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Becky GradlAcademy of Nutrition and Dietetics
Margaret DittloffAcademy of Nutrition and Dietetics
Mary GeorgeComputrition
Sue Kent
Della DunbarDM&A
James Allain
Clare HicksCBORD

HL7 Update

  • The gforge items reviewed on the 4/26 call were discussed in Montreal.
    • The Joint Commission has an interest in knowing where/how breastmilk and infant formula is represented in FHIR; this will be handled in NutritionIntake and should be additional use cases
    • They also have an interest in TPN, but this is out of scope for nutrition.
    • The group (on this call) will walk through an outpatient use case with NutritionOrder to see how it might be able to be modified since it is inpatient specific; this will be done at a later date to include some people who were traveling home from Montreal
  • Consider if substance can be used for recording of food and/or nutrients
  • Observation was suggested instead of a new NutritionIntake resource, however if 20% or more is extended, then it's recommended to create a new resource. Per the CrowdHealth team presentation on our 4/19 call, they had to do many extensions to make Observation work.

Use Case review/discussion

  • Margaret's use case is nutrition support focused (enteral); Nestle has some good I/O information
  • James did a use case on recording intake on an app for both a clinician and patient
  • Suggestion that we may need to use Langual codes (they were looked at for allergy and substance); it may not be that hard to map SNOMED to Langual
  • Della is focusing on recording a meal order and then recording how much of each item gets consumed
    • This gets recorded on meal ticket and nursing often records 50%, but this does not relate to specific food items.
    • 50% of a meal consumed is not the same as 50% consumption of the protein ordered, etc. More specifics are needed to know exactly what a patient consumed.
    • Take information in menu management software and note the key nutrients consumed (what and how much) for other clinicians. 
  • We should also include use cases on food frequency/1-day or 3-day recalls
    • Margaret will send out some examples of food frequency/food recall
  • Other use cases to include: breastfeeding--look at WIC representation and NICU usage
  • Della will add fluid consumption to her use case