Interoperability and Health Information Standards

Interoperability ensures that health information is secure, accessible, and can be exchanged between health information systems for the purposes of demonstrating and improving health care outcomes including nutrition outcomes. Health information technology standards provide the expectations and rules for data sharing among health information systems. The international standards setting organization for electronic health records (EHRs) is Health Level Seven (HL7). Standards, combined with standardized health terminologies, promotes meaningful exchange of health information.

To learn more, contact us at quality@eatright.org.

CDR's Interoperability and Standards Committee works to ensure the nutrition care process is consistently supported in healthcare systems. We develop standards—agreed-upon ways of doing things—that improve how nutrition information is collected, used, and shared. This interoperability—the ability of different systems to exchange and use information—makes nutrition care more efficient and helps improve patient outcomes. These standards provide:

• Clear Communication: We use a common "language" and coding system so that everyone involved in a patient's care understands the nutrition information. This makes it easier to interpret and use the data.
• Consistent Records: Our standards ensure that nutrition documentation is consistent and can be easily used with different medical apps and technologies. This makes it easier for healthcare providers to access and use this important information.

Our committee is made up of 9 credentialed practitioners who are committed to making a meaningful impact. We are looking for passionate, dedicated individuals ready to collaborate and contribute to the community. If you are interested in applying please see CDR Volunteer Opportunities to learn more.

FHIR (pronounced "fire") is a standard used to make healthcare data easier to share and exchange between different systems, like hospitals, clinics, and insurance companies. FHIR consists of resources which are predefined data structures for specific pieces of healthcare data. The following are the available nutrition-related resources: 

• NutritionOrder: this resource describes a request for oral diets, oral nutrition supplements, enteral nutrition, and infant formula in the inpatient setting as well as other settings (eg, outpatient, home health). This resource captures the type of oral diet, any nutrient restrictions, and any texture modifications. For supplements, the resource captures the product, schedule, amount, and any special instructions. For enteral nutrition orders, the resource captures the product type and name, route of administration, scheduling, quantity, rate, and more. Modular additives are also accounted for. 
• NutritionIntake: this resource describes intake by a patient. It allows for recording of food, liquid, breastmilk, infant formula, oral nutrition supplements, and enteral formula. The resource captures the item consumed (or not consumed), the amount, timing, and total nutrient and/or energy consumed. 
• NutritionProduct: this resource describes a food (solid or liquid) or supplement product that can be consumed by a patient. The NutritionIntake resource references the NutritionProduct resource within its structure. This resource also captures the nutritional information, ingredients, and allergens for each product.

Standards published to support the nutrition care process:

• HL7 Domain Analysis Model: Nutrition Care, Release 3: STU (standard for trial use) published in December 2022: Provides the business use case for nutrition and shows workflow activity diagrams, information models with the flow of data, and other details of nutrition care. While previous version focused only on diet orders of inpatients, this version includes the entire nutrition care process and includes outpatient examples as well. 
• HL7 EHR-System Electronic Nutrition Care Process Record System (ENCPRS) Functional Profile, Release 2: Details the functions that should be contained in an electronic health records (EHR) to support the nutrition care process (NCP) and the terms from the nutrition care process terminology (NCPT) promoting information interoperability between nutrition, food systems, and other areas of healthcare. 
• United States Core Data for Interoperability (USCDI): nationwide Standardized data set for interoperable health information exchange. It consists of nutrition related elements such as Nutrition Order and Nutrition Status.

Terminologies

Data Standards and Repositories

Standards Organizations and Advisory Resources

Organizations and Groups

Resources and Educational Materials

Data Platforms

• November 2024: Harnessing the Power of Data by Elevating Documentation to Enhance Patient Care - 1 CPEU
• Freely available Nutrition Care Process terms
• CPE Offerings and Resources