This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions
Orders and Observations Work Group | Maturity Level: 3 | Trial Use | Security Category: Patient | Compartments: Encounter, Patient, Practitioner |
A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to an individual or group.
This resource is a request resource from a FHIR workflow perspective - see Workflow. It is the intent of the Orders and Observation Workgroup to align this resource with the workflow pattern for request resources.
The NutritionOrder resource describes a request for oral diets (including general diets such as General Healthy diet, or therapeutic diets such as Consistent Carbohydrate, 2-gram Sodium, or Fluid Restricted), oral nutrition supplements (such as nutritionally complete pre-packed drinks), enteral nutrition (tube feedings) and infant formula which govern the distribution of food and nutritional products used to feed patients within a patient setting. It does not cover orders for parenteral (IV) nutrition which are typically filled by pharmacy. These nutrition orders are combined with information on a patient's food allergies and intolerances, and ethnic or cultural food preferences (e.g. Kosher or Vegetarian) to inform healthcare personnel about the type, texture, and/or quantity of foods that the patient should receive or consume.
Enteral orders are distinguished from supplements because they have some unique attributes and typically include administration information whereas oral nutritional supplements may simply be supplied (e.g. home health or outpatient settings). In a simple case, the requestor may designate the type of product, product name, and the route of administration along with free text instructions without having to complete the additional structured details.
This resource is intended to be used by practitioners from a variety of specialties such as physicians, dietitians/nutritionists, or speech therapists. One practitioner may simply order a base element oral diet such as General Healthful diet. Another practitioner, based on the scope of practice, may use other elements to communicate additional therapeutic needs or patient preferences. The optionality included gives an ordering practitioner the capability to write a simple order for an oral diet, nutritional supplement or formula with minimal requirements beyond that of specifying the diet, supplement or formula product, but also supports the ability to provide more detailed information that may be further augmented by a dietitian or nutrition specialist. For example, a physician may order a 2 g sodium diet. A speech therapist, based on the results of a swallowing evaluation, then orders an International Dysphagia Diet Standardisation Initiative Framework - Soft and Bite-Sized Level 6 food (regime/therapy).
The NutritionOrder resource is used for requesting oral diets, oral nutrition supplements, enteral feedings, and infant formula. The MedicationRequest resource should be used for requesting parenteral (IV) nutrition and prescribing dietary supplements such as vitamin or mineral supplements.
The Nutrition Order is a record of the request for the supply of a diet, oral supplement, enteral formulas, and infant formula for a patient. However, to initiate the request requires the use of the Task resource and its associated workflow with the Nutrition Order referenced from Task.basedOn, or by using the Nutrition Task resource in the context of a messaging or service workflow where the request is explicit or implicit. For further information about this separation of responsibilities, refer to the Fulfillment/Execution section of the Request pattern.
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
NutritionOrder | TU | DomainResource | Diet, formula or nutritional supplement request + Warning: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
identifier | 0..* | Identifier | Identifiers assigned to this order | |
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
instantiates | 0..* | uri | Instantiates protocol or definition | |
basedOn | 0..* | Reference(CarePlan | NutritionOrder | ServiceRequest | RequestOrchestration) | What this order fulfills | |
groupIdentifier | Σ | 0..1 | Identifier | Composite Request ID |
status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (Required) |
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (Required) |
priority | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (Required) | |
subject | Σ | 1..1 | Reference(Patient | Group) | Who requires the diet, formula or nutritional supplement |
encounter | 0..1 | Reference(Encounter) | The encounter associated with this nutrition order | |
supportingInformation | 0..* | Reference(Any) | Information to support fulfilling of the nutrition order | |
dateTime | Σ | 1..1 | dateTime | Date and time the nutrition order was requested |
orderer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Who ordered the diet, formula or nutritional supplement |
performer | 0..* | CodeableReference(CareTeam | Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | Group) | Who is intended to perform the administration of the nutrition order | |
allergyIntolerance | 0..* | Reference(AllergyIntolerance) | List of the patient's food and nutrition-related allergies and intolerances | |
foodPreferenceModifier | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (Preferred) | |
excludeFoodModifier | 0..* | CodeableConcept | Food that should not be given Binding: Types of Edible Substances (Preferred) | |
outsideFoodAllowed | 0..1 | boolean | Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver | |
oralDiet | C | 0..1 | BackboneElement | Oral diet components |
type | Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that can be consumed orally Binding: Diet Codes (Preferred) |
schedule | 0..1 | BackboneElement | Scheduling information for oral diets | |
timing | 0..* | Timing | Scheduled frequency of diet | |
asNeeded | 0..1 | boolean | Take 'as needed' | |
asNeededFor | 0..1 | CodeableConcept | Take 'as needed' for x Binding: SNOMED CT Medication As Needed Reason Codes (Example) | |
nutrient | 0..* | BackboneElement | The nutrient that is modified and the quantity in the diet | |
modifier | 0..1 | CodeableConcept | Nutrient modified in the oral diet type Binding: Nutrient Codes (Preferred) | |
amount | 0..1 | SimpleQuantity | Quantity of the specified nutrient | |
texture | 0..* | BackboneElement | Texture modifications in addition to the oral diet type | |
modifier | 0..1 | CodeableConcept | Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type Binding: Categories of Nutrition Products (Preferred) | |
type | 0..1 | CodeableConcept | Food (i.e. solid and/or liquid) types that undergo texture alteration Binding: Texture Modified Food Type Codes (Example) | |
instruction | Σ | 0..1 | string | Instructions or additional information about the oral diet |
caloricDensity | 0..1 | SimpleQuantity | Amount of energy per specified volume of oral diet | |
supplement | C | 0..* | BackboneElement | Supplement components |
type | Σ | 0..1 | CodeableReference(NutritionProduct) | Type of supplement product requested Binding: Supplement Type Codes (Preferred) |
productName | 0..1 | string | Product or brand name of the nutritional supplement | |
schedule | 0..1 | BackboneElement | Scheduling information for supplements | |
timing | 0..* | Timing | Scheduled frequency of supplement | |
asNeeded | 0..1 | boolean | Take 'as needed' | |
asNeededFor | 0..1 | CodeableConcept | Take 'as needed' for x Binding: SNOMED CT Medication As Needed Reason Codes (Example) | |
quantity | 0..1 | SimpleQuantity | Amount of the nutritional supplement | |
instruction | Σ | 0..1 | string | Instructions or additional information about the oral supplement |
caloricDensity | 0..1 | SimpleQuantity | Amount of energy per specified volume of supplement that is required | |
enteralFormula | C | 0..1 | BackboneElement | Enteral formula product |
type | Σ | 0..1 | CodeableReference(NutritionProduct) | Type of patient enteral feeding Binding: Enteral Formula Type Codes (Preferred) |
productName | 0..1 | string | Product or brand name of the enteral feeding | |
deliveryDevice | 0..* | CodeableReference(DeviceDefinition) | Intended type of device for the enteral feeding administration | |
