RIVO-Noord Zorgviewer Implementation Guide
1.23.0 - CI build Netherlands flag

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.23.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

Resource Profile: NutritionAdvice - Detailed Descriptions

Active as of 2026-02-06

Definitions for the NutritionAdvice resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. NutritionOrder
Definition

A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to a patient/resident.


This is the base resource type for everything.

ShortNutritionOrderBase Resource
Comments

Referenced by an Order Request (workflow).

Control0..*
Alternate NamesNutrition Order, Diet Order, Diet, Nutritional Supplement, Enteral Nutrition, Voedingsadvies
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
nor-1: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class (oralDiet.exists() or supplement.exists() or enteralFormula.exists())
2. NutritionOrder.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. NutritionOrder.extension:Comment
Slice NameComment
Definition

A comment on the nutrition advice.

ShortComment
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(HCIM NutritionAdvice Comment) (Extension Type: string)
Alternate Namesextensions, user content, Toelichting
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. NutritionOrder.extension:Comment.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional Content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..0*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on NutritionOrder.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. NutritionOrder.extension:Comment.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice-Explanation
    10. NutritionOrder.extension:Comment.value[x]:valueString
    Slice NamevalueString
    Definition

    A comment on the nutrition advice.


    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

    ShortCommentValue of extension
    Control0..1
    Typestring, date, dateTime, Meta, code, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Alternate NamesToelichting
    12. NutritionOrder.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Alternate Namesextensions, user content
    14. NutritionOrder.status
    Definition

    The workflow status of the nutrition order/request.

    Shortproposed | draft | planned | requested | active | on-hold | completed | cancelled | entered-in-error
    Comments

    Typically the system placing the order sets the status to "requested". Thereafter, the order is maintained by the receiver that updates the status as the request is handled.

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control0..1
    BindingThe codes SHALL be taken from NutritionOrderStatushttp://hl7.org/fhir/ValueSet/nutrition-request-status|3.0.2
    (required to http://hl7.org/fhir/ValueSet/nutrition-request-status)

    Codes specifying the state of the request. Describes the lifecycle of the nutrition order.

    Typecode
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    16. NutritionOrder.patient
    Definition

    The person (patient) who needs the nutrition order for an oral diet, nutritional supplement and/or enteral or formula feeding.

    ShortThe person who requires the diet, formula or nutritional supplement
    Control1..1
    TypeReference(nl-core-patient, Patient)
    Summarytrue
    18. NutritionOrder.dateTime
    Definition

    The date and time that this nutrition order was requested.

    ShortDate and time the nutrition order was requested
    Control1..1
    TypedateTime
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    20. NutritionOrder.oralDiet
    Definition

    Diet given orally in contrast to enteral (tube) feeding.

    ShortOral diet components
    Control0..1
    This element is affected by the following invariants: nor-1
    TypeBackboneElement
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    22. NutritionOrder.oralDiet.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Summarytrue
    Alternate Namesextensions, user content, modifiers
    24. NutritionOrder.oralDiet.type
    Definition

    The kind of diet or dietary restriction such as fiber restricted diet or diabetic diet.

    ShortType of oral diet or diet restrictions that describe what can be consumed orally
    Control0..*
    BindingFor example codes, see Diet Codeshttp://hl7.org/fhir/ValueSet/diet-type|3.0.2
    (example to http://hl7.org/fhir/ValueSet/diet-type)

    Codes used to indicate the type of diet being ordered for a patient.

    TypeCodeableConcept
    Summarytrue
    26. NutritionOrder.oralDiet.type.text
    Definition

    Description of the type of diet.


    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

    ShortDietTypePlain text representation of the concept
    Comments

    Very often the text is the same as a displayName of one of the codings.

    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

    Alternate NamesDieetType

    Guidance on how to interpret the contents of this table can be foundhere

    0. NutritionOrder
    2. NutritionOrder.oralDiet
    4. NutritionOrder.oralDiet.type
    6. NutritionOrder.oralDiet.type.text
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be foundhere

    0. NutritionOrder
    Definition

    A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to a patient/resident.

    ShortNutritionOrder
    Comments

    Referenced by an Order Request (workflow).

