# Appendix C: International Standards and Resources

## International Standards and Resources

* International Patient Summary (IPS)
  * Essential medical information for unplanned, cross border medical care. Allergies and intolerances, medications, medical devices (feeding pumps, central lines). To be implemented in 2025. Refugees with food insecurity or malnutrition(undernutrition).
* European Patient Summary
  * Essential medical information for unplanned medical care within the EU. Internally displaced persons with food insecurity or malnutrition (undernutrition).
* pan-Canadian Patient Summary Specification (PS-CA)
  * Essential medical information for unplanned medical care within Canada.
* Korean CDA Implementation Guide (K-CDA IG)
  * Adapted HL7 CDA standards to meet needs of the local healthcare system.
  * Jung S, Bae S, Seong D, Yi B. Standard Document Development for Health Information Exchange in Korea. Appl Clin Info 13:3, 592-601, 2022.
* HL7
  * FHIR, relationship described in Section 5
  * HL7 Domain Analysis Model for Nutrition Care Release 3, Universal Realm
  * HL7 EHR-System Electronic Nutrition Care Process Record System (ENCPRS) Functional Profile Release 2, Universal Realm
  * HL7 Version 3 Care Provision - Nutrition and Drug Preferences, Universal Realm

## US Standards and Resources

* Consolidated Clinical Documentation Architecture (C-CDA)
  * HL7 CDA® R2 Implementation Guide: C-CDA R2.1 Supplemental Templates for Nutrition, US Realm
* Value Set Authority Center (VSAC), National Institutes of Health, National Library of Medicine
  * Approximately 34 sets of SNOMED CT terms that support documentation of a nutrition professional's encounter using NCP. Also supports FHIR Resources
* Assistant Secretary for Technology Policy/Office of National Coordinator for Health Information Technology (ASTP/ONC), Department of Health and Human Services
  * United States Core Data for Interoperability (USCDI)
  * Allergies and intolerances, Height and Weight with BMI, problem list, progress notes, medications, discharge summary. Additional nutrition content (enteral nutrition, MNT) has been proposed.
* Centers for Medicare and Medicaid (CMS)
* Electronic Quality Measures (eCQM)
  * [Malnutrition Care Score (MCS](https://ecqi.healthit.gov/ecqm/hosp-inpt/2026/cms0986v5?qt-tabs_measure=measure-information))
    * Screening for malnutrition completed, assessment by dietitian completed in a timely manner, provider diagnosis based on dietitian's and their examination, care plan
    * Supported by a number of VSAC value sets

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