Food and Nutrition Terminology

HL7Phoenix WG Meeting

May 5, 2014

Agenda Items

• Allergy and Intolerance Substances– Update on analysis with the VA

• Diet Orders – Enterals, supplements and baby formula

• Preferences• C-CDA

– Value sets• FHIR resources for nutrition

SNOMED-CT Substances

• Decision in San Antonio– Dietary Substance will be hierarchy of choice– Allergen Class will not be used– Note some food substances have two parent

concepts• Comparison of SNOMED-CT and UNII coverage

of food substances completed– VA – 422 food concepts– Ayres – 110 unique concepts in addition to VA

SNOMED-CT vs. UNII

TOTAL TERMS SNOMED-CT UNIIMapping - all terms - VA 731 69% 61%Mapping - food terms - VA 422 301 terms - 73% 326 terms - 79%Mapping - additional food substances 110 45 terms - 41% 51 terms - 56%Mapping - VA and additional food substances 532 346 terms - 65% 377 terms - 71%

*VA has decided to use SNOMED-CT*Discussed food allergies in C-CDA R2 – UNII specified but we will file a DSTU comment to add a value set of SNOMED-CT terms*Using substances and not organisms or products

Question re classes• Alcohol (Dietary?)• Chocolate• Coffee• Egg• Fish (Dietary?)• Food Additives• Fruit• Ground Nuts?• Gelatin• Meat• Milk• Peanuts• Poultry• Seeds• Shellfish (Dietary?)• Soy• Spices• Sugars• Tree Nuts – vs almonds, cashews, ……..• Vegetables• Wheat

Translation of classes/terms into value sets?Does this work with the V3 model?

Example

• Nuts • Tree Positions

Allergy Model

Diet OrdersEnterals, Supplements and Baby Formula

HL7 Version 3 Diet Order

LEGENED1.Existing SNOMED CT terms 2.Requested terms are in red3.New suggested are in blue4.More new suggested terms

Questions re Enterals, Supplements and Baby Formula

• Product hierarchy?• Other suggestions for inclusion?

Preferences

• Additional food substance work needed?

C-CDA – R2

• Use of SNOMED and LOINC (vs. UNII)• Definition of value sets for

– Nutrition Observation– Nutrition Assessment– Nutrition Recommendation

FHIR Resources

• PSS just approved for:1. Dietitian performs and documents a nutritional assessment/consultation2. Dietitian recommends a nutritional intervention3. Provider orders a diet/supplement/enteral feeding/baby formula/consult4. Patient selects menu items for transmission to a food and nutrition management system5. Dietitian provides nutrition education/counseling6. Patient provides recorded intake and dietitian provides summary of nutrient intake/calorie intake.