Workflow
This
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is
part
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FHIR
Specification
v6.0.0-ballot3:
Release
6
Ballot
(3rd
Draft)
(see
Ballot
Notes
).
The
current
version
is
5.0.0
.
For
a
full
list
Continuous
Integration
Build
of
available
versions,
see
FHIR
(will
be
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at
times).
See
the
Directory
of
published
versions
|
Responsible
Owner:
Orders
and
Observations
Work
Group
|
|
Security Category : Patient | Compartments : Encounter , Group , Patient , Practitioner |
A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to an individual or group.
Note to Implementers: For an overview of this resource and others in the Nutrition domain, also see the module page .
This resource is a request resource from a FHIR workflow perspective - see Workflow . It is the intent of the Orders and Observation Workgroup to align this resource with the workflow pattern for request resources .
The NutritionOrder resource describes a request for oral diets (including general diets such as General Healthy diet, or therapeutic diets such as Consistent Carbohydrate, 2-gram Sodium, or Fluid Restricted), oral nutrition supplements (such as nutritionally complete pre-packed drinks), enteral nutrition (tube feedings) and infant formula which govern the distribution of food and nutritional products used to feed patients within a patient setting. It does not cover orders for parenteral (IV) nutrition which are typically filled by pharmacy. These nutrition orders are combined with information on a patient's food allergies and intolerances, and ethnic or cultural food preferences (e.g. Kosher or Vegetarian) to inform healthcare personnel about the type, texture, and/or quantity of foods that the patient should receive or consume.
Enteral orders are distinguished from supplements because they have some unique attributes and typically include administration information whereas oral nutritional supplements may simply be supplied (e.g. home health or outpatient settings). In a simple case, the requestor may designate the type of product, product name, and the route of administration along with free text instructions without having to complete the additional structured details.
This resource is intended to be used by practitioners from a variety of specialties such as physicians, dietitians/nutritionists, or speech therapists. One practitioner may simply order a base element oral diet such as General Healthful diet. Another practitioner, based on the scope of practice, may use other elements to communicate additional therapeutic needs or patient preferences. The optionality included gives an ordering practitioner the capability to write a simple order for an oral diet, nutritional supplement or formula with minimal requirements beyond that of specifying the diet, supplement or formula product, but also supports the ability to provide more detailed information that may be further augmented by a dietitian or nutrition specialist. For example, a physician may order a 2 g sodium diet. A speech therapist, based on the results of a swallowing evaluation, then orders an International Dysphagia Diet Standardisation Initiative Framework - Soft and Bite-Sized Level 6 food (regime/therapy).
The NutritionOrder resource is used for requesting oral diets, oral nutrition supplements, enteral feedings, and infant formula. The MedicationRequest resource should be used for requesting parenteral (IV) nutrition and prescribing dietary supplements such as vitamin or mineral supplements.
The Nutrition Order is a record of the request for the supply of a diet, oral supplement, enteral formulas, and infant formula for a patient. However, to initiate the request requires the use of the Task resource and its associated workflow with the Nutrition Order referenced from Task.basedOn, or by using the nutrition Task resource in the context of a messaging or service workflow where the request is explicit or implicit. For further information about this separation of responsibilities, refer to the Fulfillment/Execution section of the Request pattern.
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
Filter:
|
|---|---|---|---|---|
NutritionOrder
|
|
DomainResource |
Diet,
formula
or
nutritional
supplement
request
+ Rule: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension |
|
identifier
|
0..* | Identifier |
Identifiers
assigned
to
this
order
|
|
|
0..* | Reference ( CarePlan | NutritionOrder | ServiceRequest | RequestOrchestration ) |
What
this
order
fulfills
|
|
|
groupIdentifier
|
Σ | 0..1 | Identifier |
Composite
Request
ID
|
status
|
?! Σ | 1..1 | code |
draft
|
active
|
on-hold
|
entered-in-error
|
ended
|
completed
|
revoked
|
unknown
Binding: RequestStatus ( Required ) |
|
intent
|
?! Σ | 1..1 | code |
proposal
|
solicit-offer
|
offer-response
|
plan
|
directive
|
order
|
original-order
|
reflex-order
|
filler-order
|
instance-order
|
option
Binding: RequestIntent ( Required ) |
|
priority
|
0..1 | code |
routine
|
urgent
|
asap
|
stat
Binding: RequestPriority ( Required ) |
|
|
subject
|
Σ | 1..1 | Reference ( Patient | Group ) |
Who
requires
the
diet,
formula
or
nutritional
supplement
|
|
encounter
|
0..1 | Reference ( Encounter ) |
The
encounter
associated
with
this
nutrition
order
|
|
|
supportingInformation
|
0..* | Reference ( Any ) |
Information
to
support
fulfilling
of
the
nutrition
order
|
|
|
dateTime
|
Σ | 1..1 | dateTime |
Date
and
time
the
nutrition
order
was
requested
|
|
requester
|
Σ | 0..1 | Reference ( Practitioner | PractitionerRole ) |
Who
ordered
the
diet,
formula
or
nutritional
supplement
|
|
performer
|
0..* | CodeableReference ( CareTeam | Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | Group ) |
Who
is
intended
to
perform
the
administration
of
the
nutrition
order
|
|
|
allergyIntolerance
|
0..* | Reference ( AllergyIntolerance ) |
List
of
the
patient's
food
and
nutrition-related
allergies
and
intolerances
|
|
|
foodPreferenceModifier
|
0..* | CodeableConcept |
Order-specific
modifier
about
the
type
of
food
that
should
be
given
Binding: Types of Edible Substances ( Preferred ) |
|
|
excludeFoodModifier
|
0..* | CodeableConcept |
Food
that
should
not
be
given
Binding: Types of Edible Substances ( Preferred ) |
|
|
outsideFoodAllowed
|
0..1 | boolean |
Capture
if
patient
is
permitted
to
consume
food
from
outside
of
current
setting
brought
by
the
patient,
family,
and/or
caregiver
|
|
oralDiet
|
C | 0..1 | BackboneElement |
Oral
diet
components
|
type
|
Σ | 0..* | CodeableConcept |
Type
of
oral
diet
or
diet
restrictions
that
can
be
consumed
orally
Binding: Diet Codes ( Preferred ) |
|
schedule
|
0..1 | BackboneElement |
Scheduling
information
for
oral
diets
|
|
|
timing
|
0..* | Timing |
Scheduled
frequency
of
diet
|
|
|
asNeeded
|
0..1 | boolean |
Take
'as
needed'
|
|
asNeededFor
|
0..1 | CodeableConcept |
Take
'as
needed'
for
x
Binding: SNOMED CT Medication As Needed Reason Codes ( Example ) |
|
|
nutrient
|
0..* | BackboneElement |
The
nutrient
that
is
modified
and
the
quantity
in
the
diet
|
|
|
modifier
|
0..1 | CodeableConcept |
Nutrient
modified
in
the
oral
diet
type
Binding: Nutrient Codes ( Preferred ) |
|
|
amount
|
0..1 | Quantity |
Quantity
of
the
specified
nutrient
|
|
|
texture
|
0..* | BackboneElement |
Texture
modifications
in
addition
to
the
oral
diet
type
|
|
|
modifier
|
0..1 | CodeableConcept |
Food
(i.e.
solid
and/or
liquid)
texture
modifications
in
addition
to
those
in
the
oral
diet
type
Binding: |
|
|
type
|
0..1 | CodeableConcept |
Food
(i.e.