    Control0..*
    Alternate NamesNutrition Order, Diet Order, Diet, Nutritional Supplement, Enteral Nutrition, Voedingsadvies
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
    nor-1: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class (oralDiet.exists() or supplement.exists() or enteralFormula.exists())
    2. NutritionOrder.id
    Definition

    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

    ShortLogical id of this artifact
    Comments

    The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

    Control0..1
    Typeid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    4. NutritionOrder.meta
    Definition

    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

    ShortMetadata about the resource
    Control0..1
    TypeMeta
    Summarytrue
    6. NutritionOrder.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

    This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

    Control0..1
    Typeuri
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    8. NutritionOrder.language
    Definition

    The base language in which the resource is written.

    ShortLanguage of the resource content
    Comments

    Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from Common Languages
    (extensible to http://hl7.org/fhir/ValueSet/languages)

    A human language.

    Additional BindingsPurpose
    All LanguagesMax Binding
    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    10. NutritionOrder.text
    Definition

    A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

    ShortText summary of the resource, for human interpretation
    Comments

    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

    Control0..1
    This element is affected by the following invariants: dom-1
    TypeNarrative
    Alternate Namesnarrative, html, xhtml, display
    12. NutritionOrder.contained
    Definition

    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

    ShortContained, inline Resources
    Comments

    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

    Control0..*
    TypeResource
    Alternate Namesinline resources, anonymous resources, contained resources
    14. NutritionOrder.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortAdditional Content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Alternate Namesextensions, user content
    SlicingThis element introduces a set of slices on NutritionOrder.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 16. NutritionOrder.extension:Comment
      Slice NameComment
      Definition

      A comment on the nutrition advice.

      ShortComment
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(HCIM NutritionAdvice Comment) (Extension Type: string)
      Alternate Namesextensions, user content, Toelichting
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      18. NutritionOrder.extension:Comment.id
      Definition

      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      Shortxml:id (or equivalent in JSON)
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      20. NutritionOrder.extension:Comment.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional Content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..0
      TypeExtension
      Alternate Namesextensions, user content
      SlicingThis element introduces a set of slices on NutritionOrder.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 22. NutritionOrder.extension:Comment.url
        Definition

        Source of the definition for the extension code - a logical name or a URL.

        Shortidentifies the meaning of the extension
        Comments

        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

        Control1..1
        Typeuri
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/zib-NutritionAdvice-Explanation
        24. NutritionOrder.extension:Comment.value[x]:valueString
        Slice NamevalueString
        Definition

        A comment on the nutrition advice.

        ShortComment
        Control0..1
        Typestring
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Alternate NamesToelichting
        26. NutritionOrder.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Alternate Namesextensions, user content
        28. NutritionOrder.identifier
        Definition

        Identifiers assigned to this order by the order sender or by the order receiver.

        ShortIdentifiers assigned to this order
        Comments

        The Identifier.type element can be to indicate filler vs. placer if needed. This is explained in further detail here.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        30. NutritionOrder.status
        Definition

        The workflow status of the nutrition order/request.

        Shortproposed | draft | planned | requested | active | on-hold | completed | cancelled | entered-in-error
        Comments

        Typically the system placing the order sets the status to "requested". Thereafter, the order is maintained by the receiver that updates the status as the request is handled.

        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Control0..1
        BindingThe codes SHALL be taken from NutritionOrderStatus
        (required to http://hl7.org/fhir/ValueSet/nutrition-request-status)

        Codes specifying the state of the request. Describes the lifecycle of the nutrition order.

        Typecode
        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        32. NutritionOrder.patient
        Definition

        The person (patient) who needs the nutrition order for an oral diet, nutritional supplement and/or enteral or formula feeding.

        ShortThe person who requires the diet, formula or nutritional supplement
        Control1..1
        TypeReference(nl-core-patient)
        Summarytrue
        34. NutritionOrder.encounter
        Definition

        An encounter that provides additional information about the healthcare context in which this request is made.

        ShortThe encounter associated with this nutrition order
        Control0..1
        TypeReference(HCIM Encounter)
        36. NutritionOrder.dateTime
        Definition

        The date and time that this nutrition order was requested.

        ShortDate and time the nutrition order was requested
        Control1..1
        TypedateTime
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        38. NutritionOrder.orderer
        Definition

        The practitioner that holds legal responsibility for ordering the diet, nutritional supplement, or formula feedings.

