Where There’s Food, There’s FHIR®

By Lindsey Hoggle, MS, RDN, PMP, an exhibitor at the HIMSS Interoperability Showcase™ at the 2018 HIMSS Global Conference & Exhibition; director, nutrition informatics, Academy of Nutrition and Dietetics

We all want high-quality care to prevent disease and maintain our health, and nutrition care is a critical component for patients with diabetes, heart and kidney disease – some of the conditions that lead to the highest medical costs for patients and providers.

Medical nutrition therapy (MNT), performed by qualified providers including registered dietitian nutritionists, proves successful in treating people with conditions, such as cardiovascular disease and diabetes.

Following implementation of MNT in patients with cardiovascular disease and diabetes mellitus, the Lewin Group documented that:

  • Hospital utilization decreased by 8.6 percent; and patients with cardiovascular disease reduced visits to physicians by 16.9 percent
  • Patients with diabetes mellitus reduced hospital utilization by 9.5 percent and their need for physician visits by 23.5 percent.

Research suggests that 20 to 50 percent of hospitalized adults are at risk of malnutrition or are malnourished. Malnutrition is an independent predictor of negative patient outcomes, including mortality, length of hospital stay, preventable readmissions and hospitalization costs.

Helping to Solve Malnutrition with Information and Technology

Despite evidence that demonstrates the benefits of nutrition for healing, recovery and chronic disease management, significant variation and gaps remain in processes that can negatively affect time to screening, assessment, diagnosis, intervention and monitoring across the care continuum. The gaps occur for a number of reasons, one of which we can solve with recent advances in electronic health records and health IT. Given that the main focus of interoperability is to ensure that data follows the patient, we must ensure that nutrition care can be managed across care settings.

However, the paradox of nutrition data is that nutrition care plan components or other nutrition care process data are rarely included as the patient moves to the next setting, so the data are inaccessible by the patient or the care team. New developments in HL7 standards for nutrition, including support using the Fast Healthcare Interoperability Resources – known as FHIR® – and HL7 C-CDA R2.1 Supplemental Templates for Nutrition, Release 1, can help us bridge this gap.

The lifestyle and activities of our patients and their families – living, shopping, eating – determine their outcomes. Let’s empower them using interoperable information technology to deliver the nutrition care they need to improve health.

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