solid
and/or
liquid)
types
that
undergo
texture
alteration
Binding: Texture Modified Food Type Codes ( |
|
|
instruction
|
Σ | 0..1 | string |
Instructions
or
additional
information
about
the
oral
diet
|
|
caloricDensity
|
0..1 | Quantity |
Amount
of
energy
per
specified
volume
of
oral
diet
|
|
|
supplement
|
C | 0..* | BackboneElement |
Supplement
components
|
|
type
|
Σ | 0..1 | CodeableReference ( NutritionProduct ) |
Type
of
supplement
product
requested
Binding: Supplement Type Codes ( Preferred ) |
|
productName
|
0..1 | string |
Product
or
brand
name
of
the
nutritional
supplement
|
|
|
schedule
|
0..1 | BackboneElement |
Scheduling
information
for
supplements
|
|
|
timing
|
0..* | Timing |
Scheduled
frequency
of
supplement
|
|
|
asNeeded
|
0..1 | boolean |
Take
'as
needed'
|
|
|
asNeededFor
|
0..1 | CodeableConcept |
Take
'as
needed'
for
x
Binding: SNOMED CT Medication As Needed Reason Codes ( Example ) |
|
|
quantity
|
0..1 | Quantity |
Amount
of
the
nutritional
supplement
|
|
|
instruction
|
Σ | 0..1 | string |
Instructions
or
additional
information
about
the
oral
supplement
|
|
caloricDensity
|
0..1 | Quantity |
Amount
of
energy
per
specified
volume
of
supplement
that
is
required
|
|
|
enteralFormula
|
C | 0..1 | BackboneElement |
Enteral
formula
product
|
|
type
|
Σ | 0..1 | CodeableReference ( NutritionProduct ) |
Type
of
patient
enteral
feeding
Binding: Enteral Formula Type Codes ( Preferred ) |
|
productName
|
0..1 | string |
Product
or
brand
name
of
the
enteral
feeding
|
|
deliveryDevice[x]
|
0..1 |
|
Intended
type
of
device
for
the
enteral
feeding
administration
Binding: Delivery Device Code ( Example ) |
|
|
deliveryDeviceCodeableConcept
| CodeableConcept | |||
|
deliveryDeviceCanonical
| canonical ( DeviceDefinition ) | |||
|
caloricDensity
|
0..1 | Quantity |
Amount
of
energy
per
specified
volume
of
feeding
that
is
required
|
|
|
routeOfAdministration
|
0..* | CodeableConcept |
How
the
enteral
feeding
should
enter
the
patient's
gastrointestinal
tract
Binding: Enteral Route Codes ( Extensible ) |
|
|
administration
|
0..* | BackboneElement |
Formula
feeding
instruction
as
structured
data
|
|
|
schedule
|
0..1 | BackboneElement |
Scheduling
information
for
enteral
feeding
products
|
|
|
timing
|
0..* | Timing |
Scheduled
frequency
of
enteral
feeding
|
|
|
asNeeded
|
0..1 | boolean |
Take
'as
needed'
|
|
|
asNeededFor
|
0..1 | CodeableConcept |
Take
'as
needed'
for
x
Binding: SNOMED CT Medication As Needed Reason Codes ( Example ) |
|
|
quantity
|
0..1 | Quantity |
The
volume
of
formula
feeding
to
provide
|
|
rate[x]
|
0..1 |
Speed
with
which
the
formula
feeding
is
provided
per
period
of
time
|
||
rateQuantity
|
Quantity | |||
|
rateRatio
|
Ratio | |||
|
maxVolumeToAdminister
|
0..1 | Quantity |
Upper
limit
on
formula
feeding
volume
per
unit
of
time
|
|
|
administrationInstruction
|
Σ | 0..1 | markdown |
Formula
feeding
instructions
expressed
as
text
|
|
additive
|
0..* | BackboneElement |
Modular
additive
to
add
to
the
oral
diet,
supplement,
and/or
enteral
feeding
|
|
|
modularType
|
0..1 | CodeableReference ( NutritionProduct ) |
Type
of
modular
component
to
add
to
the
oral
diet,
supplement,
and/or
enteral
feeding
Binding: Enteral Formula Additive Type Code ( Preferred ) |
|
|
productName
|
0..1 | string |
Product
or
brand
name
of
the
modular
additive
|
|
|
quantity
|
0..1 | Quantity |
Amount
of
additive
to
be
given
or
mixed
in
with
the
oral
diet,
supplement,
and/or
enteral
feeding
|
|
|
routeOfAdministration
|
0..* | CodeableConcept |
How
the
additive
should
enter
the
patient's
gastrointestinal
tract
Binding: Enteral Route Codes ( Extensible ) |
|
|
note
|
0..* | Annotation |
Comments
|
|
|
Documentation
for
this
format
|
||||
See the Extensions for this resource
UML Diagram ( Legend )
XML Template
<NutritionOrder xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Identifiers assigned to this order --></identifier>
<</instantiatesCanonical><basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|RequestOrchestration| ServiceRequest) What this order fulfills --></basedOn> <groupIdentifier><!-- 0..1 Identifier Composite Request ID --></groupIdentifier> <status value="[code]"/><!-- 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown --><<intent value="[code]"/><!-- 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option --> <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat --> <subject><!-- 1..1 Reference(Group|Patient) Who requires the diet, formula or nutritional supplement --></subject> <encounter><!-- 0..1 Reference(Encounter) The encounter associated with this nutrition order --></encounter> <supportingInformation><!-- 0..* Reference(Any) Information to support fulfilling of the nutrition order --></supportingInformation> <dateTime value="[dateTime]"/><!-- 1..1 Date and time the nutrition order was requested --> <requester><!-- 0..1 Reference(Practitioner|PractitionerRole) Who ordered the diet, formula or nutritional supplement --></requester> <performer><!-- 0..* CodeableReference(CareTeam|Group|Organization|Patient| Practitioner|PractitionerRole|RelatedPerson) Who is intended to perform the administration of the nutrition order --></performer> <allergyIntolerance><!-- 0..* Reference(AllergyIntolerance) List of the patient's food and nutrition-related allergies and intolerances --></allergyIntolerance> <foodPreferenceModifier><!-- 0..* CodeableConcept Order-specific modifier about the type of food that should be given --></foodPreferenceModifier> <excludeFoodModifier><!-- 0..* CodeableConcept Food that should not be given --></excludeFoodModifier> <outsideFoodAllowed value="[boolean]"/><!-- 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver --> <oralDiet> <!-- I 0..1 Oral diet components --> <type><!-- 0..* CodeableConcept Type of oral diet or diet restrictions that can be consumed orally --></type> <schedule> <!-- 0..1 Scheduling information for oral diets --> <timing><!-- 0..* Timing Scheduled frequency of diet --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <nutrient> <!-- 0..* The nutrient that is modified and the quantity in the diet --> <modifier><!-- 0..1 CodeableConcept Nutrient modified in the oral diet type --></modifier> <amount><!-- 0..1 Quantity Quantity of the specified nutrient --></amount> </nutrient> <texture> <!-- 0..* Texture modifications in addition to the oral diet type --><</modifier><modifier><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type --></modifier> <type><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) types that undergo texture alteration --></type> </texture> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral diet --> <caloricDensity><!-- 0..1 Quantity Amount of energy per specified volume of oral diet --></caloricDensity> </oralDiet> <supplement> <!-- I 0..* Supplement components --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of supplement product requested --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the nutritional supplement --> <schedule> <!-- 0..1 Scheduling information for supplements --> <timing><!-- 0..* Timing Scheduled frequency of supplement --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity Amount of the nutritional supplement --></quantity> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral supplement --> <caloricDensity><!-- 0..1 Quantity Amount of energy per specified volume of supplement that is required --></caloricDensity> </supplement> <enteralFormula> <!-- I 0..1 Enteral formula product --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of patient enteral feeding --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the enteral feeding --><</deliveryDevice><deliveryDevice[x]><!-- 0..1 CodeableConcept|canonical(DeviceDefinition) Intended type of device for the enteral feeding administration --></deliveryDevice[x]> <caloricDensity><!-- 0..1 Quantity Amount of energy per specified volume of feeding that is required --></caloricDensity> <routeOfAdministration><!-- 0..* CodeableConcept How the enteral feeding should enter the patient's gastrointestinal tract --></routeOfAdministration> <administration> <!-- 0..* Formula feeding instruction as structured data --> <schedule> <!-- 0..1 Scheduling information for enteral feeding products --> <timing><!-- 0..* Timing Scheduled frequency of enteral feeding --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity The volume of formula feeding to provide --></quantity> <rate[x]><!-- 0..1 Quantity|Ratio Speed with which the formula feeding is provided per period of time --></rate[x]> </administration> <maxVolumeToAdminister><!-- 0..1 Quantity Upper limit on formula feeding volume per unit of time --></maxVolumeToAdminister> <administrationInstruction value="[markdown]"/><!-- 0..1 Formula feeding instructions expressed as text --> </enteralFormula> <additive> <!-- 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding --> <modularType><!-- 0..1 CodeableReference(NutritionProduct) Type of modular component to add to the oral diet, supplement, and/or enteral feeding --></modularType> <productName value="[string]"/><!-- 0..1 Product or brand name of the modular additive --> <quantity><!-- 0..1 Quantity Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding --></quantity> <routeOfAdministration><!-- 0..* CodeableConcept How the additive should enter the patient's gastrointestinal tract --></routeOfAdministration> </additive> <note><!-- 0..* Annotation Comments --></note> </NutritionOrder>