        ShortWho ordered the diet, formula or nutritional supplement
        Control0..1
        TypeReference(nl-core-practitioner)
        Summarytrue
        40. NutritionOrder.orderer.id
        Definition

        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        Shortxml:id (or equivalent in JSON)
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        XML FormatIn the XML format, this property is represented as an attribute.
        42. NutritionOrder.orderer.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional Content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Alternate Namesextensions, user content
        SlicingThis element introduces a set of slices on NutritionOrder.orderer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 44. NutritionOrder.orderer.extension:practitionerRole
          Slice NamepractitionerRole
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(PractitionerRole Reference) (Extension Type: Reference(nl-core-practitionerrole))
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          46. NutritionOrder.orderer.reference
          Definition

          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortLiteral reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control0..1
          This element is affected by the following invariants: ref-1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          48. NutritionOrder.orderer.identifier
          Definition

          An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          ShortLogical reference, when literal reference is not known
          Comments

          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1
          TypeIdentifier
          Summarytrue
          50. NutritionOrder.orderer.display
          Definition

          Plain text narrative that identifies the resource in addition to the resource reference.

          ShortText alternative for the resource
          Comments

          This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          52. NutritionOrder.allergyIntolerance
          Definition

          A link to a record of allergies or intolerances which should be included in the nutrition order.

          ShortList of the patient's food and nutrition-related allergies and intolerances
          Comments

          Information on a patient's food allergies and intolerances to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.

          Control0..*
          TypeReference(HCIM AllergyIntolerance)
          54. NutritionOrder.foodPreferenceModifier
          Definition

          This modifier is used to convey order-specific modifiers about the type of food that should be given. These can be derived from patient allergies, intolerances, or preferences such as Halal, Vegan or Kosher. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.

          ShortOrder-specific modifier about the type of food that should be given
          Comments

          Information on a patient's food preferences that inform healthcare personnel about the food that the patient should receive or consume.

          Control0..*
          BindingFor example codes, see Diet
          (example to http://hl7.org/fhir/ValueSet/encounter-diet)

          Medical, cultural or ethical food preferences to help with catering requirements

          TypeCodeableConcept
          56. NutritionOrder.excludeFoodModifier
          Definition

          This modifier is used to convey order-specific modifiers about the type of food that should NOT be given. These can be derived from patient allergies, intolerances, or preferences such as No Red Meat, No Soy or No Wheat or Gluten-Free. While it should not be necessary to repeat allergy or intolerance information captured in the referenced AllergyIntolerance resource in the excludeFoodModifier, this element may be used to convey additional specificity related to foods that should be eliminated from the patient’s diet for any reason. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.

          ShortOrder-specific modifier about the type of food that should not be given
          Comments

          Information on a patient's food allergies, intolerances and preferences to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.

          Control0..*
          BindingFor example codes, see Food Type Codes
          (example to http://hl7.org/fhir/ValueSet/food-type)

          Codes used to indicate the type of food that should NOT be given to the patient.

          TypeCodeableConcept
          58. NutritionOrder.oralDiet
          Definition

          Diet given orally in contrast to enteral (tube) feeding.

          ShortOral diet components
          Control0..1
          This element is affected by the following invariants: nor-1
          TypeBackboneElement
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          60. NutritionOrder.oralDiet.id
          Definition

          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          62. NutritionOrder.oralDiet.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional Content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          64. NutritionOrder.oralDiet.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          ShortExtensions that cannot be ignored
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
          Summarytrue
          Alternate Namesextensions, user content, modifiers
          66. NutritionOrder.oralDiet.type
          Definition

          The kind of diet or dietary restriction such as fiber restricted diet or diabetic diet.

          ShortType of oral diet or diet restrictions that describe what can be consumed orally
          Control0..*
          BindingFor example codes, see Diet Codes
          (example to http://hl7.org/fhir/ValueSet/diet-type)

          Codes used to indicate the type of diet being ordered for a patient.

          TypeCodeableConcept
          Summarytrue
          68. NutritionOrder.oralDiet.type.id
          Definition

          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          70. NutritionOrder.oralDiet.type.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional Content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Alternate Namesextensions, user content
          SlicingThis element introduces a set of slices on NutritionOrder.oralDiet.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 72. NutritionOrder.oralDiet.type.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Summarytrue
            Requirements

            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

            74. NutritionOrder.oralDiet.type.text
            Definition

            Description of the type of diet.

            ShortDietType
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Alternate NamesDieetType
            76. NutritionOrder.oralDiet.schedule
            Definition

            The time period and frequency at which the diet should be given. The diet should be given for the combination of all schedules if more than one schedule is present.

