Department of Nutrition, DocMode Health Technologies, Raheja Hospital, Mumbai, India

*Corresponding author:Prachi Velhal, Department of Nutrition DocMode Health Technologies, Mumbai, India. E-mail Id: prachi@docmode.com

Article Information:Submission: 20/12/2024; Accepted: 24/01/2025; Published: 29/01/2025

Copyright: ©2025 Velhal P, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

iNutriMon is a clinically validated software endorsed by ISPEN, designed specifically to assist medical professionals in Screening, Assessing, Planning, Monitoring, and Managing Nutrition. With its host of features, iNutriMon empowers to deliver optimal care to patients while reducing the risks associated with underfeeding, overfeeding, and excess fluid intake.

A 72-year-old female patient weighing 70 kg and standing 153 cm tall presents with a history of heart failure and osteoporosis. She is currently undergoing hemodialysis three times a week. She has a history of diabetes and HTN. Biochemical Parameters as below:

The primary nutrition goals are to maintain her nutritional status and prevent malnutrition, manage fluid intake, and control phosphorus and potassium levels. Fluid restrictions of 800-1,000 mL per day, plus any urine output.
Below we are adding case in the iNutrimon software. Please have a look at the screenshots.

We have provided the feature of biochemical parameters which has its normal ranges, and it notifies the status whether that particular parameter is low, normal or high which eventually helps to provide nutrient deficiency, toxicity and also the nutrition diagnosis of the patient. E.g., Hypernatremia, hyponatremia, hyperkalemia, hypokalemia etc.

Nutrition screening and assessment are crucial for identifying individuals at risk of malnutrition and developing effective interventions to improve their nutritional status considering multiple factors such as nutrition status, disease severity, patients current food intake, lab values etc.
Below are the available nutrition screening and assessment tools with some techniques. Healthcare professionals can choose any tool as per hospital protocol or disease state of the patient.
By using tools like the Malnutrition Universal Screening Tool (MUST) or the Mini Nutritional Assessment (MNA), SGA, NRS 2002, NUTRIC SCORE, Glim Criteria healthcare providers can identify individuals at risk of malnutrition based on criteria such as weight loss, BMI, and dietary intake.
Now, I will just brief about the nutritional assessment tools.
MUST - Malnutrition Universal Screening Tool
The Malnutrition Universal Screening Tool has been designed to help identify adults who are underweight and at risk of malnutrition, as well as those who are obese.
MNA - Mini Nutritional Assessment
The MNA is a validated nutrition screening and assessment tool that can identify geriatric patients aged 65 and above who are malnourished or at risk of malnutrition.
NRS 2002
The purpose of the NRS-2002 system is to detect the presence of undernutrition and the risk of developing undernutrition in the hospital setting.
MUST
The purpose of the MUST system is to detect undernutrition on the basis of knowledge about the association between impaired nutritional status and impaired function.
NUTRIC Score
The Nutrition Risk in Critically ill (NUTRIC) score is the first nutritional risk assessment tool developed and validated specifically for ICU patients. SGA
Subjective global assessment (SGA) is the gold standard for diagnosing malnutrition. SGA is a simple bedside method used to diagnose malnutrition and identify those who would benefit from nutrition care. Glim Criteria
The GLIM includes three phenotypical criteria (weight loss, low BMI, and reduced muscle mass) and two etiological criteria (reduced food intake or absorption, and increased disease burden or inflammation).
Physical assessments, including muscle wasting and edema, can indicate malnutrition and related health issues.
Functional assessments evaluate physical strength and functionality (e.g., grip strength), providing insights into conditions like sarcopenia or frailty.
Now, here I have screened the patient using Nutritional Risk Screening Tool 2002 (NRS 2002) as below and at the left side automatically calculated score is available.
NRS 2002 score is 3. The patient is nutritionally at risk and nutrition care plan has to be initiated for this patient.
SGA - Subjective Global Assessment
Now this patient has been assessed under subjective global assessment tool, which has given the score B. According to score B the patient is moderately malnourished.

