FHIR Resources for Nutrition Intervention

Nutrition Intervention Data and Associated FHIR Resources

Nutrition Intervention involves planning and implementing actions to address the nutrition diagnosis.

Several FHIR resources can be used to document these interventions:

• NutritionOrder Resource : Documents detailed nutrition care plans and orders.

• NutritionProduct Resource: Documents foods, fluids and oral nutrition supplements provided to the patient.

• Procedure Resource : Records specific nutrition-related procedures and interventions.

• CarePlan Resource : Provides a comprehensive plan of care that includes nutrition interventions.

Types of Data Collected	Purpose	Example	FHIR Resource
Food and Nutrient Delivery	Document specific details of diets, oral supplements, or enteral/parenteral nutrition plans, including prescribed nutrition interventions.	High-protein diet, Tube feeding with formula	NutritionOrder, NutritionProduct
Timing and Frequency	Specify schedules for meals, oral supplements (e.g., protein shakes), or other forms of nutrition support.	TPN daily at night, Supplements twice daily	NutritionOrder
Nutrition Counseling	Capture details of counseling sessions and educational interventions to improve nutrition knowledge or behavior.	Nutrition education session on diabetic diet	Procedure
Feeding Tube Placement	Record details of procedures related to the placement of feeding tubes for enteral nutrition support.	Placement of nasogastric feeding tube	Procedure
Goals and Objectives	Outline specific, measurable nutrition-related goals that guide the overall care plan.	Increase weight by 2 kg in 1 month	CarePlan
Activities and Interventions	Coordinate actions such as administering supplements, monitoring tube feeding, or adjusting dietary plans as needed.	Administer supplements, Monitor tube feeding	CarePlan

Examples

Nutrition Order

This example demonstrates how the NutritionOrder resource can be used to document and manage dietary requirements, restrictions, and preferences for a patient. It illustrates a comprehensive cardiac diet order for an inpatient, including specific instructions, nutrient modifications, and food exclusions.

Key features highlighted in this example:

• Diet Type: Includes a low sodium diet and fluid-restricted diet to address cardiac health needs.

• Nutrient Specifications: Details on limiting sodium intake to 2 grams per day and fluids to 1500 milliliters per day.

• Allergies and Exclusions: Accounts for patient-specific allergies (e.g., cashew nuts) and excludes related food items.

• Personalization: Modifiers for food preferences, such as dairy-free options, to cater to the patient’s dietary needs and preferences.

• Instructions: Provides specific guidance on meal preparation and fluid allowances.

This example is based on the official FHIR documentation and showcases how NutritionOrder supports structured, interoperable dietary management in healthcare.

For more examples and detailed use cases, refer to the FHIR NutritionOrder documentation and FHIR NutritionOrder examples.

Nutrition Order

{
"resourceType" : "NutritionOrder",
"id" : "cardiacdiet",
"identifier" : [{
"system" : "http://goodhealthhospital.org/nutrition-requests",
"value" : "123"
}],
"status" : "active",
"intent" : "order",
"subject" : {
"reference" : "Patient/example",
"display" : "Peter Chalmers"
},
"encounter" : {
"reference" : "Encounter/example",
"display" : "Inpatient"
},
"dateTime" : "2014-09-17",
"orderer" : {
"reference" : "Practitioner/example",
"display" : "Dr Adam Careful"
},
"allergyIntolerance" : [{
"reference" : "AllergyIntolerance/example",
"display" : "Cashew Nuts"
}],
"foodPreferenceModifier" : [{
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/diet",
"code" : "dairy-free"
}]
}],
"excludeFoodModifier" : [{
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "227493005",
"display" : "Cashew Nut"
}]
}],
"oralDiet" : {
"type" : [{
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "386619000",
"display" : "Low sodium diet"
},
{
"system" : "http://goodhealthhospital.org/diet-type-codes",
"code" : "1040",
"display" : "Low Sodium Diet"
}],
"text" : "Low sodium diet"
},
{
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "226208002",
"display" : "Fluid restricted diet"
},
{
"system" : "http://goodhealthhospital.org/diet-type-codes",
"code" : "1040",
"display" : "Fluid restricted diet"
}],
"text" : "Fluid restricted diet"
}],
"nutrient" : [{
"modifier" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "39972003",
"display" : "Sodium"
}]
},
"amount" : {
"value" : 2,
"unit" : "grams",
"system" : "http://unitsofmeasure.org",
"code" : "g"
}
},
{
"modifier" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "33463005",
"display" : "Fluid"
}]
},
"amount" : {
"value" : 1500,
"unit" : "milliliter",
"system" : "http://unitsofmeasure.org",
"code" : "mL"
}
}],
"instruction" : "Starting on 2/10 breakfast, maximum 400 ml fluids per meal"
}
}