Addressing Patient Dietary Limits: A new use of mail-order subscriptions

Some Background

So before I launch into my crazy off the wall idea, let me tell you a story.

My practice site focuses on heart failure and transitions of care. Mainly, I work on helping patients with their medications after discharge from the hospital after an acute exacerbation, and work with nurse practioners and physician assistants seeing patients. One thing that has always caught my attention is dietary limitations. One patient I remember that stood out to me was having trouble understanding fluid and salt intake. Listening to the exchange between the provider and patient, and his recent weight gain in two days of 4 pounds, it went like this:

"Do you watch your salt intake?" "Yes, I dont add salt to anything" "Do you watch your fluid intake?" "Yes, I track what I drink daily and only drink about 4-6 glasses of water a day" "Thats good! Did you do anything differently lately with your diet?" "No." "What did you have for the past few days" "Chicken Noodle soup that I got at the store" "...Do you include that in your salt limit or fluid intake" "No, should I?"

I feel for these patients, I really do, dietary limits are tough. Imagine one day someone telling you that you can no longer eat XY & Z, and trying to overcome a lifetime of habits. It's tough. We refer patients to nutritionists and social groups, but sometimes it just doesnt pan out like we want it too. I feel really bad when patients start asking about snacks and what they can eat through the day, and sometimes they just want a list of what is alright to eat, and recipes of what to cook (especially if its a spouse who cooks or other family members that take care of the patient). 

So that got me to thinking...

What if We Mailed Patients Food?

Lets face it, we live in an era where everything can be ordered online and sent to your home. Amazon has invaded our lives. They even launched buttons that you can press to send you a product as soon as possible (Look into it). I subscribe to a company that sends me a box of items every month for me to sample (mainly clothing and lifestyle items), and my wife has  a monthly box delivered every month with a small sampling of Japanese candy.

There are food related companies that send food on a weekly and monthly basis. These services range from snacks to full meals to items to help you prep your next meal with specialized ingredients. Some examples include:

• SimplyCook - This startup sends you a box of ingredients and recipes for you to follow using the provided ingredients. The customer then goes and buys the other produce and food items in the store, and then cooks the food at home. 
• Gousto - This company supplies the customer with a list of recipes that they can choose from, and upon selection, will mail all of the ingredients to the patient home for them to then cook.
• Marley Spoon - Very similar to Gousto (available in the US) and mails a weekly supply of food items that you can then prepare by following recipes.
• HelloFresh - Similar to the other recipe based mail programs.
• Shuttlecook - Similar to the others, based in London.
• Graze - Snack box mailed to the customers home.

You get the idea. Most of these programs are designed for those looking for certain organic or related products, and also curtail to those looking to cut down on having to do the shopping. So my question is why not a program or box service for patients with special dietary limitations? 

Food Services or Even Snack Boxes for Special Disease Related Diets

So here is my proposal. Why not one of these companies put together a box subscription for patients with dietary limitations? Maybe a snack box to start with, and then maybe full meals. The meals could be designed by nutritionists and chefs that address certain concerns (I always thought it would be fun to watch a cooking show like Chopped themed around this issue). This could include food allergies, Celiac Disease, DASH diets, or as I started with, snacks for my heart failure patients.

I think some patients would like this service. If done right, this takes out the guess work in terms of their concerns on what is and is not good for them. It also allows them to explore beyond the norm (which is the hardest part) and find foods they may never have known were good for them. 

Food to me is a comfort. For patients that have to live with a chronic disease that may rob them of certain joys, food should not be one of them. I think helping patients rediscover the joy of eating again would really be helpful, and have some good benefits. I know I didn't address concerns on liability or other oversight, but I think that is beyond this topic, but if anyone that wanted to pursue it would have to consider. In any event, leave comments or thoughts!