JSON Template
{
"resourceType" : "NutritionOrder",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Identifiers assigned to this order
"
"basedOn" : [{ Reference(CarePlan|NutritionOrder|RequestOrchestration|
ServiceRequest) }], // What this order fulfills
"groupIdentifier" : { Identifier }, // Composite Request ID
"status" : "<code>", // R! draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
"
"intent" : "<code>", // R! proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
"priority" : "<code>", // routine | urgent | asap | stat
"subject" : { Reference(Group|Patient) }, // R! Who requires the diet, formula or nutritional supplement
"encounter" : { Reference(Encounter) }, // The encounter associated with this nutrition order
"supportingInformation" : [{ Reference(Any) }], // Information to support fulfilling of the nutrition order
"dateTime" : "<dateTime>", // R! Date and time the nutrition order was requested
"requester" : { Reference(Practitioner|PractitionerRole) }, // Who ordered the diet, formula or nutritional supplement
"performer" : [{ CodeableReference(CareTeam|Group|Organization|Patient|
Practitioner|PractitionerRole|RelatedPerson) }], // Who is intended to perform the administration of the nutrition order
"allergyIntolerance" : [{ Reference(AllergyIntolerance) }], // List of the patient's food and nutrition-related allergies and intolerances
"foodPreferenceModifier" : [{ CodeableConcept }], // Order-specific modifier about the type of food that should be given
"excludeFoodModifier" : [{ CodeableConcept }], // Food that should not be given
"outsideFoodAllowed" : <boolean>, // Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver
"oralDiet" : { // I Oral diet components
"type" : [{ CodeableConcept }], // Type of oral diet or diet restrictions that can be consumed orally
"schedule" : { // Scheduling information for oral diets
"timing" : [{ Timing }], // Scheduled frequency of diet
"asNeeded" : <boolean>, // Take 'as needed'
"asNeededFor" : { CodeableConcept } // Take 'as needed' for x
},
"nutrient" : [{ // The nutrient that is modified and the quantity in the diet
"modifier" : { CodeableConcept }, // Nutrient modified in the oral diet type
"amount" : { Quantity } // Quantity of the specified nutrient
}],
"texture" : [{ // Texture modifications in addition to the oral diet type
"
"modifier" : { CodeableConcept }, // Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type
"type" : { CodeableConcept } // Food (i.e. solid and/or liquid) types that undergo texture alteration
}],
"instruction" : "<string>", // Instructions or additional information about the oral diet
"caloricDensity" : { Quantity } // Amount of energy per specified volume of oral diet
},
"supplement" : [{ // I Supplement components
"type" : { CodeableReference(NutritionProduct) }, // Type of supplement product requested
"productName" : "<string>", // Product or brand name of the nutritional supplement
"schedule" : { // Scheduling information for supplements
"timing" : [{ Timing }], // Scheduled frequency of supplement
"asNeeded" : <boolean>, // Take 'as needed'
"asNeededFor" : { CodeableConcept } // Take 'as needed' for x
},
"quantity" : { Quantity }, // Amount of the nutritional supplement
"instruction" : "<string>", // Instructions or additional information about the oral supplement
"caloricDensity" : { Quantity } // Amount of energy per specified volume of supplement that is required
}],
"enteralFormula" : { // I Enteral formula product
"type" : { CodeableReference(NutritionProduct) }, // Type of patient enteral feeding
"productName" : "<string>", // Product or brand name of the enteral feeding
"
// deliveryDevice[x]: Intended type of device for the enteral feeding administration. One of these 2:
"deliveryDeviceCodeableConcept" : { CodeableConcept },
"deliveryDeviceCanonical" : "<canonical(DeviceDefinition)>",
"caloricDensity" : { Quantity }, // Amount of energy per specified volume of feeding that is required
"routeOfAdministration" : [{ CodeableConcept }], // How the enteral feeding should enter the patient's gastrointestinal tract
"administration" : [{ // Formula feeding instruction as structured data
"schedule" : { // Scheduling information for enteral feeding products
"timing" : [{ Timing }], // Scheduled frequency of enteral feeding
"asNeeded" : <boolean>, // Take 'as needed'
"asNeededFor" : { CodeableConcept } // Take 'as needed' for x
},
"quantity" : { Quantity }, // The volume of formula feeding to provide
// rate[x]: Speed with which the formula feeding is provided per period of time. One of these 2:
"rateQuantity" : { Quantity },
"rateRatio" : { Ratio }
}],
"maxVolumeToAdminister" : { Quantity }, // Upper limit on formula feeding volume per unit of time
"administrationInstruction" : "<markdown>" // Formula feeding instructions expressed as text
},
"additive" : [{ // Modular additive to add to the oral diet, supplement, and/or enteral feeding
"modularType" : { CodeableReference(NutritionProduct) }, // Type of modular component to add to the oral diet, supplement, and/or enteral feeding
"productName" : "<string>", // Product or brand name of the modular additive
"quantity" : { Quantity }, // Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding
"routeOfAdministration" : [{ CodeableConcept }] // How the additive should enter the patient's gastrointestinal tract
}],
"note" : [{ Annotation }] // Comments
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .# from # from# from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension fhir:identifier ( [ Identifier ] ... ) ; # 0..* Identifiers assigned to this orderfhir:fhir:basedOn ( [ Reference(CarePlan|NutritionOrder|RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* What this order fulfills fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite Request ID fhir:status [ code ] ; # 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknownfhir:fhir:intent [ code ] ; # 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who requires the diet, formula or nutritional supplement fhir:encounter [ Reference(Encounter) ] ; # 0..1 The encounter associated with this nutrition order fhir:supportingInformation ( [ Reference(Any) ] ... ) ; # 0..* Information to support fulfilling of the nutrition order fhir:dateTime [ dateTime ] ; # 1..1 Date and time the nutrition order was requested fhir:requester [ Reference(Practitioner|PractitionerRole) ] ; # 0..1 Who ordered the diet, formula or nutritional supplement fhir:performer ( [ CodeableReference(CareTeam|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who is intended to perform the administration of the nutrition order fhir:allergyIntolerance ( [ Reference(AllergyIntolerance) ] ... ) ; # 0..* List of the patient's food and nutrition-related allergies and intolerances fhir:foodPreferenceModifier ( [ CodeableConcept ] ... ) ; # 0..* Order-specific modifier about the type of food that should be given fhir:excludeFoodModifier ( [ CodeableConcept ] ... ) ; # 0..* Food that should not be given fhir:outsideFoodAllowed [ boolean ] ; # 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver fhir:oralDiet [ # 0..1 I Oral diet components fhir:type ( [ CodeableConcept ] ... ) ; # 0..* Type of oral diet or diet restrictions that can be consumed orally fhir:schedule [ # 0..1 Scheduling information for oral diets fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of diet fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:nutrient ( [ # 0..* The nutrient that is modified and the quantity in the diet fhir:modifier [ CodeableConcept ] ; # 0..1 Nutrient modified in the oral diet type fhir:amount [ Quantity ] ; # 0..1 Quantity of the specified nutrient ] ... ) ; fhir:texture ( [ # 0..