By Nutrition Monitoring and nutrition reassessment, we can keep a track on nutritional status and recovery of the patient.
iNutrimon helps to monitor actual nutrition intake which eventually helps to identify underfeeding and overfeeding and then can reinitiate appropriate nutrition therapy.
iNutrimon has a feature where dietician or nurses can maintain a record of actual nutrition intake of the patient.
As mentioned earlier we can save biochemical reports from day one and keep on adding latest parameters everyday which will help us to track the progress of the patient towards treatment.

Now we can see how we have managed patient discharge with iNutriMon. Patient basic details are automatically updated in discharge card. Diagnosis, comorbidities, Nutrition status on admission as well as on discharge, Lab investigation, surgical procedure, Nutrition therapy during hospital stay followed by nutrition advice at home and follow up is managed by iNutriMon.

We have managed 72-year-old female patient with Diabetes, Hypertension and Renal failure who is on hemodialysis using clinical nutrition management software. Right from patient got admitted to hospital till she gets discharge from hospital iNutrimon has managed entire nutrition care process. The time patient got admitted iNutrimon had absorbed all basic history of the patient and then We have to assess the patient nutritionally using two different tools and we got the nutritional status of the patient i.e., patient is at nutrition risk by NRS 2002 and patient is malnourished by SGA score B. which was helpful to take appropriate decision of initiation of nutrition intervention. After nutritional assessment software has calculated nutritional requirements of the patients based on anthropometry, biochemical parameters clinical condition and nutrition assessments score. Based on evidence based guidelines ASPEN (American Society of Parenteral and Enteral Nutrition) and ESPEN (European Society of Parenteral and Enteral Nutrition) and Critical Care Nutrition Guidelines iNutriMon has suggested nutritional recommendations such as calories, protein and fluid along with micronutrients which can be gradually initiated as per patients hemodynamic stability and tolerance to the feed. Initially patient was on RTF and then gradually progressed to semisolid to soft to full diet. Diet Progression was absolutely possible because of nutritional monitoring feature of iNutriMon which was helpful to track under or overfeeding of the patient/s which eventually helps to achieve target nutritional requirements hence speedy recovery was possible.

Along with Ryles tube feed planning, iNutrimon is equipped with Indian food composition table which is helpful to auto calculate nutritive value of the planned recipes and track actual intake of micronutrients along with macronutrients.
We have seen in the above case in hospital settings, but we can utilize iNutrimon in outpatient departments and clinics as well as we have developed the feature considering OPD patients and flow of how it works such as basic details, vitals, nutritional requirements followed by prescription and manage follow ups etc.

iNutrimon plays an important role in enhancing patient care across critical such as ICU and hospitals as well as non-critical care area i.e., OPD and clinics. ICU patients have specific nutritional needs due to critical illness then the software like iNutriMon calculates precise nutritional requirements based on evidence-based guidelines and also ensures the accurate amount of nutrient delivery as per the prescription by nutrition monitoring feature. Critically ill patients are at high risk of malnutrition which can negatively impact recovery. iNutrimon helps in early identification of malnutrition risk ensuring timely intervention to optimize nutritional support.

In the OPD and Clinical set up the software is assisted in developing customized nutrition plans for patients with chronic conditions like diabetes, obesity, cardiovascular diseases. It allows healthcare professionals to track patient progress followed by modification if required.

Overall, softwares like iNutriMon facilitates communication between dieticians, doctors and other healthcare professionals ensures appropriate nutrition care plan is aligned. Proper nutrition management through the software aids in faster recovery, reduced infection rates, and overall better patient health, especially in high-risk patients like those in ICUs.

1. Comparison of Nutric Score, Nutritional Risk Screening 2002, Subjective Global Assessment in the ICU: a cohort study
https://symbiosisonlinepublishing.com/nutritionalhealth-foodscience/nutritionalhealth-foodscience165.pdf
2. Making Nutrition Management Scientific, Objective and Simple with the Help of Technology
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5713792/
3. Cost of Enteral Formulae Feed in Critically Ill Patients in a Tertiary Care Centre: An Observational Study from India
https://www.opensciencepublications.com/fulltextarticles/IJN-2395-2326-6-205.html
4. Nutrition Management practices in critical care in tertiary hospitals _a survey from India
https://ijirms.in/index.php/ijirms/article/view/196/182
5. The application of AI in clinical nutrition
https://drive.google.com/file/d/1m4cIHxyxvxnPc_j05BrIN82Lfk9V7Kv/view?usp=sharing