Ms Charlene Tan-smith1
1Canterbury District Health Board, Christchurch Hospital, Christchurch, New Zealand
The South Island paediatric ketogenic dietary therapy service has been providing care since 2016 for children with refractory (drug-resistant) epilepsy. Suffering hundreds of seizures per day medicalised ketogenic dietary therapy is used to reduce or eliminate seizures by inducing and maintaining ketosis through forms of ketogenic diet ranging up to 90% fat composition.
The traditional challenges to delivering medicalised ketogenic therapy are accessibility and adherence to the diet. Accessibility is restricted due to the intense demand on registered dietitian time, and adherence is limited through the requirement to balance meals to a patient-specific prescription of fat, protein and carbohydrate and measuring of ingredients to 0.1g. We describe the time consuming and complex calculations required to match a macro food prescription as the ketogenic algorithmic challenge.
The KetoSuite product development cycle consisted of an initial proof of concept, patient focus groups, wireframe, Beta testing version, and benefited from a short feedback loop between clinical lead dietitians and developers. The lean startup process continues with feedback from practitioners and patients.
KetoSuite is a suite of platform, device and browser agnostic web apps. Endorsed by Matthews Friends Canada and UK the suite includes world-first keto technology recipe and meal auto-balancers, along with recipe book, wizard, label scanner and auto-generated exchange lists.
NZ South Island and Toronto, Canada patients have benefited directly from the provision of patient accounts. They are able to take part in their treatment through the creation and balancing of recipes and meals.
Charlene has been a registered dietitian since 2005 working both in private and public practice with most of that time at Christchurch Public Hospital, CDHB. She has specialised in paediatrics since 2006. Previously a nutritionist for the Ministry of Health at the Child Health Services in Singapore she is currently the South Island Clinical Lead for Ketogenics, working with the team to treat children with refractory epilepsy. She has a fresh perspective on treatment delivery, use of digital tools, and is currently a doctorate candidate researching acceptability of medical app technology.