* Texture modifications in addition to the oral diet type fhir:modifier [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type fhir:type [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) types that undergo texture alteration ] ... ) ; fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral diet fhir:caloricDensity [ Quantity ] ; # 0..1 Amount of energy per specified volume of oral diet ] ; fhir:supplement ( [ # 0..* I Supplement components fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of supplement product requested fhir:productName [ string ] ; # 0..1 Product or brand name of the nutritional supplement fhir:schedule [ # 0..1 Scheduling information for supplements fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of supplement fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity ] ; # 0..1 Amount of the nutritional supplement fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral supplement fhir:caloricDensity [ Quantity ] ; # 0..1 Amount of energy per specified volume of supplement that is required ] ... ) ; fhir:enteralFormula [ # 0..1 I Enteral formula product fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of patient enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the enteral feedingfhir:# deliveryDevice[x] : 0..1 Intended type of device for the enteral feeding administration. One of these 2 fhir:deliveryDevice [ a fhir:CodeableConcept ; CodeableConcept ] fhir:deliveryDevice [ a fhir:Canonical ; canonical(DeviceDefinition) ] fhir:caloricDensity [ Quantity ] ; # 0..1 Amount of energy per specified volume of feeding that is required fhir:routeOfAdministration ( [ CodeableConcept ] ... ) ; # 0..* How the enteral feeding should enter the patient's gastrointestinal tract fhir:administration ( [ # 0..* Formula feeding instruction as structured data fhir:schedule [ # 0..1 Scheduling information for enteral feeding products fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of enteral feeding fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity ] ; # 0..1 The volume of formula feeding to provide # rate[x] : 0..1 Speed with which the formula feeding is provided per period of time. One of these 2 fhir:rate [ a fhir:Quantity ; Quantity ] fhir:rate [ a fhir:Ratio ; Ratio ] ] ... ) ; fhir:maxVolumeToAdminister [ Quantity ] ; # 0..1 Upper limit on formula feeding volume per unit of time fhir:administrationInstruction [ markdown ] ; # 0..1 Formula feeding instructions expressed as text ] ; fhir:additive ( [ # 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding fhir:modularType [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of modular component to add to the oral diet, supplement, and/or enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the modular additive fhir:quantity [ Quantity ] ; # 0..1 Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding fhir:routeOfAdministration ( [ CodeableConcept ] ... ) ; # 0..* How the additive should enter the patient's gastrointestinal tract ] ... ) ; fhir:note ( [ Annotation ] ... ) ; # 0..* Comments ]
Changes from both R4 and R4B
| NutritionOrder | |
| NutritionOrder.basedOn |
|
| NutritionOrder.groupIdentifier |
|
| NutritionOrder.status |
|
| NutritionOrder.intent |
|
| NutritionOrder.priority |
|
| NutritionOrder.subject |
|
| NutritionOrder.supportingInformation |
|
| NutritionOrder.requester |
|
| NutritionOrder.performer |
|
| NutritionOrder.outsideFoodAllowed |
|
| NutritionOrder.oralDiet.schedule |
|
| NutritionOrder.oralDiet.schedule.timing |
|
| NutritionOrder.oralDiet.schedule.asNeeded |
|
| NutritionOrder.oralDiet.schedule.asNeededFor |
|
| NutritionOrder.oralDiet.nutrient.amount |
|
| NutritionOrder.oralDiet.texture.type |
|
| NutritionOrder.oralDiet.caloricDensity |
|
| NutritionOrder.supplement.type |
|
| NutritionOrder.supplement.schedule |
|
| NutritionOrder.supplement.schedule.timing |
|
| NutritionOrder.supplement.schedule.asNeeded |
|
| NutritionOrder.supplement.schedule.asNeededFor |
|
| NutritionOrder.supplement.quantity |
|
| NutritionOrder.supplement.caloricDensity |
|
| NutritionOrder.enteralFormula.type |
|
| NutritionOrder.enteralFormula.productName |
|
|
|
|
| NutritionOrder.enteralFormula.caloricDensity |
|
| NutritionOrder.enteralFormula.routeOfAdministration |
|
| NutritionOrder.enteralFormula.administration.schedule |
|
| NutritionOrder.enteralFormula.administration.schedule.timing |
|
| NutritionOrder.enteralFormula.administration.schedule.asNeeded |
|
| NutritionOrder.enteralFormula.administration.schedule.asNeededFor |
|
| NutritionOrder.enteralFormula.administration.quantity |
|
| NutritionOrder.enteralFormula.administration.rate[x] |
|
| NutritionOrder.enteralFormula.maxVolumeToAdminister |
|
| NutritionOrder.enteralFormula.administrationInstruction |
|
| NutritionOrder.additive |
|
| NutritionOrder.additive.modularType |
|
| NutritionOrder.additive.productName |
|
| NutritionOrder.additive.quantity |
|
| NutritionOrder.additive.routeOfAdministration |
|
| NutritionOrder.instantiatesCanonical |
|
| NutritionOrder.instantiatesUri |
|
| NutritionOrder.instantiates |
|
| NutritionOrder.patient |
|
| NutritionOrder.orderer |
|
| NutritionOrder.oralDiet.texture.foodType |
|
| NutritionOrder.oralDiet.fluidConsistencyType |
|
| NutritionOrder.enteralFormula.baseFormulaType |
|
| NutritionOrder.enteralFormula.baseFormulaProductName |
|
| NutritionOrder.enteralFormula.additiveType |
|
| NutritionOrder.enteralFormula.additiveProductName |
|
| NutritionOrder.enteralFormula.routeofAdministration |
|
| NutritionOrder.enteralFormula.maxVolumeToDeliver |
|
See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
Filter:
|
|---|---|---|---|---|
|
NutritionOrder
|
|
DomainResource |
Diet,
formula
or
nutritional
supplement
request
+ Rule: Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension |
|
|
identifier
|
0..* | Identifier |
Identifiers
assigned
to
this
order
|
|
|
|
0..* | Reference ( CarePlan | NutritionOrder | ServiceRequest | RequestOrchestration ) |
What
this
order
fulfills
|
|
|
groupIdentifier
|
Σ | 0..1 | Identifier |
Composite
Request
ID
|
|
status
|
?! Σ | 1..1 | code |
draft
|
active
|
on-hold
|
entered-in-error
|
ended
|
completed
|
revoked
|
unknown
Binding: RequestStatus ( Required ) |
|
intent
|
?! Σ | 1..1 | code |
proposal
|
solicit-offer
|
offer-response
|
plan
|
directive
|
order
|
original-order
|
reflex-order
|
filler-order
|
instance-order
|
option
Binding: RequestIntent ( Required ) |
|
priority
|
0..1 | code |
routine
|
urgent
|
asap
|
stat
Binding: RequestPriority ( Required ) |
|
|
subject
|
Σ | 1..1 | Reference ( Patient | Group ) |
Who
requires
the
diet,
formula
or
nutritional
supplement
|
|
encounter
|
0..1 | Reference ( Encounter ) |
The
encounter
associated
with
this
nutrition
order
|
|
|
supportingInformation
|
0..* | Reference ( Any ) |
Information
to
support
fulfilling
of
the
nutrition
order
|
|
|
dateTime
|
Σ | 1..1 | dateTime |
Date
and
time
the
nutrition
order
was
requested
|
|
requester
|
Σ | 0..1 | Reference ( Practitioner | PractitionerRole ) |
Who
ordered
the
diet,
formula
or
nutritional
supplement
|
|
performer
|
0..* | CodeableReference ( CareTeam | Practitioner | PractitionerRole | RelatedPerson | Patient | Organization | Group ) |
Who
is
intended
to
perform
the
administration
of
the
nutrition
order
|
|
|
allergyIntolerance
|
0..* | Reference ( AllergyIntolerance ) |
List
of
the
patient's
food
and
nutrition-related
allergies
and
intolerances
|
|
|
foodPreferenceModifier
|
0..* | CodeableConcept |
Order-specific
modifier
about
the
type
of
food
that
should
be
given
Binding: Types of Edible Substances ( Preferred ) |
|
|
excludeFoodModifier
|
0..* | CodeableConcept |
Food
that
should
not
be
given
Binding: Types of Edible Substances ( Preferred ) |
|
|
outsideFoodAllowed
|
0..1 | boolean |
Capture
if
patient
is
permitted
to
consume
food
from
outside
of
current
setting
brought
by
the
patient,
family,
and/or
caregiver
|
|
|
oralDiet
|
C | 0..1 | BackboneElement |
Oral
diet
components
|
|
type
|
Σ | 0..* | CodeableConcept |
Type
of
oral
diet
or
diet
restrictions
that
can
be
consumed
orally
Binding: Diet Codes ( Preferred ) |
|
schedule
|
0..1 | BackboneElement |
Scheduling
information
for
oral
diets
|
|
|
timing
|
0..* | Timing |
Scheduled
frequency
of
diet
|
|
|
asNeeded
|
0..1 | boolean |
Take
'as
needed'
|
|
|
asNeededFor
|
0..1 | CodeableConcept |
Take
'as
needed'
for
x
Binding: SNOMED CT Medication As Needed Reason Codes ( Example ) |
|
|
nutrient
|
0..* | BackboneElement |
The
nutrient
that
is
modified
and
the
quantity
in
the
diet
|
|
|
modifier
|
0..1 | CodeableConcept |
Nutrient
modified
in
the
oral
diet
type
Binding: Nutrient Codes ( Preferred ) |
|
|
amount
|
0..1 | Quantity |
Quantity
of
the
specified
nutrient
|
|
|
texture
|
0..* | BackboneElement |
Texture
modifications
in
addition
to
the
oral
diet
type
|
|
|
modifier
|
0..1 | CodeableConcept |
Food
(i.e.
