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NameOrganization
Becky GradlAcademy of Nutrition and Dietetics
Margaret DittloffAcademy of Nutrition and Dietetics
Ben Atkinson
Sandy Miller
Sue Kent
James Allain
Casey McCoy
Michael WatersFDA
Donna Quirk
Yanyan HuThe Joint Commission

clinFHIR modeling of NutritionIntake

  • James walked the group through what he modeled in ClinFHIR for NutritionIntake using the observation resource
  • Right now the logical model has 2 arrays in it to represent food and ingredients/nutrients, but it might need 3 arrays and no other resources have 3 arrays
  • Nutrition might need the 3 arrays to compute things with the nutrients and ingredient amounts
  • In observation the foodOrRecipe, there should be a description
  • The value[x] could be a quantity, such as a cup
  • The nutritientOrIngredient is added, so it shows that observation cannot be done with its existing format

Review of a proposed NutritionIntake resource

  • The data elements were build off the MedicationStatement (to be renamed MedicationUsage) resource
  • MedicationStatement and MedicationAdministration were compared and MedicationStatement seemed like the best fit for NutritionIntake elements
  • This is a first draft and elements can be added, deleted or change
  • The goal is to have something for NutritionIntake available for the Connectathon in September to test out. Feedback will come out of the Connectathon as well.
  • What about discharge and recording diet? That is not part of the scope for NutritionIntake as intake would not be documented on a discharge notice; the last diet order for a discharge notice can possibly be found on the NutritionOrder resource
  • What about Parenteral Nutrition? Parenteral nutrition is part of medication, so look to MedicationAdministration to get that information
  • On NutritionOrder, what are the values for modifier and can modifier under oralDiet.nutrient.modifier have more than one value?
    • The values can be found here: (https://www.hl7.org/fhir/valueset-nutrient-code.html). Discussion around the number of values for modifier was deferred until we have a more detailed discussion on NutritionOrder. NutritionOrder needs to be reviewed for possible changes to make it usable for outpatient, if possible, because it is now focused on an inpatient setting. Today's discussion needs to be focused on the data elements necessary for NutritionIntake because we are up against the clock for getting something into the build for the September Connectathon.
  • Nutrient information is missing: Nutrient info was not represented because it was assumed it might be under nutritionProduct, which might be/should be another resource similar to the medication resource
  • Should we have composite nutrient information? Yes we should; it was not initially added in because of the thought that nutrition information would be under nutritionProduct, but if we want a total for the nutrition, we should have composite information
  • Brief discussion around the use of SimpleQuantity vs Quantity (https://www.hl7.org/fhir/datatypes.html#Quantity) as a data type

NutritionIntake-spreadsheet.xml

Homework for August 2 call: Review attached proposed NutritionIntake spreadsheet 

Note: spreadsheet is .xml as this is the format needed to get it into the build

  • Be prepared to re-review the data elements
  • Come with questions, changes, suggestions, etc.
  • Keep in mind the spreadsheet needs to be finalized on Friday so it can get into the build before August 11 (but can be modified at a later date)


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