caloricDensity | 0..1 | SimpleQuantity | Amount of energy per specified volume of feeding that is required | |
routeOfAdministration | 0..* | CodeableConcept | How the enteral feeding should enter the patient's gastrointestinal tract Binding: Enteral Route Codes (Extensible) | |
administration | 0..* | BackboneElement | Formula feeding instruction as structured data | |
schedule | 0..1 | BackboneElement | Scheduling information for enteral feeding products | |
timing | 0..* | Timing | Scheduled frequency of enteral feeding | |
asNeeded | 0..1 | boolean | Take 'as needed' | |
asNeededFor | 0..1 | CodeableConcept | Take 'as needed' for x Binding: SNOMED CT Medication As Needed Reason Codes (Example) | |
quantity | 0..1 | SimpleQuantity | The volume of formula feeding to provide | |
rate[x] | 0..1 | Speed with which the formula feeding is provided per period of time | ||
rateQuantity | SimpleQuantity | |||
rateRatio | Ratio | |||
maxVolumeToAdminister | 0..1 | SimpleQuantity | Upper limit on formula feeding volume per unit of time | |
administrationInstruction | Σ | 0..1 | markdown | Formula feeding instructions expressed as text |
additive | 0..* | BackboneElement | Modular additive to add to the oral diet, supplement, and/or enteral feeding | |
modularType | 0..1 | CodeableReference(NutritionProduct) | Type of modular component to add to the oral diet, supplement, and/or enteral feeding Binding: Enteral Formula Additive Type Code (Preferred) | |
productName | 0..1 | string | Product or brand name of the modular additive | |
quantity | 0..1 | SimpleQuantity | Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding | |
note | 0..* | Annotation | Comments | |
Documentation for this format |
See the Extensions for this resource
UML Diagram (Legend)
XML Template
<NutritionOrder xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Identifiers assigned to this order --></identifier> <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|PlanDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical> <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition --> <instantiates value="[uri]"/><!-- 0..* Instantiates protocol or definition --> <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|RequestOrchestration| ServiceRequest) What this order fulfills --></basedOn> <groupIdentifier><!-- 0..1 Identifier Composite Request ID --></groupIdentifier> <status value="[code]"/><!-- 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown --> <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option --> <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat --> <subject><!-- 1..1 Reference(Group|Patient) Who requires the diet, formula or nutritional supplement --></subject> <encounter><!-- 0..1 Reference(Encounter) The encounter associated with this nutrition order --></encounter> <supportingInformation><!-- 0..* Reference(Any) Information to support fulfilling of the nutrition order --></supportingInformation> <dateTime value="[dateTime]"/><!-- 1..1 Date and time the nutrition order was requested --> <orderer><!-- 0..1 Reference(Practitioner|PractitionerRole) Who ordered the diet, formula or nutritional supplement --></orderer> <performer><!-- 0..* CodeableReference(CareTeam|Group|Organization|Patient| Practitioner|PractitionerRole|RelatedPerson) Who is intended to perform the administration of the nutrition order --></performer> <allergyIntolerance><!-- 0..* Reference(AllergyIntolerance) List of the patient's food and nutrition-related allergies and intolerances --></allergyIntolerance> <foodPreferenceModifier><!-- 0..* CodeableConcept Order-specific modifier about the type of food that should be given --></foodPreferenceModifier> <excludeFoodModifier><!-- 0..* CodeableConcept Food that should not be given --></excludeFoodModifier> <outsideFoodAllowed value="[boolean]"/><!-- 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver --> <oralDiet> <!-- I 0..1 Oral diet components --> <type><!-- 0..* CodeableConcept Type of oral diet or diet restrictions that can be consumed orally --></type> <schedule> <!-- 0..1 Scheduling information for oral diets --> <timing><!-- 0..* Timing Scheduled frequency of diet --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <nutrient> <!-- 0..* The nutrient that is modified and the quantity in the diet --> <modifier><!-- 0..1 CodeableConcept Nutrient modified in the oral diet type --></modifier> <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity of the specified nutrient --></amount> </nutrient> <texture> <!-- 0..* Texture modifications in addition to the oral diet type --> <modifier><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type --></modifier> <type><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) types that undergo texture alteration --></type> </texture> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral diet --> <caloricDensity><!-- 0..1 Quantity(SimpleQuantity) Amount of energy per specified volume of oral diet --></caloricDensity> </oralDiet> <supplement> <!-- I 0..* Supplement components --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of supplement product requested --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the nutritional supplement --> <schedule> <!-- 0..1 Scheduling information for supplements --> <timing><!-- 0..* Timing Scheduled frequency of supplement --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of the nutritional supplement --></quantity> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral supplement --> <caloricDensity><!-- 0..1 Quantity(SimpleQuantity) Amount of energy per specified volume of supplement that is required --></caloricDensity> </supplement> <enteralFormula> <!-- I 0..1 Enteral formula product --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of patient enteral feeding --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the enteral feeding --> <deliveryDevice><!-- 0..* CodeableReference(DeviceDefinition) Intended type of device for the enteral feeding administration --></deliveryDevice> <caloricDensity><!-- 0..1 Quantity(SimpleQuantity) Amount of energy per specified volume of feeding that is required --></caloricDensity> <routeOfAdministration><!-- 0..* CodeableConcept How the enteral feeding should enter the patient's gastrointestinal tract --></routeOfAdministration> <administration> <!-- 0..* Formula feeding instruction as structured data --> <schedule> <!-- 0..1 Scheduling information for enteral feeding products --> <timing><!-- 0..* Timing Scheduled frequency of enteral feeding --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity(SimpleQuantity) The volume of formula feeding to provide --></quantity> <rate[x]><!-- 0..1 Quantity(SimpleQuantity)|Ratio Speed with which the formula feeding is provided per period of time --></rate[x]> </administration> <maxVolumeToAdminister><!-- 0..1 Quantity(SimpleQuantity) Upper limit on formula feeding volume per unit of time --></maxVolumeToAdminister> <administrationInstruction value="[markdown]"/><!-- 0..1 Formula feeding instructions expressed as text --> </enteralFormula> <additive> <!-- 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding --> <modularType><!-- 0..1 CodeableReference(NutritionProduct) Type of modular component to add to the oral diet, supplement, and/or enteral feeding --></modularType> <productName value="[string]"/><!-- 0..1 Product or brand name of the modular additive --> <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding --></quantity> </additive> <note><!-- 0..* Annotation Comments --></note> </NutritionOrder>
JSON Template