solid
and/or
liquid)
texture
modifications
in
addition
to
those
in
the
oral
diet
type
Binding: |
|
|
type
|
0..1 | CodeableConcept |
Food
(i.e.
solid
and/or
liquid)
types
that
undergo
texture
alteration
Binding: Texture Modified Food Type Codes ( |
|
|
instruction
|
Σ | 0..1 | string |
Instructions
or
additional
information
about
the
oral
diet
|
|
caloricDensity
|
0..1 | Quantity |
Amount
of
energy
per
specified
volume
of
oral
diet
|
|
|
supplement
|
C | 0..* | BackboneElement |
Supplement
components
|
|
type
|
Σ | 0..1 | CodeableReference ( NutritionProduct ) |
Type
of
supplement
product
requested
Binding: Supplement Type Codes ( Preferred ) |
|
productName
|
0..1 | string |
Product
or
brand
name
of
the
nutritional
supplement
|
|
|
schedule
|
0..1 | BackboneElement |
Scheduling
information
for
supplements
|
|
|
timing
|
0..* | Timing |
Scheduled
frequency
of
supplement
|
|
|
asNeeded
|
0..1 | boolean |
Take
'as
needed'
|
|
|
asNeededFor
|
0..1 | CodeableConcept |
Take
'as
needed'
for
x
Binding: SNOMED CT Medication As Needed Reason Codes ( Example ) |
|
|
quantity
|
0..1 | Quantity |
Amount
of
the
nutritional
supplement
|
|
|
instruction
|
Σ | 0..1 | string |
Instructions
or
additional
information
about
the
oral
supplement
|
|
caloricDensity
|
0..1 | Quantity |
Amount
of
energy
per
specified
volume
of
supplement
that
is
required
|
|
|
enteralFormula
|
C | 0..1 | BackboneElement |
Enteral
formula
product
|
|
type
|
Σ | 0..1 | CodeableReference ( NutritionProduct ) |
Type
of
patient
enteral
feeding
Binding: Enteral Formula Type Codes ( Preferred ) |
|
productName
|
0..1 | string |
Product
or
brand
name
of
the
enteral
feeding
|
|
|
deliveryDevice[x]
|
0..1 |
|
Intended
type
of
device
for
the
enteral
feeding
administration
Binding: Delivery Device Code ( Example ) |
|
|
deliveryDeviceCodeableConcept
| CodeableConcept | |||
|
deliveryDeviceCanonical
| canonical ( DeviceDefinition ) | |||
|
caloricDensity
|
0..1 | Quantity |
Amount
of
energy
per
specified
volume
of
feeding
that
is
required
|
|
|
routeOfAdministration
|
0..* | CodeableConcept |
How
the
enteral
feeding
should
enter
the
patient's
gastrointestinal
tract
Binding: Enteral Route Codes ( Extensible ) |
|
|
administration
|
0..* | BackboneElement |
Formula
feeding
instruction
as
structured
data
|
|
|
schedule
|
0..1 | BackboneElement |
Scheduling
information
for
enteral
feeding
products
|
|
|
timing
|
0..* | Timing |
Scheduled
frequency
of
enteral
feeding
|
|
|
asNeeded
|
0..1 | boolean |
Take
'as
needed'
|
|
|
asNeededFor
|
0..1 | CodeableConcept |
Take
'as
needed'
for
x
Binding: SNOMED CT Medication As Needed Reason Codes ( Example ) |
|
|
quantity
|
0..1 | Quantity |
The
volume
of
formula
feeding
to
provide
|
|
|
rate[x]
|
0..1 |
Speed
with
which
the
formula
feeding
is
provided
per
period
of
time
|
||
|
rateQuantity
|
Quantity | |||
|
rateRatio
|
Ratio | |||
|
maxVolumeToAdminister
|
0..1 | Quantity |
Upper
limit
on
formula
feeding
volume
per
unit
of
time
|
|
|
administrationInstruction
|
Σ | 0..1 | markdown |
Formula
feeding
instructions
expressed
as
text
|
|
additive
|
0..* | BackboneElement |
Modular
additive
to
add
to
the
oral
diet,
supplement,
and/or
enteral
feeding
|
|
|
modularType
|
0..1 | CodeableReference ( NutritionProduct ) |
Type
of
modular
component
to
add
to
the
oral
diet,
supplement,
and/or
enteral
feeding
Binding: Enteral Formula Additive Type Code ( Preferred ) |
|
|
productName
|
0..1 | string |
Product
or
brand
name
of
the
modular
additive
|
|
|
quantity
|
0..1 | Quantity |
Amount
of
additive
to
be
given
or
mixed
in
with
the
oral
diet,
supplement,
and/or
enteral
feeding
|
|
|
routeOfAdministration
|
0..* | CodeableConcept |
How
the
additive
should
enter
the
patient's
gastrointestinal
tract
Binding: Enteral Route Codes ( Extensible ) |
|
|
note
|
0..* | Annotation |
Comments
|
|
|
Documentation
for
this
format
|
||||
See the Extensions for this resource
XML Template
<NutritionOrder xmlns="http://hl7.org/fhir"><</instantiatesCanonical><basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|RequestOrchestration| ServiceRequest) What this order fulfills --></basedOn> <groupIdentifier><!-- 0..1 Identifier Composite Request ID --></groupIdentifier> <status value="[code]"/><!-- 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown --><<intent value="[code]"/><!-- 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option --> <priority value="[code]"/><!-- 0..1 routine | urgent | asap | stat --> <subject><!-- 1..1 Reference(Group|Patient) Who requires the diet, formula or nutritional supplement --></subject> <encounter><!-- 0..1 Reference(Encounter) The encounter associated with this nutrition order --></encounter> <supportingInformation><!-- 0..* Reference(Any) Information to support fulfilling of the nutrition order --></supportingInformation> <dateTime value="[dateTime]"/><!-- 1..1 Date and time the nutrition order was requested --> <requester><!-- 0..1 Reference(Practitioner|PractitionerRole) Who ordered the diet, formula or nutritional supplement --></requester> <performer><!-- 0..* CodeableReference(CareTeam|Group|Organization|Patient| Practitioner|PractitionerRole|RelatedPerson) Who is intended to perform the administration of the nutrition order --></performer> <allergyIntolerance><!-- 0..* Reference(AllergyIntolerance) List of the patient's food and nutrition-related allergies and intolerances --></allergyIntolerance> <foodPreferenceModifier><!-- 0..* CodeableConcept Order-specific modifier about the type of food that should be given --></foodPreferenceModifier> <excludeFoodModifier><!-- 0..* CodeableConcept Food that should not be given --></excludeFoodModifier> <outsideFoodAllowed value="[boolean]"/><!-- 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver --> <oralDiet> <!-- I 0..1 Oral diet components --> <type><!-- 0..* CodeableConcept Type of oral diet or diet restrictions that can be consumed orally --></type> <schedule> <!-- 0..1 Scheduling information for oral diets --> <timing><!-- 0..* Timing Scheduled frequency of diet --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <nutrient> <!-- 0..* The nutrient that is modified and the quantity in the diet --> <modifier><!-- 0..1 CodeableConcept Nutrient modified in the oral diet type --></modifier> <amount><!-- 0..1 Quantity Quantity of the specified nutrient --></amount> </nutrient> <texture> <!-- 0..* Texture modifications in addition to the oral diet type --><</modifier><modifier><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type --></modifier> <type><!-- 0..1 CodeableConcept Food (i.e. solid and/or liquid) types that undergo texture alteration --></type> </texture> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral diet --> <caloricDensity><!-- 0..1 Quantity Amount of energy per specified volume of oral diet --></caloricDensity> </oralDiet> <supplement> <!-- I 0..* Supplement components --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of supplement product requested --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the nutritional supplement --> <schedule> <!-- 0..1 Scheduling information for supplements --> <timing><!-- 0..* Timing Scheduled frequency of supplement --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity Amount of the nutritional supplement --></quantity> <instruction value="[string]"/><!-- 0..1 Instructions or additional information about the oral supplement --> <caloricDensity><!-- 0..1 Quantity Amount of energy per specified volume of supplement that is required --></caloricDensity> </supplement> <enteralFormula> <!-- I 0..1 Enteral formula product --> <type><!-- 0..1 CodeableReference(NutritionProduct) Type of patient enteral feeding --></type> <productName value="[string]"/><!-- 0..1 Product or brand name of the enteral feeding --><</deliveryDevice><deliveryDevice[x]><!