Nutrition FHIR Resource Proposal
- 1 NutritionOrder
- 1.1 Owning committee name
- 1.2 Contributing or Reviewing Work Groups
- 1.3 FHIR Resource Development Project Insight ID
- 1.4 Scope of coverage
- 1.5 RIM scope
- 1.6 Resource appropriateness
- 1.7 Expected implementations
- 1.8 Content sources
- 1.9 Example Scenarios
- 1.10 Resource Relationships
- 1.11 Timelines
- 1.12 gForge Users
Owning committee name
Contributing or Reviewing Work Groups
- Patient Care (for review)
- Pharmacy (for review)
FHIR Resource Development Project Insight ID
Project ID - 1081
Scope of coverage
Nutrition Order resource covers information needed for ordering oral diets (including general diets such as General Healthy diet, or therapeutic diets such as Consistent Carbohydrate, 2 gram Sodium, Fluid Restricted), enteral nutrition (tube feedings), infant formula and oral nutritional supplements which govern the distribution of food and nutritional products used to feed patients in in-patient healthcare settings. These nutrition orders are combined with information on a patient's food allergies and intolerances, and ethnic or cultural food preferences (Kosher, Vegetarian) to inform healthcare personnel about the type, texture, and/or quantity of foods that the patient should receive or consume.
Out of scope for initial resource work:
- Parenteral Nutrition (IV nutrition)
- Food Preferences
Diet and Nutrition is a critical aspect of human health. Many health conditions require dietary or nutrition modifications. It is essential to share or exchange information about a patient’s nutritional requirements with multiple healthcare providers and with the food and nutrition/catering operations within an in-patient healthcare setting.
Can be expected to be implemented as messaging between EHR/EMR and Food and Nutrition Management Systems in hospitals and long-term care facilities.
- Diet and Nutrition Domain Analysis Model, R2
- V3 Nutrition Orders Clinical Messaging DSTU
- C-CDA R2 Nutrition Templates (Nutrition Recommendation template)
- HL7 v2 specification (ORC – ODS segment)
- vMR Logical Model
- OpenEHR (?)
Provider orders a diet/enteral nutrition/infant formula/oral nutritional supplement for a patient or resident in a healthcare facility.
- Specific use cases were taken from the V3 Doman Analysis Model: Diet and Nutrition Orders, Release 2 
1. Provider places an order for an oral diet which may include nutrient medications and texture modifications.
- Order a 'General Healthy' diet (no other dietary restrictions) for a newly admitted patient
- Order a complex nutrient modified diet (80 g Protein, Consistent Carbohydrate, 2 gram Sodium, 2 gram Potassium, 800-1000 mg Phosphorus, 1500 mL Fluid Restriction) for a diabetic patient undergoing renal dialysis for chronic kidney disease.
- Order a texture modified diet (Mechanical Soft with Pureed Meats) for a stroke patient in rehabilitation.
2. Oral for addition of high-protein oral nutritional supplement product 3 times per day between Meals (AM / PM / HS snack periods). Note this is in addition to the order for this patient's oral diet.
3. Enteral (tube feeding)for adult patient requiring a Standard High Energy (1.5 Calorie/mL) Enteral Formula product to be administered via continuous pump, start at 20 mL/hour and increase rate by 10 mL/hour every hour until target/goal rate of 60 mL/hour. Follow standard administration protocol (order set) for elevating head of bed, flushing tube with water.
4. Infant formula order for a specialty hydrolyzed protein infant formula prepared to 27 Calories/fluid oz plus 5 gram carbohydrate/fat additive per ounce; feeding 2 fluid ounces orally via bottle or syringe every 4 hours.
- MedicationPrescription - (Need to harmonize overlap that relates to ordering dietary supplements vs. oral nutritional supplements/medical foods)
Next FHIR DSTU Ballot - January 2015 Ballot Cycle
- Draft Content to be ready for QA by FHIR ballot prep deadline (2014-09-21)