Details
-
Change Request
-
Resolution: Persuasive with Modification
-
Medium
-
US QI Core (FHIR)
-
current
-
Clinical Quality Information
-
NutrientOrder example
QICore NutritionOrder -
QI-Core Profiles
-
-
Floyd Eisenberg/Jen Seeman: 24-0-0
-
Enhancement
-
Compatible, substantive
Description
QI-Core 5.0 and previous versions have included a [NutritionOrder|http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-nutritionorder.html|http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-nutritionorder.html] profile which fails to meet the need for its intended purpose. See related tracker FHIR-41337. The intent that led to inclusion of NutritionOrder was basically to determine all intake received by a newborn in the hospital to assure it included only one substance at exclusion of all other substances. The way to address that intent is to identify the intake record in clinical systems. FHIR R5 includes a new resource, [NutritionIntake|https://hl7.org/fhir/nutritionintake.html] which allows specification of nutrition (and other substances) received by a patient (orally, enterally, or otherwise). The resource is not yet available in FHIR R4 and its maturity level in FHIR R5 is only 1. That means that QI-Core would have to create a profile as an extension based on the FHIR R5 resource and that any use by a measure developer would be somewhat "experimental" for testing and evaluation. But, allowing such evaluation will help inform use of the profile.
Recommended MustSupport elements for the proposed profile:
- code
- status - value set binding to [EventStatus|EventStatus] required
- statusReason (make the value set binding to [ClinicalImpressionStatusReason|ClinicalImpression Status Reason] preferred
- occurrence
- recorded
- consumedItem
- [consumedItem.nutritionProduct|nutritionProduct] with preferred binding to [nutritionProduct|nutritionProduct]
The new profile will require guidance regarding how to express the "not done" concepts handled for other QI-Core profile. The use case of determining NutritionIntake includes nutritionProduct = breast milk and nothing else could be identified by indicating something to the effect that NutritionIntake status=not-done for nutritionProduct = All non-breast milk substances. It is not clear that QI-Core needs a NutritionIntakeNotDone profile but that requires discussion.
Note that this request is orthogonal to other change requests for the September 2023 ballot (version 6.0). Many other requests are to keep QI-Core as close to US Core as possible. However, there are concepts required that US Core does not address and such concepts should be considered with the understanding that any user o such profiles must evaluate implementer feedback regarding feasibility and potential burden. This request falls into the category of new and/or considered additional data needs.
Attachments
Issue Links
- mentioned in
-
Page Loading...