-- 0..1 CodeableConcept|canonical(DeviceDefinition) Intended type of device for the enteral feeding administration --></deliveryDevice[x]> <caloricDensity><!-- 0..1 Quantity Amount of energy per specified volume of feeding that is required --></caloricDensity> <routeOfAdministration><!-- 0..* CodeableConcept How the enteral feeding should enter the patient's gastrointestinal tract --></routeOfAdministration> <administration> <!-- 0..* Formula feeding instruction as structured data --> <schedule> <!-- 0..1 Scheduling information for enteral feeding products --> <timing><!-- 0..* Timing Scheduled frequency of enteral feeding --></timing> <asNeeded value="[boolean]"/><!-- 0..1 Take 'as needed' --> <asNeededFor><!-- 0..1 CodeableConcept Take 'as needed' for x --></asNeededFor> </schedule> <quantity><!-- 0..1 Quantity The volume of formula feeding to provide --></quantity> <rate[x]><!-- 0..1 Quantity|Ratio Speed with which the formula feeding is provided per period of time --></rate[x]> </administration> <maxVolumeToAdminister><!-- 0..1 Quantity Upper limit on formula feeding volume per unit of time --></maxVolumeToAdminister> <administrationInstruction value="[markdown]"/><!-- 0..1 Formula feeding instructions expressed as text --> </enteralFormula> <additive> <!-- 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding --> <modularType><!-- 0..1 CodeableReference(NutritionProduct) Type of modular component to add to the oral diet, supplement, and/or enteral feeding --></modularType> <productName value="[string]"/><!-- 0..1 Product or brand name of the modular additive --> <quantity><!-- 0..1 Quantity Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding --></quantity> <routeOfAdministration><!-- 0..* CodeableConcept How the additive should enter the patient's gastrointestinal tract --></routeOfAdministration> </additive> <note><!-- 0..* Annotation Comments --></note> </NutritionOrder>
JSON Template
{
"resourceType" : "NutritionOrder",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Identifiers assigned to this order
"
"basedOn" : [{ Reference(CarePlan|NutritionOrder|RequestOrchestration|
ServiceRequest) }], // What this order fulfills
"groupIdentifier" : { Identifier }, // Composite Request ID
"status" : "<code>", // R! draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
"
"intent" : "<code>", // R! proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
"priority" : "<code>", // routine | urgent | asap | stat
"subject" : { Reference(Group|Patient) }, // R! Who requires the diet, formula or nutritional supplement
"encounter" : { Reference(Encounter) }, // The encounter associated with this nutrition order
"supportingInformation" : [{ Reference(Any) }], // Information to support fulfilling of the nutrition order
"dateTime" : "<dateTime>", // R! Date and time the nutrition order was requested
"requester" : { Reference(Practitioner|PractitionerRole) }, // Who ordered the diet, formula or nutritional supplement
"performer" : [{ CodeableReference(CareTeam|Group|Organization|Patient|
Practitioner|PractitionerRole|RelatedPerson) }], // Who is intended to perform the administration of the nutrition order
"allergyIntolerance" : [{ Reference(AllergyIntolerance) }], // List of the patient's food and nutrition-related allergies and intolerances
"foodPreferenceModifier" : [{ CodeableConcept }], // Order-specific modifier about the type of food that should be given
"excludeFoodModifier" : [{ CodeableConcept }], // Food that should not be given
"outsideFoodAllowed" : <boolean>, // Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver
"oralDiet" : { // I Oral diet components
"type" : [{ CodeableConcept }], // Type of oral diet or diet restrictions that can be consumed orally
"schedule" : { // Scheduling information for oral diets
"timing" : [{ Timing }], // Scheduled frequency of diet
"asNeeded" : <boolean>, // Take 'as needed'
"asNeededFor" : { CodeableConcept } // Take 'as needed' for x
},
"nutrient" : [{ // The nutrient that is modified and the quantity in the diet
"modifier" : { CodeableConcept }, // Nutrient modified in the oral diet type
"amount" : { Quantity } // Quantity of the specified nutrient
}],
"texture" : [{ // Texture modifications in addition to the oral diet type
"
"modifier" : { CodeableConcept }, // Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type
"type" : { CodeableConcept } // Food (i.e. solid and/or liquid) types that undergo texture alteration
}],
"instruction" : "<string>", // Instructions or additional information about the oral diet
"caloricDensity" : { Quantity } // Amount of energy per specified volume of oral diet
},
"supplement" : [{ // I Supplement components
"type" : { CodeableReference(NutritionProduct) }, // Type of supplement product requested
"productName" : "<string>", // Product or brand name of the nutritional supplement
"schedule" : { // Scheduling information for supplements
"timing" : [{ Timing }], // Scheduled frequency of supplement
"asNeeded" : <boolean>, // Take 'as needed'
"asNeededFor" : { CodeableConcept } // Take 'as needed' for x
},
"quantity" : { Quantity }, // Amount of the nutritional supplement
"instruction" : "<string>", // Instructions or additional information about the oral supplement
"caloricDensity" : { Quantity } // Amount of energy per specified volume of supplement that is required
}],
"enteralFormula" : { // I Enteral formula product
"type" : { CodeableReference(NutritionProduct) }, // Type of patient enteral feeding
"productName" : "<string>", // Product or brand name of the enteral feeding
"
// deliveryDevice[x]: Intended type of device for the enteral feeding administration. One of these 2:
"deliveryDeviceCodeableConcept" : { CodeableConcept },
"deliveryDeviceCanonical" : "<canonical(DeviceDefinition)>",
"caloricDensity" : { Quantity }, // Amount of energy per specified volume of feeding that is required
"routeOfAdministration" : [{ CodeableConcept }], // How the enteral feeding should enter the patient's gastrointestinal tract
"administration" : [{ // Formula feeding instruction as structured data
"schedule" : { // Scheduling information for enteral feeding products
"timing" : [{ Timing }], // Scheduled frequency of enteral feeding
"asNeeded" : <boolean>, // Take 'as needed'
"asNeededFor" : { CodeableConcept } // Take 'as needed' for x
},
"quantity" : { Quantity }, // The volume of formula feeding to provide
// rate[x]: Speed with which the formula feeding is provided per period of time. One of these 2:
"rateQuantity" : { Quantity },
"rateRatio" : { Ratio }
}],
"maxVolumeToAdminister" : { Quantity }, // Upper limit on formula feeding volume per unit of time
"administrationInstruction" : "<markdown>" // Formula feeding instructions expressed as text
},
"additive" : [{ // Modular additive to add to the oral diet, supplement, and/or enteral feeding
"modularType" : { CodeableReference(NutritionProduct) }, // Type of modular component to add to the oral diet, supplement, and/or enteral feeding
"productName" : "<string>", // Product or brand name of the modular additive
"quantity" : { Quantity }, // Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding
"routeOfAdministration" : [{ CodeableConcept }] // How the additive should enter the patient's gastrointestinal tract
}],
"note" : [{ Annotation }] // Comments