{ "resourceType" : "NutritionOrder", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // Identifiers assigned to this order "instantiatesCanonical" : ["<canonical(ActivityDefinition|PlanDefinition)>"], // Instantiates FHIR protocol or definition "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition "instantiates" : ["<uri>"], // Instantiates protocol or definition "basedOn" : [{ Reference(CarePlan|NutritionOrder|RequestOrchestration| ServiceRequest) }], // What this order fulfills "groupIdentifier" : { Identifier }, // Composite Request ID "status" : "<code>", // R! draft | active | on-hold | revoked | completed | entered-in-error | unknown "intent" : "<code>", // R! proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option "priority" : "<code>", // routine | urgent | asap | stat "subject" : { Reference(Group|Patient) }, // R! Who requires the diet, formula or nutritional supplement "encounter" : { Reference(Encounter) }, // The encounter associated with this nutrition order "supportingInformation" : [{ Reference(Any) }], // Information to support fulfilling of the nutrition order "dateTime" : "<dateTime>", // R! Date and time the nutrition order was requested "orderer" : { Reference(Practitioner|PractitionerRole) }, // Who ordered the diet, formula or nutritional supplement "performer" : [{ CodeableReference(CareTeam|Group|Organization|Patient| Practitioner|PractitionerRole|RelatedPerson) }], // Who is intended to perform the administration of the nutrition order "allergyIntolerance" : [{ Reference(AllergyIntolerance) }], // List of the patient's food and nutrition-related allergies and intolerances "foodPreferenceModifier" : [{ CodeableConcept }], // Order-specific modifier about the type of food that should be given "excludeFoodModifier" : [{ CodeableConcept }], // Food that should not be given "outsideFoodAllowed" : <boolean>, // Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver "oralDiet" : { // I Oral diet components "type" : [{ CodeableConcept }], // Type of oral diet or diet restrictions that can be consumed orally "schedule" : { // Scheduling information for oral diets "timing" : [{ Timing }], // Scheduled frequency of diet "asNeeded" : <boolean>, // Take 'as needed' "asNeededFor" : { CodeableConcept } // Take 'as needed' for x }, "nutrient" : [{ // The nutrient that is modified and the quantity in the diet "modifier" : { CodeableConcept }, // Nutrient modified in the oral diet type "amount" : { Quantity(SimpleQuantity) } // Quantity of the specified nutrient }], "texture" : [{ // Texture modifications in addition to the oral diet type "modifier" : { CodeableConcept }, // Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type "type" : { CodeableConcept } // Food (i.e. solid and/or liquid) types that undergo texture alteration }], "instruction" : "<string>", // Instructions or additional information about the oral diet "caloricDensity" : { Quantity(SimpleQuantity) } // Amount of energy per specified volume of oral diet }, "supplement" : [{ // I Supplement components "type" : { CodeableReference(NutritionProduct) }, // Type of supplement product requested "productName" : "<string>", // Product or brand name of the nutritional supplement "schedule" : { // Scheduling information for supplements "timing" : [{ Timing }], // Scheduled frequency of supplement "asNeeded" : <boolean>, // Take 'as needed' "asNeededFor" : { CodeableConcept } // Take 'as needed' for x }, "quantity" : { Quantity(SimpleQuantity) }, // Amount of the nutritional supplement "instruction" : "<string>", // Instructions or additional information about the oral supplement "caloricDensity" : { Quantity(SimpleQuantity) } // Amount of energy per specified volume of supplement that is required }], "enteralFormula" : { // I Enteral formula product "type" : { CodeableReference(NutritionProduct) }, // Type of patient enteral feeding "productName" : "<string>", // Product or brand name of the enteral feeding "deliveryDevice" : [{ CodeableReference(DeviceDefinition) }], // Intended type of device for the enteral feeding administration "caloricDensity" : { Quantity(SimpleQuantity) }, // Amount of energy per specified volume of feeding that is required "routeOfAdministration" : [{ CodeableConcept }], // How the enteral feeding should enter the patient's gastrointestinal tract "administration" : [{ // Formula feeding instruction as structured data "schedule" : { // Scheduling information for enteral feeding products "timing" : [{ Timing }], // Scheduled frequency of enteral feeding "asNeeded" : <boolean>, // Take 'as needed' "asNeededFor" : { CodeableConcept } // Take 'as needed' for x }, "quantity" : { Quantity(SimpleQuantity) }, // The volume of formula feeding to provide // rate[x]: Speed with which the formula feeding is provided per period of time. One of these 2: "rateQuantity" : { Quantity(SimpleQuantity) }, "rateRatio" : { Ratio } }], "maxVolumeToAdminister" : { Quantity(SimpleQuantity) }, // Upper limit on formula feeding volume per unit of time "administrationInstruction" : "<markdown>" // Formula feeding instructions expressed as text }, "additive" : [{ // Modular additive to add to the oral diet, supplement, and/or enteral feeding "modularType" : { CodeableReference(NutritionProduct) }, // Type of modular component to add to the oral diet, supplement, and/or enteral feeding "productName" : "<string>", // Product or brand name of the modular additive "quantity" : { Quantity(SimpleQuantity) } // Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding }], "note" : [{ Annotation }] // Comments }
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> . [ a fhir:NutritionOrder; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from Resource: .id, .meta, .implicitRules, and .language # from DomainResource: .text, .contained, .extension, and .modifierExtension fhir:identifier ( [ Identifier ] ... ) ; # 0..* Identifiers assigned to this order fhir:instantiatesCanonical ( [ canonical(ActivityDefinition|PlanDefinition) ] ... ) ; # 0..* Instantiates FHIR protocol or definition fhir:instantiatesUri ( [ uri ] ... ) ; # 0..* Instantiates external protocol or definition fhir:instantiates ( [ uri ] ... ) ; # 0..* Instantiates protocol or definition fhir:basedOn ( [ Reference(CarePlan|NutritionOrder|RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* What this order fulfills fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite Request ID fhir:status [ code ] ; # 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown fhir:intent [ code ] ; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who requires the diet, formula or nutritional supplement fhir:encounter [ Reference(Encounter) ] ; # 0..1 The encounter associated with this nutrition order fhir:supportingInformation ( [ Reference(Any) ] ... ) ; # 0..* Information to support fulfilling of the nutrition order fhir:dateTime [ dateTime ] ; # 1..1 Date and time the nutrition order was requested fhir:orderer [ Reference(Practitioner|PractitionerRole) ] ; # 0..1 Who ordered the diet, formula or nutritional supplement fhir:performer ( [ CodeableReference(CareTeam|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who is intended to perform the administration of the nutrition order fhir:allergyIntolerance ( [ Reference(AllergyIntolerance) ] ... ) ; # 0..* List of the patient's food and nutrition-related allergies and intolerances fhir:foodPreferenceModifier ( [ CodeableConcept ] ... ) ; # 0..* Order-specific modifier about the type of food that should be given fhir:excludeFoodModifier ( [ CodeableConcept ] ... ) ; # 0..* Food that should not be given fhir:outsideFoodAllowed [ boolean ] ; # 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver fhir:oralDiet [ # 0..1 I Oral diet components fhir:type ( [ CodeableConcept ] ... ) ; # 0..* Type of oral diet or diet restrictions that can be consumed orally fhir:schedule [ # 0..1 Scheduling information for oral diets fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of diet fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:nutrient ( [ # 0..* The nutrient that is modified and the quantity in the diet fhir:modifier [ CodeableConcept ] ; # 0..1 Nutrient modified in the oral diet type fhir:amount [ Quantity(SimpleQuantity) ] ; # 0..1 Quantity of the specified nutrient ] ... ) ; fhir:texture ( [ # 0..* Texture modifications in addition to the oral diet type fhir:modifier [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type fhir:type [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) types that undergo texture alteration ] ... ) ; fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral diet fhir:caloricDensity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of energy per specified volume of oral diet ] ; fhir:supplement ( [ # 0..