The impact of electronic meal ordering systems on hospital and patient outcomes: a systematic review

Background: Malnutrition is a serious clinical issue associated with adverse patient and hospital outcomes. Hospitals need to consider interventions that support the provision of optimal nutritional management and care for patients. Electronic meal ordering (EMO) systems provide an alternative to traditional paper-based meal ordering with the capacity to support appropriate orders, monitor nutritional status, and potentially improve clinical outcomes. Methods: This review aimed to identify the impact of EMO systems on hospital and patient outcomes. We sought quantitative evidence (peer-reviewed and grey literature) from studies evaluating EMO systems in healthcare facilities, published after 1999 and available in the English language. Results: We identified 23 studies evaluating one of three distinct EMO system-supported models: spoken menu, room service, and self-service. While limited, the evidence indicated that EMO systems were associated with: improved patient satisfaction; decreased food waste; increased consumption; and, for spoken menus, more time with patients. There was no substantive evidence of impact on clinical outcomes. Conclusions: Whether EMO systems meet their potential to support nutritional monitoring and positively impact clinical outcomes remains unanswered within the evidence. Thus, policy makers and hospital management currently have a poor evidence base upon which to make decisions about the value of implementing EMO. Whether these systems can provide support and guidance to patients during meal ordering, improve order appropriateness and accuracy through compliance checking, identify patients in need of dietary education or those at risk of malnutrition are critical areas of focus for future research.