            ShortScheduled frequency of diet
            Control0..*
            TypeTiming
            Alternate NamesFrequency
            78. NutritionOrder.oralDiet.nutrient
            Definition

            Class that defines the quantity and type of nutrient modifications (for example carbohydrate, fiber or sodium) required for the oral diet.

            ShortRequired nutrient modifications
            Control0..*
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            80. NutritionOrder.oralDiet.nutrient.id
            Definition

            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            82. NutritionOrder.oralDiet.nutrient.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            84. NutritionOrder.oralDiet.nutrient.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            86. NutritionOrder.oralDiet.nutrient.modifier
            Definition

            The nutrient that is being modified such as carbohydrate or sodium.

            ShortType of nutrient that is being modified
            Control0..1
            BindingFor example codes, see Nutrient Modifier Codes
            (example to http://hl7.org/fhir/ValueSet/nutrient-code)

            Codes for types of nutrient that is being modified such as carbohydrate or sodium.

            TypeCodeableConcept
            88. NutritionOrder.oralDiet.nutrient.amount
            Definition

            The quantity of the specified nutrient to include in diet.

            ShortQuantity of the specified nutrient
            Control0..1
            TypeQuantity(SimpleQuantity)
            90. NutritionOrder.oralDiet.texture
            Definition

            Class that describes any texture modifications required for the patient to safely consume various types of solid foods.

            ShortRequired texture modifications
            Control0..*
            TypeBackboneElement
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
            92. NutritionOrder.oralDiet.texture.id
            Definition

            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            94. NutritionOrder.oralDiet.texture.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            96. NutritionOrder.oralDiet.texture.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
            Summarytrue
            Alternate Namesextensions, user content, modifiers
            98. NutritionOrder.oralDiet.texture.modifier
            Definition

            Any texture modifications (for solid foods) that should be made, e.g. easy to chew, chopped, ground, and pureed.

            ShortCode to indicate how to alter the texture of the foods, e.g. pureed
            Comments

            Coupled with the foodType (Meat).

            Control0..1
            BindingFor example codes, see Texture Modifier Codes
            (example to http://hl7.org/fhir/ValueSet/texture-code)

            Codes for food consistency types or texture modifications to apply to foods.

            TypeCodeableConcept
            100. NutritionOrder.oralDiet.texture.modifier.id
            Definition

            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            102. NutritionOrder.oralDiet.texture.modifier.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional Content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on NutritionOrder.oralDiet.texture.modifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 104. NutritionOrder.oralDiet.texture.modifier.coding
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..*
              TypeCoding
              Summarytrue
              Requirements

              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

              106. NutritionOrder.oralDiet.texture.modifier.text
              Definition

              A description of the consistency of the food.

              ShortConsistency
              Comments

              Because of a granularity difference between the HCIM NutritionAdvice and the NutritionOrder resource, the HCIM concept Consistency is mapped to the elements .oralDiet.texture.modifier.text, .oralDiet.texture.foodType.text and .oralDiet.fluidConsistencyType.text.

              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Alternate NamesConsistentie
              108. NutritionOrder.oralDiet.texture.foodType
              Definition

              The food type(s) (e.g. meats, all foods) that the texture modification applies to. This could be all foods types.

              ShortConcepts that are used to identify an entity that is ingested for nutritional purposes
              Comments

              Coupled with the textureModifier; could be (All Foods).

              Control0..1
              BindingFor example codes, see Texture Modified Food Type Codes
              (example to http://hl7.org/fhir/ValueSet/modified-foodtype)

              Codes for types of foods that are texture modified.

              TypeCodeableConcept
              110. NutritionOrder.oralDiet.texture.foodType.id
              Definition

              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              112. NutritionOrder.oralDiet.texture.foodType.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional Content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on NutritionOrder.oralDiet.texture.foodType.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 114. NutritionOrder.oralDiet.texture.foodType.coding
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..*
                TypeCoding
                Summarytrue
                Requirements

                Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                116. NutritionOrder.oralDiet.texture.foodType.text
                Definition

                A description of the consistency of the food.

                ShortConsistency
                Comments

                Because of a granularity difference between the HCIM NutritionAdvice and the NutritionOrder resource, the HCIM concept Consistency is mapped to the elements .oralDiet.texture.modifier.text, .oralDiet.texture.foodType.text and .oralDiet.fluidConsistencyType.text.