* I Supplement components fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of supplement product requested fhir:productName [ string ] ; # 0..1 Product or brand name of the nutritional supplement fhir:schedule [ # 0..1 Scheduling information for supplements fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of supplement fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of the nutritional supplement fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral supplement fhir:caloricDensity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of energy per specified volume of supplement that is required ] ... ) ; fhir:enteralFormula [ # 0..1 I Enteral formula product fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of patient enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the enteral feeding fhir:deliveryDevice ( [ CodeableReference(DeviceDefinition) ] ... ) ; # 0..* Intended type of device for the enteral feeding administration fhir:caloricDensity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of energy per specified volume of feeding that is required fhir:routeOfAdministration ( [ CodeableConcept ] ... ) ; # 0..* How the enteral feeding should enter the patient's gastrointestinal tract fhir:administration ( [ # 0..* Formula feeding instruction as structured data fhir:schedule [ # 0..1 Scheduling information for enteral feeding products fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of enteral feeding fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 The volume of formula feeding to provide # rate[x] : 0..1 Speed with which the formula feeding is provided per period of time. One of these 2 fhir:rate [ a fhir:SimpleQuantity ; Quantity(SimpleQuantity) ] fhir:rate [ a fhir:Ratio ; Ratio ] ] ... ) ; fhir:maxVolumeToAdminister [ Quantity(SimpleQuantity) ] ; # 0..1 Upper limit on formula feeding volume per unit of time fhir:administrationInstruction [ markdown ] ; # 0..1 Formula feeding instructions expressed as text ] ; fhir:additive ( [ # 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding fhir:modularType [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of modular component to add to the oral diet, supplement, and/or enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the modular additive fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding ] ... ) ; fhir:note ( [ Annotation ] ... ) ; # 0..* Comments ]
Changes from both R4 and R4B
NutritionOrder | |
NutritionOrder.basedOn |
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NutritionOrder.groupIdentifier |
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NutritionOrder.priority |
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NutritionOrder.subject |
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NutritionOrder.supportingInformation |
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NutritionOrder.performer |
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NutritionOrder.outsideFoodAllowed |
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NutritionOrder.oralDiet.schedule |
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NutritionOrder.oralDiet.schedule.timing |
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NutritionOrder.oralDiet.schedule.asNeeded |
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NutritionOrder.oralDiet.schedule.asNeededFor |
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NutritionOrder.oralDiet.texture.type |
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NutritionOrder.oralDiet.caloricDensity |
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NutritionOrder.supplement.type |
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NutritionOrder.supplement.schedule |
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NutritionOrder.supplement.schedule.timing |
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NutritionOrder.supplement.schedule.asNeeded |
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NutritionOrder.supplement.schedule.asNeededFor |
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NutritionOrder.supplement.caloricDensity |
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NutritionOrder.enteralFormula.type |
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NutritionOrder.enteralFormula.productName |
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NutritionOrder.enteralFormula.deliveryDevice |
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NutritionOrder.enteralFormula.routeOfAdministration |
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NutritionOrder.enteralFormula.administration.schedule |
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NutritionOrder.enteralFormula.administration.schedule.timing |
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NutritionOrder.enteralFormula.administration.schedule.asNeeded |
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NutritionOrder.enteralFormula.administration.schedule.asNeededFor |
|
NutritionOrder.enteralFormula.maxVolumeToAdminister |
|
NutritionOrder.enteralFormula.administrationInstruction |
|
NutritionOrder.additive |
|
NutritionOrder.additive.modularType |
|
NutritionOrder.additive.productName |
|
NutritionOrder.additive.quantity |
|
NutritionOrder.patient |
|
NutritionOrder.oralDiet.texture.foodType |
|
NutritionOrder.oralDiet.fluidConsistencyType |
|
NutritionOrder.enteralFormula.baseFormulaType |
|
NutritionOrder.enteralFormula.baseFormulaProductName |
|
NutritionOrder.enteralFormula.additiveType |
|
NutritionOrder.enteralFormula.additiveProductName |
|
NutritionOrder.enteralFormula.routeofAdministration |
|
NutritionOrder.enteralFormula.maxVolumeToDeliver |
|
See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
NutritionOrder | TU | DomainResource | Diet, formula or nutritional supplement request + Warning: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | |
identifier | 0..* | Identifier | Identifiers assigned to this order | |
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition |
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition |
instantiates | 0..* | uri | Instantiates protocol or definition | |
basedOn | 0..* | Reference(CarePlan | NutritionOrder | ServiceRequest | RequestOrchestration) | What this order fulfills | |
groupIdentifier | Σ | 0..1 | Identifier | Composite Request ID |
status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (Required) |
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (Required) |
priority | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (Required) | |
subject | Σ | 1..1 | Reference(Patient | Group) | Who requires the diet, formula or nutritional supplement |
encounter | 0..1 | Reference(Encounter) | The encounter associated with this nutrition order | |
supportingInformation | 0..* | Reference(Any) | Information to support fulfilling of the nutrition order | |
dateTime | Σ | 1..1 | dateTime | Date and time the nutrition order was requested |
orderer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Who ordered the diet, formula or nutritional supplement |
performer | 0..* | CodeableReference(CareTeam | Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | Group) | Who is intended to perform the administration of the nutrition order | |
allergyIntolerance | 0..* | Reference(AllergyIntolerance) | List of the patient's food and nutrition-related allergies and intolerances | |
foodPreferenceModifier | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (Preferred) | |
excludeFoodModifier | 0..* | CodeableConcept | Food that should not be given Binding: Types of Edible Substances (Preferred) | |
outsideFoodAllowed | 0..1 | boolean | Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver | |
oralDiet | C | 0..1 | BackboneElement | Oral diet components |
type | Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that can be consumed orally Binding: Diet Codes (Preferred) |
schedule | 0..1 | BackboneElement | Scheduling information for oral diets | |
timing | 0..* | Timing | Scheduled frequency of diet | |
asNeeded | 0..1 | boolean | Take 'as needed' | |
asNeededFor | 0..1 | CodeableConcept | Take 'as needed' for x Binding: SNOMED CT Medication As Needed Reason Codes (Example) | |
nutrient | 0..* | BackboneElement | The nutrient that is modified and the quantity in the diet | |
modifier | 0..1 | CodeableConcept | Nutrient modified in the oral diet type Binding: Nutrient Codes (Preferred) | |
amount | 0..1 | SimpleQuantity | Quantity of the specified nutrient | |
texture | 0..* | BackboneElement | Texture modifications in addition to the oral diet type | |
modifier | 0..1 | CodeableConcept | Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type Binding: Categories of Nutrition Products (Preferred) | |
type | 0..1 | CodeableConcept | Food (i.e. solid and/or liquid) types that undergo texture alteration Binding: Texture Modified Food Type Codes (Example) | |
instruction | Σ | 0..1 | string | Instructions or additional information about the oral diet |
caloricDensity | 0..1 | SimpleQuantity | Amount of energy per specified volume of oral diet | |
supplement | C | 0..* | BackboneElement | Supplement components |
type | Σ | 0..1 | CodeableReference(NutritionProduct) | Type of supplement product requested Binding: Supplement Type Codes (Preferred) |
productName | 0..1 | string | Product or brand name of the nutritional supplement | |
schedule | 0..1 | BackboneElement | Scheduling information for supplements | |
timing | 0..* | Timing | Scheduled frequency of supplement | |
asNeeded | 0..1 | boolean | Take 'as needed' | |
asNeededFor | 0..1 | CodeableConcept | Take 'as needed' for x Binding: SNOMED CT Medication As Needed Reason Codes (Example) | |
quantity | 0..1 | SimpleQuantity | Amount of the nutritional supplement | |
instruction | Σ | 0..1 | string | Instructions or additional information about the oral supplement |
caloricDensity | 0..1 | SimpleQuantity | Amount of energy per specified volume of supplement that is required | |
enteralFormula | C | 0..1 | BackboneElement | Enteral formula product |
type | Σ | 0..1 | CodeableReference(NutritionProduct) | Type of patient enteral feeding Binding: Enteral Formula Type Codes (Preferred) |
productName | 0..1 | string | Product or brand name of the enteral feeding | |
deliveryDevice | 0..* | CodeableReference(DeviceDefinition) | Intended type of device for the enteral feeding administration | |
caloricDensity | 0..1 | SimpleQuantity | Amount of energy per specified volume of feeding that is required | |
routeOfAdministration | 0..* | CodeableConcept | How the enteral feeding should enter the patient's gastrointestinal tract Binding: Enteral Route Codes (Extensible) | |
administration | 0..* | BackboneElement | Formula feeding instruction as structured data | |
schedule | 0..1 | BackboneElement | Scheduling information for enteral feeding products | |
timing | 0..* | Timing | Scheduled frequency of enteral feeding | |
asNeeded | 0..1 | boolean | Take 'as needed' | |
asNeededFor | 0..1 | CodeableConcept | Take 'as needed' for x Binding: SNOMED CT Medication As Needed Reason Codes (Example) | |
quantity | 0..1 | SimpleQuantity | The volume of formula feeding to provide | |
rate[x] | 0..1 | Speed with which the formula feeding is provided per period of time | ||
rateQuantity | SimpleQuantity | |||
rateRatio | Ratio | |||
maxVolumeToAdminister | 0..1 | SimpleQuantity | Upper limit on formula feeding volume per unit of time | |
administrationInstruction | Σ | 0..1 | markdown | Formula feeding instructions expressed as text |
additive | 0..* | BackboneElement | Modular additive to add to the oral diet, supplement, and/or enteral feeding | |
modularType | 0..1 | CodeableReference(NutritionProduct) | Type of modular component to add to the oral diet, supplement, and/or enteral feeding Binding: Enteral Formula Additive Type Code (Preferred) | |
productName | 0..1 | string | Product or brand name of the modular additive | |
quantity | 0..1 | SimpleQuantity | Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding | |
note | 0..* | Annotation | Comments | |
Documentation for this format |
See the Extensions for this resource
XML Template
<NutritionOrder xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Identifiers assigned to this order --></identifier> <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|PlanDefinition) Instantiates FHIR protocol or definition --></instantiatesCanonical> <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition --> <instantiates value="[uri]"/><!-- 0..* Instantiates protocol or definition --> <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|RequestOrchestration| ServiceRequest) What this order fulfills --></basedOn> <groupIdentifier><!-- 0..1 Identifier Composite Request ID --></groupIdentifier> <status value="[code]"/><!-- 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown --> <intent value="[code]"/><!-- 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option --> <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat --> <subject><!-- 1..1 Reference(Group|Patient) Who requires the diet, formula or nutritional supplement --></subject> <encounter><!-- 0..1 Reference(Encounter) The encounter associated with this nutrition order --></encounter> <supportingInformation><!-- 0..* Reference(Any) Information to support fulfilling of the nutrition order --></supportingInformation> <dateTime value="[dateTime]"/><!-- 1..1 Date and time the nutrition order was requested --> <orderer><!-- 0..1 Reference(Practitioner|PractitionerRole) Who ordered the diet, formula or nutritional supplement --></orderer> <performer><!-- 0..* CodeableReference(CareTeam|Group|Organization|Patient| Practitioner|PractitionerRole|RelatedPerson) Who is intended to perform the administration of the nutrition order --></performer> <allergyIntolerance><!-- 0..* Reference(AllergyIntolerance) List of the patient's food and nutrition-related allergies and intolerances --></allergyIntolerance> <foodPreferenceModifier><!-- 0..* CodeableConcept Order-specific modifier about the type of food that should be given --></foodPreferenceModifier> <excludeFoodModifier><!-- 0..* CodeableConcept Food that should not be given --></excludeFoodModifier> <outsideFoodAllowed value="[boolean]"/><!-- 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver --> <oralDiet> <!-- I 0..1 Oral diet components --> <type><!-- 0..* CodeableConcept Type of oral diet or diet restrictions that can be consumed orally --></type> <schedule> <!-- 0..1 Scheduling information for oral diets --> <timing><!-- 0..* Timing Scheduled frequency of diet --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <nutrient> <!-- 0..* The nutrient that is modified and the quantity in the diet --> <modifier><!-- 0..1 CodeableConcept Nutrient modified in the oral diet type --></modifier> <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity of the specified nutrient --></amount> </nutrient> <texture> <!-- 0..* Texture modifications in addition to the oral diet type --> <modifier><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type --></modifier> <type><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) types that undergo texture alteration --></type> </texture> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral diet --> <caloricDensity><!-- 0..1 Quantity(SimpleQuantity) Amount of energy per specified volume of oral diet --></caloricDensity> </oralDiet> <supplement> <!-- I 0..* Supplement components --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of supplement product requested --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the nutritional supplement --> <schedule> <!-- 0..1 Scheduling information for supplements --> <timing><!-- 0..* Timing Scheduled frequency of supplement --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of the nutritional supplement --></quantity> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral supplement --> <caloricDensity><!-- 0..1 Quantity(SimpleQuantity) Amount of energy per specified volume of supplement that is required --></caloricDensity> </supplement> <enteralFormula> <!-- I 0..1 Enteral formula product --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of patient enteral feeding --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the enteral feeding --> <deliveryDevice><!-- 0..* CodeableReference(DeviceDefinition) Intended type of device for the enteral feeding administration --></deliveryDevice> <caloricDensity><!-- 0..1 Quantity(SimpleQuantity) Amount of energy per specified volume of feeding that is required --></caloricDensity> <routeOfAdministration><!-- 0..* CodeableConcept How the enteral feeding should enter the patient's gastrointestinal tract --></routeOfAdministration> <administration> <!-- 0..* Formula feeding instruction as structured data --> <schedule> <!-- 0..1 Scheduling information for enteral feeding products --> <timing><!-- 0..* Timing Scheduled frequency of enteral feeding --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity(SimpleQuantity) The volume of formula feeding to provide --></quantity> <rate[x]><!-- 0..1 Quantity(SimpleQuantity)|Ratio Speed with which the formula feeding is provided per period of time --></rate[x]> </administration> <maxVolumeToAdminister><!-- 0..1 Quantity(SimpleQuantity) Upper limit on formula feeding volume per unit of time --></maxVolumeToAdminister> <administrationInstruction value="[markdown]"/><!-- 0..1 Formula feeding instructions expressed as text --> </enteralFormula> <additive> <!-- 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding --> <modularType><!-- 0..1 CodeableReference(NutritionProduct) Type of modular component to add to the oral diet, supplement, and/or enteral feeding --></modularType> <productName value="[string]"/><!-- 0..1 Product or brand name of the modular additive --> <quantity><!-- 0..1 Quantity(SimpleQuantity) Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding --></quantity> </additive> <note><!-- 0..* Annotation Comments --></note> </NutritionOrder>