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .# from # from# from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension fhir:identifier ( [ Identifier ] ... ) ; # 0..* Identifiers assigned to this orderfhir:fhir:basedOn ( [ Reference(CarePlan|NutritionOrder|RequestOrchestration|ServiceRequest) ] ... ) ; # 0..* What this order fulfills fhir:groupIdentifier [ Identifier ] ; # 0..1 Composite Request ID fhir:status [ code ] ; # 1..1 draft | active | on-hold | entered-in-error | ended | completed | revoked | unknownfhir:fhir:intent [ code ] ; # 1..1 proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option fhir:priority [ code ] ; # 0..1 routine | urgent | asap | stat fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who requires the diet, formula or nutritional supplement fhir:encounter [ Reference(Encounter) ] ; # 0..1 The encounter associated with this nutrition order fhir:supportingInformation ( [ Reference(Any) ] ... ) ; # 0..* Information to support fulfilling of the nutrition order fhir:dateTime [ dateTime ] ; # 1..1 Date and time the nutrition order was requested fhir:requester [ Reference(Practitioner|PractitionerRole) ] ; # 0..1 Who ordered the diet, formula or nutritional supplement fhir:performer ( [ CodeableReference(CareTeam|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ... ) ; # 0..* Who is intended to perform the administration of the nutrition order fhir:allergyIntolerance ( [ Reference(AllergyIntolerance) ] ... ) ; # 0..* List of the patient's food and nutrition-related allergies and intolerances fhir:foodPreferenceModifier ( [ CodeableConcept ] ... ) ; # 0..* Order-specific modifier about the type of food that should be given fhir:excludeFoodModifier ( [ CodeableConcept ] ... ) ; # 0..* Food that should not be given fhir:outsideFoodAllowed [ boolean ] ; # 0..1 Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver fhir:oralDiet [ # 0..1 I Oral diet components fhir:type ( [ CodeableConcept ] ... ) ; # 0..* Type of oral diet or diet restrictions that can be consumed orally fhir:schedule [ # 0..1 Scheduling information for oral diets fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of diet fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:nutrient ( [ # 0..* The nutrient that is modified and the quantity in the diet fhir:modifier [ CodeableConcept ] ; # 0..1 Nutrient modified in the oral diet type fhir:amount [ Quantity ] ; # 0..1 Quantity of the specified nutrient ] ... ) ; fhir:texture ( [ # 0..* Texture modifications in addition to the oral diet type fhir:modifier [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type fhir:type [ CodeableConcept ] ; # 0..1 Food (i.e. solid and/or liquid) types that undergo texture alteration ] ... ) ; fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral diet fhir:caloricDensity [ Quantity ] ; # 0..1 Amount of energy per specified volume of oral diet ] ; fhir:supplement ( [ # 0..* I Supplement components fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of supplement product requested fhir:productName [ string ] ; # 0..1 Product or brand name of the nutritional supplement fhir:schedule [ # 0..1 Scheduling information for supplements fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of supplement fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity ] ; # 0..1 Amount of the nutritional supplement fhir:instruction [ string ] ; # 0..1 Instructions or additional information about the oral supplement fhir:caloricDensity [ Quantity ] ; # 0..1 Amount of energy per specified volume of supplement that is required ] ... ) ; fhir:enteralFormula [ # 0..1 I Enteral formula product fhir:type [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of patient enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the enteral feedingfhir:# deliveryDevice[x] : 0..1 Intended type of device for the enteral feeding administration. One of these 2 fhir:deliveryDevice [ a fhir:CodeableConcept ; CodeableConcept ] fhir:deliveryDevice [ a fhir:Canonical ; canonical(DeviceDefinition) ] fhir:caloricDensity [ Quantity ] ; # 0..1 Amount of energy per specified volume of feeding that is required fhir:routeOfAdministration ( [ CodeableConcept ] ... ) ; # 0..* How the enteral feeding should enter the patient's gastrointestinal tract fhir:administration ( [ # 0..* Formula feeding instruction as structured data fhir:schedule [ # 0..1 Scheduling information for enteral feeding products fhir:timing ( [ Timing ] ... ) ; # 0..* Scheduled frequency of enteral feeding fhir:asNeeded [ boolean ] ; # 0..1 Take 'as needed' fhir:asNeededFor [ CodeableConcept ] ; # 0..1 Take 'as needed' for x ] ; fhir:quantity [ Quantity ] ; # 0..1 The volume of formula feeding to provide # rate[x] : 0..1 Speed with which the formula feeding is provided per period of time. One of these 2 fhir:rate [ a fhir:Quantity ; Quantity ] fhir:rate [ a fhir:Ratio ; Ratio ] ] ... ) ; fhir:maxVolumeToAdminister [ Quantity ] ; # 0..1 Upper limit on formula feeding volume per unit of time fhir:administrationInstruction [ markdown ] ; # 0..1 Formula feeding instructions expressed as text ] ; fhir:additive ( [ # 0..* Modular additive to add to the oral diet, supplement, and/or enteral feeding fhir:modularType [ CodeableReference(NutritionProduct) ] ; # 0..1 Type of modular component to add to the oral diet, supplement, and/or enteral feeding fhir:productName [ string ] ; # 0..1 Product or brand name of the modular additive fhir:quantity [ Quantity ] ; # 0..1 Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding fhir:routeOfAdministration ( [ CodeableConcept ] ... ) ; # 0..* How the additive should enter the patient's gastrointestinal tract ] ... ) ; fhir:note ( [ Annotation ] ... ) ; # 0..* Comments ]
Changes from both R4 and R4B
| NutritionOrder | |
| NutritionOrder.basedOn |
|
| NutritionOrder.groupIdentifier |
|
| NutritionOrder.status |
|
| NutritionOrder.intent |
|
| NutritionOrder.priority |
|
| NutritionOrder.subject |
|
| NutritionOrder.supportingInformation |
|
| NutritionOrder.requester |
|
| NutritionOrder.performer |
|
| NutritionOrder.outsideFoodAllowed |
|
| NutritionOrder.oralDiet.schedule |
|
| NutritionOrder.oralDiet.schedule.timing |
|
| NutritionOrder.oralDiet.schedule.asNeeded |
|
| NutritionOrder.oralDiet.schedule.asNeededFor |
|
| NutritionOrder.oralDiet.nutrient.amount |
|
| NutritionOrder.oralDiet.texture.type |
|
| NutritionOrder.oralDiet.caloricDensity |
|
| NutritionOrder.supplement.type |
|
| NutritionOrder.supplement.schedule |
|
| NutritionOrder.supplement.schedule.timing |
|
| NutritionOrder.supplement.schedule.asNeeded |
|
| NutritionOrder.supplement.schedule.asNeededFor |
|
| NutritionOrder.supplement.quantity |
|
| NutritionOrder.supplement.caloricDensity |
|
| NutritionOrder.enteralFormula.type |
|
| NutritionOrder.enteralFormula.productName |
|
|
|
|
| NutritionOrder.enteralFormula.caloricDensity |
|
| NutritionOrder.enteralFormula.routeOfAdministration |
|
| NutritionOrder.enteralFormula.administration.schedule |
|
| NutritionOrder.enteralFormula.administration.schedule.timing |
|
| NutritionOrder.enteralFormula.administration.schedule.asNeeded |
|
| NutritionOrder.enteralFormula.administration.schedule.asNeededFor |
|
| NutritionOrder.enteralFormula.administration.quantity |
|
| NutritionOrder.enteralFormula.administration.rate[x] |
|
| NutritionOrder.enteralFormula.maxVolumeToAdminister |
|
| NutritionOrder.enteralFormula.administrationInstruction |
|
| NutritionOrder.additive |
|
| NutritionOrder.additive.modularType |
|
| NutritionOrder.additive.productName |
|
| NutritionOrder.additive.quantity |
|
| NutritionOrder.additive.routeOfAdministration |
|
| NutritionOrder.instantiatesCanonical |
|
| NutritionOrder.instantiatesUri |
|
| NutritionOrder.instantiates |
|
| NutritionOrder.patient |
|
| NutritionOrder.orderer |
|
| NutritionOrder.oralDiet.texture.foodType |
|
| NutritionOrder.oralDiet.fluidConsistencyType |
|
| NutritionOrder.enteralFormula.baseFormulaType |
|
| NutritionOrder.enteralFormula.baseFormulaProductName |
|
| NutritionOrder.enteralFormula.additiveType |
|
| NutritionOrder.enteralFormula.additiveProductName |
|
| NutritionOrder.enteralFormula.routeofAdministration |
|
| NutritionOrder.enteralFormula.maxVolumeToDeliver |
|
See the Full Difference for further information
This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .
Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis
| Path | ValueSet | Type | Documentation |
|---|---|---|---|
| NutritionOrder.status | RequestStatus | Required |
Codes identifying the lifecycle stage of a request. |
| NutritionOrder.intent | RequestIntent | Required |
Codes indicating the degree of authority/intentionality associated with a request. |
| NutritionOrder.priority | RequestPriority | Required |
Identifies the level of importance to be assigned to actioning the request. |
| NutritionOrder.foodPreferenceModifier | TypesOfEdibleSubstances | Preferred |
This
value
set
represents
codes
for
types
of
edible
substances.
It
include
codes
from
SNOMED
CT
|
| NutritionOrder.excludeFoodModifier | TypesOfEdibleSubstances | Preferred |
This
value
set
represents
codes
for
types
of
edible
substances.
It
include
codes
from
SNOMED
CT
|
| NutritionOrder.oralDiet.type | DietCodes | Preferred |
Codes
that
can
be
used
to
indicate
the
type
of
food
being
ordered
for
a
patient.
It
includes
codes
from
SNOMED
CT
|
| NutritionOrder.oralDiet.schedule.asNeededFor | SNOMEDCTMedicationAsNeededReasonCodes | Example |
This value set includes all clinical findings from SNOMED CT - provided as an exemplar value set. |
| NutritionOrder.oralDiet.nutrient.modifier | NutrientCodes | Preferred |
NutrientModifier
:
Codes
for
types
of
nutrients
that
are
being
modified
such
as
carbohydrate
or
sodium.
This
value
set
includes
codes
from
SNOMED
CT
|
| NutritionOrder.oralDiet.texture.modifier |
|
Preferred |
TextureModifier:
Codes
for
food
consistency
types
or
texture
modifications
to
apply
to
foods.
This
value
set
|
| NutritionOrder.oralDiet.texture.type | TextureModifiedFoodTypeCodes |
|
TextureModifiedFoodType: Codes for types of foods that are texture-modified. This value set is composed SNOMED CT Concepts from SCTID 255620007 Foods (substance) and is provided as a suggestive example. |
| NutritionOrder.supplement.type | SupplementTypeCodes | Preferred |
SupplementType : Codes for nutritional supplements to be provided to the patient. This value set is composed of SNOMED CT Concepts from SCTID 346415002 (Enteral and supplement feeds (product)). |
| NutritionOrder.supplement.schedule.asNeededFor | SNOMEDCTMedicationAsNeededReasonCodes | Example |
This value set includes all clinical findings from SNOMED CT - provided as an exemplar value set. |
| NutritionOrder.enteralFormula.type | EnteralFormulaTypeCodes | Preferred |
SupplementType : Codes for nutritional supplements to be provided to the patient. This value set is composed of SNOMED CT Concepts from SCTID 346415002 (Enteral and supplement feeds (product)). |
| NutritionOrder.enteralFormula.deliveryDevice[x] | DeliveryDeviceCode | Example | Codes for devices used for enteral formula delivery. |
| NutritionOrder.enteralFormula.routeOfAdministration | EnteralRouteCodes | Extensible |
EnteralRouteOfAdministration: Codes specifying the route of administration of enteral formula. This value set is composed of HL7 V3 codes and is provided as a suggestive example. |
| NutritionOrder.enteralFormula.administration.schedule.asNeededFor | SNOMEDCTMedicationAsNeededReasonCodes | Example |
This value set includes all clinical findings from SNOMED CT - provided as an exemplar value set. |
| NutritionOrder.additive.modularType | EnteralFormulaAdditiveTypeCode | Preferred |
Codes for modular components to be added to the diet. |
| NutritionOrder.additive.routeOfAdministration | EnteralRouteCodes | Extensible |
EnteralRouteOfAdministration: Codes specifying the route of administration of enteral formula. This value set is composed of HL7 V3 codes and is provided as a suggestive example. |
| UniqueKey | Level | Location | Description | Expression |
nor-1
|
Rule | (base) | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class | oralDiet.exists() or supplement.exists() or enteralFormula.exists() |
Tube
feedings
can
be
administered
via
continuous
drip
using
a
pump
or
via
intermittent
feedings,
using
gravity
drip
or
a
pump.
The
examples
Nutrition
Order
Enteral
Bolus
Feeding
Example
and
Nutrition
Order
Enteral
Continuous
Cycled
Feeding
Example
show
how
this
resource
can
be
used
to
order
both
kinds
of
enteral
feeding
using
the
structured
data
elements.
The
continuous
feeding
typically
specifies
rate
of
administration
and
a
maximum
volume
of
delivery
using
the
enteralFormula.administration.rate
and
enteralFormula.maxVolumeToDeliver
elements.
On
the
other
hand,
the
intermittent
feeding
typically
specifies
the
amount
and
frequency
of
administration
using
the
enteralFormula.administration.quantity
and
enteralFormula.schedule
elements.
In
both
cases,
to
vary
the
rate
or
quantity
over
time
the
enteralFormula.administration
element
can
be
repeated.
The examples associated with this resource demonstrate the core elements and do not necessarily reflect real-world implementations that may be constrained by future profiles for a given implementation or setting. For example, a renal diet is often comprised of pre-coordinated components including common nutrient modifications such as protein, potassium and phosphorus to assist with the speed of entry of complex diet orders.
Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
| Name | Type | Description | Expression | In Common |
| additive | token | Type of module component to add to the diet | NutritionOrder.additive.modularType.concept | |
| datetime | date | Return nutrition orders requested on this date | NutritionOrder.dateTime | |
| encounter | reference | Return nutrition orders with this encounter identifier |
NutritionOrder.encounter
( Encounter ) |
|
| formula | token | Type of enteral or infant formula | NutritionOrder.enteralFormula.type.concept | |
| group-identifier | token | Composite Request ID | NutritionOrder.groupIdentifier | |
| identifier | token | Return nutrition orders with this external identifier | NutritionOrder.identifier |
|
| oraldiet | token | Type of diet that can be consumed orally (i.e., take via the mouth). | NutritionOrder.oralDiet.type | |
| patient | reference | The identity of the individual or set of individuals who requires the diet, formula or nutritional supplement |
NutritionOrder.subject.where(resolve()
is
Patient)
( Patient ) |
|
| requester | reference | The identity of the provider who placed the nutrition order |
NutritionOrder.requester
( Practitioner , PractitionerRole ) |
|
| status | token | Status of the nutrition order. | NutritionOrder.status | |
| subject | reference | The identity of the individual or set of individuals who requires the diet, formula or nutritional supplement |
NutritionOrder.subject
( Group , Patient ) |
|
| supplement | token | Type of supplement product requested | NutritionOrder.supplement.type.concept |
FHIR
®©
HL7.org
2011+.
FHIR
R6
hl7.fhir.core#6.0.0-ballot3
generated
on
Tue,
Apr
1,
Thu,
Nov
13,
2025
12:25+1100.
11:15+0000.
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