Submitted by jpatterson@mitre.org on
PACIO Appreciates and Supports Inclusion of Nutrition Order
- Data Class: Orders
- Data Element: Nutrition Order (Level 2)
- Recommendation: Accept the Nutrition Order data element and include it in final USCDI as a Level 2 data element.
- Rationale: The PACIO Project Community* would like to thank ASTP for recognizing the importance of Nutrition Order and its inclusion in as a Level 2 data element. The community welcomes the submission of the Nutrition Order data element by the Academy of Nutrition and Dietetics. Nutrition orders are a foundational component of safe patient care across post-acute and acute care settings. The information in a nutrition order ranges from the nutritional contents of the patient’s diet, the textures and modifications needed for a patient to safely eat that diet, to restrictions (e.g., religious needs) that must be met for the patient to find the meal acceptable. Nutrition orders are a daily tool in many different provider workflows including practitioners, dietitians, and speech language pathologists and capture information that must be exchanged between settings for safe and effective care.
- A Nutrition Order Profile has been developed as part of the Personal Functioning and Engagement FHIR Implementation Guide. The profile has been successfully exchanged by a commercial EHR.
- * The PACIO (Post-Acute Care Interoperability) Project, established February 2019, is a collaborative effort between industry, government, and other stakeholders, with the goal of establishing a framework for the development of FHIR implementation guides to facilitate health information exchange.
Submitted by rdillaire on
CMS-CCSQ Supports Nutrition Order for USCDI v6
Recommendation: CMS CCSQ recommends the Nutrition Order element be added to final USCDI v6.
Rationale: CMS CCSQ appreciates the addition of Nutrition Order as a Level 2 data element in the draft v6 and recommends its inclusion in USCDI v6. A Nutrition Order encompasses critical details about a patient’s diet, including required textures and modifications necessary for safe consumption.
This data element is essential for comprehensive patient care, ensuring proper dietary modifications for individuals with conditions like dysphagia, malnutrition, or other swallowing and digestion issues. Accurate Nutrition Orders help prevent complications such as aspiration, dehydration, and malnutrition, which can lead to hospital readmissions. They also optimize healing by providing necessary metabolic support, reducing risks, and improving patient outcomes. Additionally, Nutrition Orders can address cultural and religious dietary needs, enhancing patient satisfaction and engagement in their care. Currently, existing supporting information to support the data element upgrade to final version 6:
Implementation Guide (IG):
i. A Nutrition Order Profile has been developed as part of the PFE IG that is currently in Ballot (Resource Profile: PFE Nutrition Order Profile). The profile has been successfully exchanged by a commercial EHR.
PAC assessment items:
i. Swallowing status (Item 27 - IRF-PAI assessment).
ii. Swallowing disorders. Check all that apply (Item K0100 - MDS 3.0 assessment).
iii. Swallowing/nutritional status. Check all that apply (Item K0110 - IRF-PAI assessment).
iv. Nutritional approaches. Check all that apply (Item K0520 - IRF-PAI, LCDS, MDS 3.0, and OASIS assessments).
SNOMED codes for conditions related to safe consumption include:
i. Dysphagia (SNOMED 40739000).
ii. Swallowing reflex (SNOMED 284551006).
iii. Chewing (SNOMED 226353009).
iv. Chewing difficulty (SNOMED 16257007).
The existing IG, SNOMED codes, and assessment items reinforce the need for detailed nutrition orders that account for individual patient needs, promoting safety and improving clinical outcomes.