                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                Alternate NamesConsistentie
                118. NutritionOrder.oralDiet.fluidConsistencyType
                Definition

                The required consistency (e.g. honey-thick, nectar-thick, thin, thickened.) of liquids or fluids served to the patient.

                ShortThe required consistency of fluids and liquids provided to the patient
                Control0..*
                BindingFor example codes, see Fluid Consistency Type Codes
                (example to http://hl7.org/fhir/ValueSet/consistency-type)

                Codes used to represent the consistency of fluids and liquids provided to the patient.

                TypeCodeableConcept
                120. NutritionOrder.oralDiet.fluidConsistencyType.id
                Definition

                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                122. NutritionOrder.oralDiet.fluidConsistencyType.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional Content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Alternate Namesextensions, user content
                SlicingThis element introduces a set of slices on NutritionOrder.oralDiet.fluidConsistencyType.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 124. NutritionOrder.oralDiet.fluidConsistencyType.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  TypeCoding
                  Summarytrue
                  Requirements

                  Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                  126. NutritionOrder.oralDiet.fluidConsistencyType.text
                  Definition

                  A description of the consistency of the food.

                  ShortConsistency
                  Comments

                  Because of a granularity difference between the HCIM NutritionAdvice and the NutritionOrder resource, the HCIM concept Consistency is mapped to the elements .oralDiet.texture.modifier.text, .oralDiet.texture.foodType.text and .oralDiet.fluidConsistencyType.text.

                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                  Alternate NamesConsistentie
                  128. NutritionOrder.oralDiet.instruction
                  Definition

                  Free text or additional instructions or information pertaining to the oral diet.

                  ShortInstructions or additional information about the oral diet
                  Comments

                  Free text dosage instructions can be used for cases where the instructions are too complex to code.

                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  130. NutritionOrder.supplement
                  Definition

                  Oral nutritional products given in order to add further nutritional value to the patient's diet.

                  ShortSupplement components
                  Control0..*
                  This element is affected by the following invariants: nor-1
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  132. NutritionOrder.supplement.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  134. NutritionOrder.supplement.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional Content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  136. NutritionOrder.supplement.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  ShortExtensions that cannot be ignored
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Summarytrue
                  Alternate Namesextensions, user content, modifiers
                  138. NutritionOrder.supplement.type
                  Definition

                  The kind of nutritional supplement product required such as a high protein or pediatric clear liquid supplement.

                  ShortType of supplement product requested
                  Control0..1
                  BindingFor example codes, see Supplement Type Codes
                  (example to http://hl7.org/fhir/ValueSet/supplement-type)

                  Codes for nutritional supplements to be provided to the patient

                  TypeCodeableConcept
                  Summarytrue
                  140. NutritionOrder.supplement.productName
                  Definition

                  The product or brand name of the nutritional supplement such as "Acme Protein Shake".

                  ShortProduct or brand name of the nutritional supplement
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  142. NutritionOrder.supplement.schedule
                  Definition

                  The time period and frequency at which the supplement(s) should be given. The supplement should be given for the combination of all schedules if more than one schedule is present.

                  ShortScheduled frequency of supplement
                  Control0..*
                  TypeTiming
                  Alternate NamesFrequency
                  144. NutritionOrder.supplement.quantity
                  Definition

                  The amount of the nutritional supplement to be given.

                  ShortAmount of the nutritional supplement
                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  146. NutritionOrder.supplement.instruction
                  Definition

                  Free text or additional instructions or information pertaining to the oral supplement.

                  ShortInstructions or additional information about the oral supplement
                  Comments

                  Free text dosage instructions can be used for cases where the instructions are too complex to code.

                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  148. NutritionOrder.enteralFormula
                  Definition

                  Feeding provided through the gastrointestinal tract via a tube, catheter, or stoma that delivers nutrition distal to the oral cavity.

                  ShortEnteral formula components
                  Control0..1
                  This element is affected by the following invariants: nor-1
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  150. NutritionOrder.enteralFormula.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  152. NutritionOrder.enteralFormula.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional Content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  154. NutritionOrder.enteralFormula.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  ShortExtensions that cannot be ignored
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Summarytrue
                  Alternate Namesextensions, user content, modifiers
                  156. NutritionOrder.enteralFormula.baseFormulaType
                  Definition

                  The type of enteral or infant formula such as an adult standard formula with fiber or a soy-based infant formula.

                  ShortType of enteral or infant formula
                  Control0..1
                  BindingFor example codes, see Enteral Formula Type Codes
                  (example to http://hl7.org/fhir/ValueSet/entformula-type)

                  Codes for type of enteral formula to be administered to patient.

