) and parenteral nutrition(PN).

The nurses can monitor the delivery the delivery of nutrition in a real time manner. The deficit as a result of stoppage of feed can be added to the feed on the next day in order to avoid caloric and protein deficit.A weekly graph based on the suggested versus the delivered proteins and calories is provided giving the user a visual estimate of the amount of energy and proteins supplied v/s prescribed helping the user to understand the case better. This software also works as a powerful research tool helping to study various aspects of nutrition prescription and delivery.

Such computer assisted prescriptions may thus help in:

  • Improving the provision of energy and proteins as per guidelines.
  •  Reducing the work load of nurses and dietitian in complex dietary calculations that are common to critically ill patients.
  • Making the prescription rather objective, rational, scientific and simple thus improving prescription quality.

Our Founders on iNutriMon:

“iNutrimon was an interesting innovative project to work with. It was more than just translating the nutrition delivery into a web-based application. It took us more than two years to create the comprehensive software where we had to understand the different clinical nutrition processes in the intensive care unit and extend the application throughout the hospital to suggest and manage the entire nutrition therapy. 

We realised the importance of assessment tools, risk scores and predictive equations in evidence based medicine to help build the acumen, decision making of the healthcare providers. We also understood that softwares used in clinical environments need to undergo testing and feedback which is essential for building a robust clinical application.”

           – Hans Lewis & Paulson Paul

References:
Making Nutrition Management Scientific, Objective and Simple with the Help of Technology
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5713792/
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