© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Food and Nutrition Terminology HL7 San Antonio WG Meeting Monday Lunch January 19, 2015
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Agenda Items C-CDA Nutrition Templates (R2) Terms in SNOMED and LOINC Value sets Allergy and Intolerance Food Substances C-CDA -- Discuss use of UNII vs. other systems Diet Orders Update on SNOMED Terms Issues Amounts Negatives Need for means to display enterals, baby formula and food supplements FoodNORM and Structured Product Labels Preferences FHIR resources for nutrition
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off C-CDA R2 Nutrition Templates
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off
C-CDA – R2 Use of SNOMED and LOINC (vs. UNII) Definition of value sets for Nutrition Observation Nutrition Assessment Nutrition Recommendation
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off C-CDA Terms Nutrition Status Observation SNOMED-CT Nutrition Assessment LOINC (need more) Nutrition Recommendations SNOMED-CT Status of US Extension
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Status of Mapping NCPT - SNOMED
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off NCPT Assessment Terms Working on LOINC Mappings
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off C-CDA R2
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Nutrition Status Value Set: Nutritional Status A Value Set of SNOMED-CT codes representing nutrition problems. Value Set Source: CodeCode SystemCode System OIDPrint Name SNOMED CT emaciated (finding) SNOMED CT nutritionally compromised (finding) SNOMED CT undernourished (finding) SNOMED CT well nourished (finding) SNOMED CT Food intolerance (finding) SNOMED CT Food allergy (disorder) SNOMED CT Obese (finding) SNOMED CT Swallowing difficulty (finding) SNOMED CT Altered GI function SNOMED CT drug interaction with food (finding)...
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Nutrition Recommendations Value Set: Nutrition Recommendations Types of nutritional regimes, therapies or interventions. Specific URL Pending Value Set Source: CodeCode SystemCode System OIDPrint Name SNOMED CT nutrition education (procedure) SNOMED CT nutrition therapy (regime/therapy) SNOMED CT feeding regime (regime/therapy) SNOMED CT nutrition / feeding management (regime/therapy) SNOMED CT dietary regime (regime/therapy) SNOMED CT enteral feeding (regime/therapy) SNOMED CT total parenteral nutrition (regime/therapy) SNOMED CT oral nutritional support
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Need for Value Sets C-CDA R2 testing and implementation VA Smart Forms FHIR nutrition resources Quality measures
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Allergy Model
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off NutritionOrder Resource
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off FHIR ClarificationNeeded: Encounter-diet or Pref Modifier
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off FluidConsistency: Dietary Regime vs Substance
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off ALLERGY AND INTOLERANCE
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Allergy and Intolerance Models
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Terminology Bindings C-CDA -- UNII vs. SNOMED for food substances Substances project - IHTSDO
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Example Nuts Tree Positions
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Dietary Substance vs. Food Allergen Dietary Substance ( ) Substance Allergen Food allergen or pseudoallergen
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Food Allergens Food Pseudoallergens …..
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Diet Orders
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Version 3 Diet Order
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off HL7 Model – Diet Orders
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off vMR – CDS (Quality Improvement and Clinical Knowledge)
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Issues Need “coding” standards for enteral nutrition products and baby formula Used in EHR’s To order products for use Check for allergies Clinical decision support Support information exchange between providers Critical issue for allergies and intolerances Need a system similar to drugs (RxNORM)
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Diet Orders Update on SNOMED - CT Terms Issues Amounts Negatives Need for means to display enterals, baby formula and food supplements RxFOOD and Structured Product Labels
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Supplements & Formulas – Class Structure
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off FoodNORM Similar to RxNORM for drugs Avenue for substances without rate, dose, strength Use Structured Product Labeling pathway for provision of supplements and food through NLM
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Manufacturers FoodNORM Knowledge Based Systems SPL FoodNORM Codes EHR Role of GS1 Food/Products?
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off FDA and FoodNORM FDA – CFSAN has agreed to pilot Start with medical foods (supplemental enterals) Also exploring database of supplements through the NIH Office of Dietary Supplements
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off Preferences Additional terms added to SNOMED-CT? Examples Raw fruit Hot cereal Toddler foods
© 2009 Health Level Seven ®, Inc. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven, Inc. Reg. U.S. Pat & TM Off FHIR Resources Nutrition Orders In current publication Clinical Assessment In current publication