                  TypeCodeableConcept
                  Summarytrue
                  158. NutritionOrder.enteralFormula.baseFormulaProductName
                  Definition

                  The product or brand name of the enteral or infant formula product such as "ACME Adult Standard Formula".

                  ShortProduct or brand name of the enteral or infant formula
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  160. NutritionOrder.enteralFormula.additiveType
                  Definition

                  Indicates the type of modular component such as protein, carbohydrate, fat or fiber to be provided in addition to or mixed with the base formula.

                  ShortType of modular component to add to the feeding
                  Control0..1
                  BindingFor example codes, see Enteral Formula Additive Type Code
                  (example to http://hl7.org/fhir/ValueSet/entformula-additive)

                  Codes for the type of modular component such as protein, carbohydrate or fiber to be provided in addition to or mixed with the base formula.

                  TypeCodeableConcept
                  162. NutritionOrder.enteralFormula.additiveProductName
                  Definition

                  The product or brand name of the type of modular component to be added to the formula.

                  ShortProduct or brand name of the modular additive
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  164. NutritionOrder.enteralFormula.caloricDensity
                  Definition

                  The amount of energy (calories) that the formula should provide per specified volume, typically per mL or fluid oz. For example, an infant may require a formula that provides 24 calories per fluid ounce or an adult may require an enteral formula that provides 1.5 calorie/mL.

                  ShortAmount of energy per specified volume that is required
                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  166. NutritionOrder.enteralFormula.routeofAdministration
                  Definition

                  The route or physiological path of administration into the patient's gastrointestinal tract for purposes of providing the formula feeding, e.g. nasogastric tube.

                  ShortHow the formula should enter the patient's gastrointestinal tract
                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from Enteral Route Codes
                  (extensible to http://hl7.org/fhir/ValueSet/enteral-route)

                  Codes specifying the route of administration of enteral formula.

                  TypeCodeableConcept
                  168. NutritionOrder.enteralFormula.administration
                  Definition

                  Formula administration instructions as structured data. This repeating structure allows for changing the administration rate or volume over time for both bolus and continuous feeding. An example of this would be an instruction to increase the rate of continuous feeding every 2 hours.

                  ShortFormula feeding instruction as structured data
                  Comments

                  See implementation notes below for further discussion on how to order continuous vs bolus enteral feeding using this resource.

                  Control0..*
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  170. NutritionOrder.enteralFormula.administration.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  172. NutritionOrder.enteralFormula.administration.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional Content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  174. NutritionOrder.enteralFormula.administration.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  ShortExtensions that cannot be ignored
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                  Summarytrue
                  Alternate Namesextensions, user content, modifiers
                  176. NutritionOrder.enteralFormula.administration.schedule
                  Definition

                  The time period and frequency at which the enteral formula should be delivered to the patient.

                  ShortScheduled frequency of enteral feeding
                  Control0..1
                  TypeTiming
                  Alternate NamesFrequency
                  178. NutritionOrder.enteralFormula.administration.quantity
                  Definition

                  The volume of formula to provide to the patient per the specified administration schedule.

                  ShortThe volume of formula to provide
                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  180. NutritionOrder.enteralFormula.administration.rate[x]
                  Definition

                  The rate of administration of formula via a feeding pump, e.g. 60 mL per hour, according to the specified schedule.

                  ShortSpeed with which the formula is provided per period of time
                  Comments

                  Ratio is used when the quantity value in the denominator is not "1", otherwise use Quantity. For example, the Ratio datatype is used for "200 mL/4 hrs" versus the Quantity datatype for "50 mL/hr".

                  Control0..1
                  TypeChoice of: Quantity(SimpleQuantity), Ratio
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  182. NutritionOrder.enteralFormula.maxVolumeToDeliver
                  Definition

                  The maximum total quantity of formula that may be administered to a subject over the period of time, e.g. 1440 mL over 24 hours.

                  ShortUpper limit on formula volume per unit of time
                  Control0..1
                  TypeQuantity(SimpleQuantity)
                  184. NutritionOrder.enteralFormula.administrationInstruction
                  Definition

                  Free text formula administration, feeding instructions or additional instructions or information.

                  ShortFormula feeding instructions expressed as text
                  Comments

                  Free text dosage instructions can be used for cases where the instructions are too complex to code.

                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue