Stream: implementers
Topic: Nutrition Consumption Data in FHIR
Aditya Joshi (Jan 16 2020 at 09:48):
Hi All. I am trying to figure out what would be the best way to represent Patient Daily Nutrition intake data in FHIR. Data consists-dietary water, sugar, fiber, protein, fatSaturated, sodium, energy consumed etc.
I got very good post created by @Grahame Grieve - http://www.healthintersections.com.au/?p=2487
This talks about mapping Exercise data in Observation resource, it was really helpful. On this post, @Eric Haas has commented that- “next logical step is nutritional obs. food, grams, calories etc. be nice if barcodes had nutritional info – do they?”
But could not find any answer for his question.
Definitions for category.coding.code (for example “activity” or “vital-signs”. Definition of this code: https://hl7.org/fhir/R4/valueset-observation-category.html
Definition of “activity” suggests that step count, sleep data can be mapped to FHIR using Observation resource.
Same thing I could not find for Nutritional data intake, no such category as of now in FHIR R4 specification.
It feels like Observation is the choice with appropriate set of codes but if anyone can provide more insights/examples, that would be helpful.
Thanks for your help and support.
@Lloyd McKenzie
Michele Mottini (Jan 16 2020 at 13:49):
There seems to be LOINC codes already: https://loinc.org/75282-4/ (with suggested measurement units) - so just creates Observations using those ?
Lloyd McKenzie (Jan 16 2020 at 15:31):
The expectation is Observation for 'inputs' and 'outputs' with the possible exception of IV solutions which would be represented using MedicationAdministration.
Lloyd McKenzie (Jan 16 2020 at 15:32):
You could certainly submit a change request asking for that to be clarified...
Aditya Joshi (Jan 16 2020 at 21:37):
Thanks @Lloyd McKenzie dose it mean that dietary intake is simply Observations with correct set of codes?
Any pointers to get some examples. Like @Grahame Grieve article was giving good examples for exercise data.
Aditya Joshi (Jan 16 2020 at 21:38):
sure. It would be nice to have one more category code or activity describes to contain dietary intake. Binding strength is Preferred, so user can always add category code from their side but having defined somewhere in spec gives confidence on how FHIR handles it. Thanks.
Lloyd McKenzie (Jan 16 2020 at 23:07):
Agree that a category would be useful. @Eric Haas may have other info from the dietary space
Eric Haas (Jan 17 2020 at 00:11):
There is a lot of interest in this area, I have not kept up on it howere. @Margaret Dittloff or @Lorraine Constable might have more info...
Aditya Joshi (Jan 20 2020 at 15:44):
@Margaret Dittloff , @Lorraine Constable any help would be much appreciated. Thanks.
Mikael Rinnetmäki (Jan 29 2020 at 06:16):
Hi @Aditya Joshi, in #finnish PHR we have for instance:
Finnish PHR Nutrition profile, a base profile for nutrition entries: https://simplifier.net/finnishphr/fiphr-sd-nutrition-stu3
Finnish PHR Calorie Intake profile, concentrated on enery intake: https://simplifier.net/finnishphr/fiphr-sd-calorieintake-stu3
Finnish PHR Macronutrient Intake profile, for macronutrients: https://simplifier.net/finnishphr/fiphr-sd-macronutrientintake-stu3
Finnish PHR Fluid Intake profile, for fluid intake: https://simplifier.net/finnishphr/fiphr-sd-fluidintake-stu3
We have discussed extending to tracking detailed micronutrients too, but so far there has not been a strong enough use case. And when we checked, LOINC did not seem to include codes for point-in-time observations for micronutrients, the granularity was on daily consumption level.
Aditya Joshi (Jan 30 2020 at 15:41):
Thanks a lot @Mikael Rinnetmäki for sharing the information, it helped.
Last updated: Apr 12 2022 at 19:14 UTC