JSON Template
{ "resourceType" : "NutritionOrder", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "identifier" : [{ Identifier }], // Identifiers assigned to this order "instantiatesCanonical" : ["<canonical(ActivityDefinition|PlanDefinition)>"], // Instantiates FHIR protocol or definition "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition "instantiates" : ["<uri>"], // Instantiates protocol or definition "basedOn" : [{ Reference(CarePlan|NutritionOrder|RequestOrchestration| ServiceRequest) }], // What this order fulfills "groupIdentifier" : { Identifier }, // Composite Request ID "status" : "<code>", // R! draft | active | on-hold | revoked | completed | entered-in-error | unknown "intent" : "<code>", // R! proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option "priority" : "<code>", // routine | urgent | asap | stat "subject" : { Reference(Group|Patient) }, // R! Who requires the diet, formula or nutritional supplement "encounter" : { Reference(Encounter) }, // The encounter associated with this nutrition order "supportingInformation" : [{ Reference(Any) }], // Information to support fulfilling of the nutrition order "dateTime" : "<dateTime>", // R! Date and time the nutrition order was requested "orderer" : { Reference(Practitioner|PractitionerRole) }, // Who ordered the diet, formula or nutritional supplement "performer" : [{ CodeableReference(CareTeam|Group|Organization|Patient| Practitioner|PractitionerRole|RelatedPerson) }], // Who is intended to perform the administration of the nutrition order "allergyIntolerance" : [{ Reference(AllergyIntolerance) }], // List of the patient's food and nutrition-related allergies and intolerances "foodPreferenceModifier" : [{ CodeableConcept }], // Order-specific modifier about the type of food that should be given "excludeFoodModifier" : [{ CodeableConcept }], // Food that should not be given "outsideFoodAllowed" : <boolean>, // Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver "oralDiet" : { // I Oral diet components "type" : [{ CodeableConcept }], // Type of oral diet or diet restrictions that can be consumed orally "schedule" : { // Scheduling information for oral diets "timing" : [{ Timing }], // Scheduled frequency of diet "asNeeded" : <boolean>, // Take 'as needed' "asNeededFor" : { CodeableConcept } // Take 'as needed' for x }, "nutrient" : [{ // The nutrient that is modified and the quantity in the diet "modifier" : { CodeableConcept }, // Nutrient modified in the oral diet type "amount" : { Quantity(SimpleQuantity) } // Quantity of the specified nutrient }], "texture" : [{ // Texture modifications in addition to the oral diet type "modifier" : { CodeableConcept }, // Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type "type" : { CodeableConcept } // Food (i.e. solid and/or liquid) types that undergo texture alteration }], "instruction" : "<string>", // Instructions or additional information about the oral diet "caloricDensity" : { Quantity(SimpleQuantity) } // Amount of energy per specified volume of oral diet }, "supplement" : [{ // I Supplement components "type" : { CodeableReference(NutritionProduct) }, // Type of supplement product requested "productName" : "<string>", // Product or brand name of the nutritional supplement "schedule" : { // Scheduling information for supplements "timing" : [{ Timing }], // Scheduled frequency of supplement "asNeeded" : <boolean>, // Take 'as needed' "asNeededFor" : { CodeableConcept } // Take 'as needed' for x }, "quantity" : { Quantity(SimpleQuantity) }, // Amount of the nutritional supplement "instruction" : "<string>", // Instructions or additional information about the oral supplement "caloricDensity" : { Quantity(SimpleQuantity) } // Amount of energy per specified volume of supplement that is required }], "enteralFormula" : { // I Enteral formula product "type" : { CodeableReference(NutritionProduct) }, // Type of patient enteral feeding "productName" : "<string>", // Product or brand name of the enteral feeding "deliveryDevice" : [{ CodeableReference(DeviceDefinition) }], // Intended type of device for the enteral feeding administration "caloricDensity" : { Quantity(SimpleQuantity) }, // Amount of energy per specified volume of feeding that is required "routeOfAdministration" : [{ CodeableConcept }], // How the enteral feeding should enter the patient's gastrointestinal tract "administration" : [{ // Formula feeding instruction as structured data "schedule" : { // Scheduling information for enteral feeding products "timing" : [{ Timing }], // Scheduled frequency of enteral feeding "asNeeded" : <boolean>, // Take 'as needed' "asNeededFor" : { CodeableConcept } // Take 'as needed' for x }, "quantity" : { Quantity(SimpleQuantity) }, // The volume of formula feeding to provide // rate[x]: Speed with which the formula feeding is provided per period of time. One of these 2: "rateQuantity" : { Quantity(SimpleQuantity) }, "rateRatio" : { Ratio } }], "maxVolumeToAdminister" : { Quantity(SimpleQuantity) }, // Upper limit on formula feeding volume per unit of time "administrationInstruction" : "<markdown>" // Formula feeding instructions expressed as text }, "additive" : [{ // Modular additive to add to the oral diet, supplement, and/or enteral feeding "modularType" : { CodeableReference(NutritionProduct) }, // Type of modular component to add to the oral diet, supplement, and/or enteral feeding "productName" : "<string>", // Product or brand name of the modular additive "quantity" : { Quantity(SimpleQuantity) } // Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding }], "note" : [{ Annotation }] // Comments }
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> . [ a fhir:NutritionOrder; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from Resource: .id, .meta, .implicitRules, and .language # from DomainResource: .text, .contained, .extension, and .modifierExtension fhir:identifier ( [ Identifier ] ... ) ; # 0..* Identifiers assigned to this order fhir:instantiatesCanonical ( [ canonical(ActivityDefinition|PlanDefinition) ] ... ) ; # 0..* Instantiates FHIR protocol or definition fhir:instantiatesUri ( [ uri ] ... ) ; # 0..* Instantiates external protocol or definition fhir:instantiates ( [ uri ] ... ) ; # 0..* Instantiates protocol or definition fhir:basedOn ( [ Reference(CarePlan|NutritionOrder|RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* What this order fulfills fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite Request ID fhir:status [ code ] ; # 1..1 draft | active | on-hold | revoked | completed | entered-in-error | unknown fhir:intent [ code ] ; # 1..1 proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who requires the diet, formula or nutritional supplement fhir:encounter [ Reference(Encounter) ] ; # 0..1 The encounter associated with this nutrition order fhir:supportingInformation ( [ Reference(Any) ] ... ) ; # 0..