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Becky GradlAcademy of Nutrition and Dietetics
Sue Kent
Leslye Rauth
James Allain
Clare HicksCBORD
Yanyan HuThe Joint Commission

Healthcare Product Landscape Discussion for breastmilk

Notes from previous Healthcare Product Landscape call to be discussed with nutrition: what is the boundary between biologically derived product/supply and nutrition? This is in relation to breastmilk and how it may or may not fit in with supply. Is breastmilk considered BDP when it is floor stock? Does it become part of NutritionOrder once it is ordered for a patient? How does breastmilk move from floor stock to the patient? When floor stock, can it be considered supply or should it be BDP?

  • If breastmilk is a food product, how does the food product get put into the system?
  • The only reason to collect breastmilk is for a nutrition product.
  • There is also donor breastmilk.
  • Breastmilk does not get sent to a lab like blood does. 
  • Would the breastmilk ever be tested for exposure to a foreign substance? --we have never heard of the milk being sent to a lab (question brought back to Healthcare Product Landscape call)
  • At the Cleveland Clinic, there is a pantry for pediatrics food products (breastmilk, formula); we are not sure what happens at a smaller facility that may not have a pantry
    • They would have to get to the pediatrics pantry through an order from the food service (usually through food service system), but the use NutritionOrder to get it to the patient (can someone from the pediatric practice group (in the Academy of Nutrition and Dietetics) help with this question related to the flow of breastmilk/pediatrics products?)
  • The term expressed breastmilk is what should be used because breastmilk would not be used unless it is expressed

Review of clinFHIR logical model for NutritionIntake

  • James has been working in clinFHIR to create several versions of the resource to "test" how it might work using other resources and as well as being its own resource
  • Under the LogicalModeller (, click on the all tab, then in the filter box, type in "nutrition" to see the 4 versions he has created
    • NutritionIntake is built off the Observation resource
    • NutritionIntakeV2 is built off the MedicationAdministration resource
    • NutritionIntakeV3 is built off the MedicationStatement resource
    • NutritionIntakeV4 is created as an independent resource (not yet built out)
  • James will continue to work on this to have something ready for the July 12 call (if we have it) or the July 19 call

The July 5 call will be cancelled due to the holiday

July 12 may be cancelled: Sue will be out of town, Yanyan will be gone, MD will be not be available, Becky may be on vacation

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