* Information to support fulfilling of the nutrition order fhir:dateTime [ dateTime ] ; # 1..1 Date and time the nutrition order was requested fhir:orderer [ Reference(Practitioner|PractitionerRole) ] ; # 0..1 Who ordered the diet, formula or nutritional supplement fhir:performer ( [ CodeableReference(CareTeam|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who is intended to perform the administration of the nutrition order fhir:allergyIntolerance ( [ Reference(AllergyIntolerance) ] ... ) ; # 0..* List of the patient's food and nutrition-related allergies and intolerances fhir:foodPreferenceModifier ( [ CodeableConcept ] ... ) ; # 0..* Order-specific modifier about the type of food that should be given fhir:excludeFoodModifier ( [ CodeableConcept ] ... ) ; # 0..* Food that should not be given fhir:outsideFoodAllowed [ boolean ] ; # 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver fhir:oralDiet [ # 0..1 I Oral diet components fhir:type ( [ CodeableConcept ] ... ) ; # 0..* Type of oral diet or diet restrictions that can be consumed orally fhir:schedule [ # 0..1 Scheduling information for oral diets fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of diet fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:nutrient ( [ # 0..* The nutrient that is modified and the quantity in the diet fhir:modifier [ CodeableConcept ] ; # 0..1 Nutrient modified in the oral diet type fhir:amount [ Quantity(SimpleQuantity) ] ; # 0..1 Quantity of the specified nutrient ] ... ) ; fhir:texture ( [ # 0..* Texture modifications in addition to the oral diet type fhir:modifier [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type fhir:type [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) types that undergo texture alteration ] ... ) ; fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral diet fhir:caloricDensity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of energy per specified volume of oral diet ] ; fhir:supplement ( [ # 0..* I Supplement components fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of supplement product requested fhir:productName [ string ] ; # 0..1 Product or brand name of the nutritional supplement fhir:schedule [ # 0..1 Scheduling information for supplements fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of supplement fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of the nutritional supplement fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral supplement fhir:caloricDensity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of energy per specified volume of supplement that is required ] ... ) ; fhir:enteralFormula [ # 0..1 I Enteral formula product fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of patient enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the enteral feeding fhir:deliveryDevice ( [ CodeableReference(DeviceDefinition) ] ... ) ; # 0..* Intended type of device for the enteral feeding administration fhir:caloricDensity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of energy per specified volume of feeding that is required fhir:routeOfAdministration ( [ CodeableConcept ] ... ) ; # 0..* How the enteral feeding should enter the patient's gastrointestinal tract fhir:administration ( [ # 0..* Formula feeding instruction as structured data fhir:schedule [ # 0..1 Scheduling information for enteral feeding products fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of enteral feeding fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 The volume of formula feeding to provide # rate[x] : 0..1 Speed with which the formula feeding is provided per period of time. One of these 2 fhir:rate [ a fhir:SimpleQuantity ; Quantity(SimpleQuantity) ] fhir:rate [ a fhir:Ratio ; Ratio ] ] ... ) ; fhir:maxVolumeToAdminister [ Quantity(SimpleQuantity) ] ; # 0..1 Upper limit on formula feeding volume per unit of time fhir:administrationInstruction [ markdown ] ; # 0..1 Formula feeding instructions expressed as text ] ; fhir:additive ( [ # 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding fhir:modularType [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of modular component to add to the oral diet, supplement, and/or enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the modular additive fhir:quantity [ Quantity(SimpleQuantity) ] ; # 0..1 Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding ] ... ) ; fhir:note ( [ Annotation ] ... ) ; # 0..* Comments ]
Changes from both R4 and R4B
NutritionOrder | |
NutritionOrder.basedOn |
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NutritionOrder.groupIdentifier |
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NutritionOrder.priority |
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NutritionOrder.subject |
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NutritionOrder.supportingInformation |
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NutritionOrder.performer |
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NutritionOrder.outsideFoodAllowed |
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NutritionOrder.oralDiet.schedule |
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NutritionOrder.oralDiet.schedule.timing |
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NutritionOrder.oralDiet.schedule.asNeeded |
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NutritionOrder.oralDiet.schedule.asNeededFor |
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NutritionOrder.oralDiet.texture.type |
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NutritionOrder.oralDiet.caloricDensity |
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NutritionOrder.supplement.type |
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NutritionOrder.supplement.schedule |
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NutritionOrder.supplement.schedule.timing |
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NutritionOrder.supplement.schedule.asNeeded |
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NutritionOrder.supplement.schedule.asNeededFor |
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NutritionOrder.supplement.caloricDensity |
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NutritionOrder.enteralFormula.type |
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NutritionOrder.enteralFormula.productName |
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NutritionOrder.enteralFormula.deliveryDevice |
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NutritionOrder.enteralFormula.routeOfAdministration |
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NutritionOrder.enteralFormula.administration.schedule |
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NutritionOrder.enteralFormula.administration.schedule.timing |
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NutritionOrder.enteralFormula.administration.schedule.asNeeded |
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NutritionOrder.enteralFormula.administration.schedule.asNeededFor |
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NutritionOrder.enteralFormula.maxVolumeToAdminister |
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NutritionOrder.enteralFormula.administrationInstruction |
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NutritionOrder.additive |
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NutritionOrder.additive.modularType |
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NutritionOrder.additive.productName |
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NutritionOrder.additive.quantity |
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NutritionOrder.patient |
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NutritionOrder.oralDiet.texture.foodType |
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NutritionOrder.oralDiet.fluidConsistencyType |
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NutritionOrder.enteralFormula.baseFormulaType |
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NutritionOrder.enteralFormula.baseFormulaProductName |
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NutritionOrder.enteralFormula.additiveType |
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NutritionOrder.enteralFormula.additiveProductName |
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NutritionOrder.enteralFormula.routeofAdministration |
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NutritionOrder.enteralFormula.maxVolumeToDeliver |
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See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.
Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis
Path | ValueSet | Type | Documentation |
---|---|---|---|
NutritionOrder.status | RequestStatus | Required | Codes identifying the lifecycle stage of a request. |
NutritionOrder.intent | RequestIntent | Required | Codes indicating the degree of authority/intentionality associated with a request. |
NutritionOrder.priority | RequestPriority | Required | Identifies the level of importance to be assigned to actioning the request. |
NutritionOrder.foodPreferenceModifier | TypesOfEdibleSubstances | Preferred | This value set represents codes for types of edible substances. It include codes from SNOMED CT where concept 762766007 Edible Substance (substance) and its sub-concepts, Infant Formula (412413001) and its sub-concepts, Enteral and Supplement Feeds (346415002) and its sub-concepts, Water (11713004), Potable Water (890302005) and its sub-concepts, and Tap Water (444923006). |
NutritionOrder.excludeFoodModifier | TypesOfEdibleSubstances | Preferred | This value set represents codes for types of edible substances. It include codes from SNOMED CT where concept 762766007 Edible Substance (substance) and its sub-concepts, Infant Formula (412413001) and its sub-concepts, Enteral and Supplement Feeds (346415002) and its sub-concepts, Water (11713004), Potable Water (890302005) and its sub-concepts, and Tap Water (444923006). |
NutritionOrder.oralDiet.type | DietCodes | Preferred | Codes that can be used to indicate the type of food being ordered for a patient. It includes codes from SNOMED CT where concept is Dietary Regime (182922004) and its sub-concepts, Enteral Feeding (229912004) and its sub-concepts, Mixed Breast Milk and Bottle Feeding (35011000087100), Breast Milk Feeding (1297276008), Bottle Feeding of Patient (40043006). |
NutritionOrder.oralDiet.schedule.asNeededFor | SNOMEDCTMedicationAsNeededReasonCodes | Example | This value set includes all clinical findings from SNOMED CT - provided as an exemplar value set. |
NutritionOrder.oralDiet.nutrient.modifier | NutrientCodes | Preferred | NutrientModifier : Codes for types of nutrients that are being modified such as carbohydrate or sodium. This value set includes codes from SNOMED CT where concept is-a 226355009 (Nutrients(substance)), and the concepts for Sodium, Potassium and Fluid. This is provided as a suggestive example. |
NutritionOrder.oralDiet.texture.modifier | CategoriesOfNutritionProducts | Preferred | This value set represents codes for categories of nutrition products. It includes all of the codes from the Food Type Modifiers valueset. It include codes from SNOMED CT where concept is Breast Milk (226789007) and its sub-concepts, Infant Formula (412413001) and its sub-concepts, Enteral and Supplement Feeds (346415002) and its sub-concepts, Drinks (226465004) and its sub-concepts, Water (11713004), Potable Water (890302005) and its sub-concepts, and 444923006 (Tap Water). |
NutritionOrder.oralDiet.texture.type | TextureModifiedFoodTypeCodes | Example | TextureModifiedFoodType: Codes for types of foods that are texture-modified. This value set is composed SNOMED CT Concepts from SCTID 255620007 Foods (substance) and is provided as a suggestive example. |
NutritionOrder.supplement.type | SupplementTypeCodes | Preferred | SupplementType : Codes for nutritional supplements to be provided to the patient. This value set is composed of SNOMED CT Concepts from SCTID 346415002 (Enteral and supplement feeds (product)). |
NutritionOrder.supplement.schedule.asNeededFor | SNOMEDCTMedicationAsNeededReasonCodes | Example | This value set includes all clinical findings from SNOMED CT - provided as an exemplar value set. |
NutritionOrder.enteralFormula.type | EnteralFormulaTypeCodes | Preferred | SupplementType : Codes for nutritional supplements to be provided to the patient. This value set is composed of SNOMED CT Concepts from SCTID 346415002 (Enteral and supplement feeds (product)). |
NutritionOrder.enteralFormula.routeOfAdministration | EnteralRouteCodes | Extensible | EnteralRouteOfAdministration: Codes specifying the route of administration of enteral formula. This value set is composed of HL7 V3 codes and is provided as a suggestive example. |
NutritionOrder.enteralFormula.administration.schedule.asNeededFor | SNOMEDCTMedicationAsNeededReasonCodes | Example | This value set includes all clinical findings from SNOMED CT - provided as an exemplar value set. |
NutritionOrder.additive.modularType | EnteralFormulaAdditiveTypeCode | Preferred | Codes for modular components to be added to the diet. |
UniqueKey | Level | Location | Description | Expression |
nor-1 | Warning | (base) | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class | oralDiet.exists() or supplement.exists() or enteralFormula.exists() |
Tube feedings can be administered via continuous drip using a pump or via intermittent feedings, using gravity drip or a pump. The examples Nutrition Order Enteral Bolus Feeding Example and Nutrition Order Enteral Continuous Feeding Example show how this resource can be used to order both kinds of enteral feeding using the structured data elements. The continuous feeding typically specifies rate of administration and a maximum volume of delivery using the enteralFormula.administration.rate and enteralFormula.maxVolumeToDeliver elements. On the other hand, the intermittent feeding typically specifies the amount and frequency of administration using the enteralFormula.administration.quantity and enteralFormula.schedule elements. In both cases, to vary the rate or quantity over time the enteralFormula.administration element can be repeated.
The examples associated with this resource demonstrate the core elements and do not necessarily reflect real-world implementations that may be constrained by future profiles for a given implementation or setting. For example, a renal diet is often comprised of pre-coordinated components including common nutrient modifications such as protein, potassium and phosphorus to assist with the speed of entry of complex diet orders.
Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
Name | Type | Description | Expression | In Common |
additive | token | Type of module component to add to the diet | NutritionOrder.additive.modularType.concept | |
datetime | date | Return nutrition orders requested on this date | NutritionOrder.dateTime | |
encounter | reference | Return nutrition orders with this encounter identifier | NutritionOrder.encounter (Encounter) |
29 Resources |
formula | token | Type of enteral or infant formula | NutritionOrder.enteralFormula.type.concept | |
group-identifier | token | Composite Request ID | NutritionOrder.groupIdentifier | |
identifier | token | Return nutrition orders with this external identifier | NutritionOrder.identifier | 65 Resources |
oraldiet | token | Type of diet that can be consumed orally (i.e., take via the mouth). | NutritionOrder.oralDiet.type | |
patient | reference | The identity of the individual or set of individuals who requires the diet, formula or nutritional supplement | NutritionOrder.subject.where(resolve() is Patient) (Patient) |
65 Resources |
provider | reference | The identity of the provider who placed the nutrition order | NutritionOrder.orderer (Practitioner, PractitionerRole) |
|
status | token | Status of the nutrition order. | NutritionOrder.status | |
subject | reference | The identity of the individual or set of individuals who requires the diet, formula or nutritional supplement | NutritionOrder.subject (Group, Patient) |
|
supplement | token | Type of supplement product requested | NutritionOrder.supplement.type.concept |