HL7 Nutrition Orders Domain Analysis Model – R2

1. HL7 Nutrition Orders Domain Analysis Model – R2 Food & Medication Preferences HL7 May 2013 Ballot (See links on Nutrition Management page on the HL7 wiki) http://wiki.hl7.org/index.php?title=Nutrition_Management

2. Agenda & Minutes – March 8, 2013 • Agenda Review • Review & Finalize Preferences Use Cases to include in DAM R2 • Record Food Concerns – (from DAM R1) • Use Case 11 – Record Food Preference • AllergyUseCasereportedFood and MedicationPreference – from Allergy/Intolerance DAM Jan 2013 • New - Use Case Patient Preference 2013 01 28 • Review Model (Jean/Lorraine) • Determine Ballot Countdown Action Items • DAM R1 Errata edits – Dittloff (by March 12) – • R1 Document (Amy) • DAM R2 • Correct errata from DAM R1 in new document (Margaret) • Incorporate final use cases for R2 & rename section from food Concerns to Record Food & Medication Preferences • Use Case – Broccoli/Ibuprofen vs Acetaminophen/Epinephrine (from Allergy DAM work) • Use Case 11– Fish on Fridays during Lent to highlight reason as religious (from DAM R1) • Use Case LTC Beverage & Chocolate Ice Cream requests (from Amy) • Pharmacy call for Monday (Jean/Margaret) • Send slides to Jean/ Sunday for new section on Sunday & send to OO list (Margaret) • Nutrition Order DIM Model updates (Jean/Lorraine – March 14 for review on OO call) • DIM V3 Models – updated with Harmonization changes – (Jean has this done) • PubDB – Lorraine has this in progress – working on links • End of Tuesday DAM R2& Information Model (may need to request a delayed open on DAM R2 ) • Final DAM PDF (Dittloff – March 17th final content deadline – Lorraine/Jean to submit) • Next Meeting - March 15 2 PM ET Review Final Content Meeting

3. Food Concerns Section • Do we want to keep Use Cases for Food Allergy & Food Intolerances? • Rename to encompass medication preferences? • Record Food & Medication Preferences • Motion Approved - Against - 0/Abstain - 0 /In Favor -9

4. Record Food & Medication Preferences Activity Diagram: Record Patient Preferences • ADD - Healthcare Provider can ADD a food or medication preference to the master list • MODIFY - Healthcare Provider can MODIFY (meaning edit) an existing food or medication preference that is part of the patient’s record. • REMOVE/DELETE – Healthcare Provider can Remove or Mark as Inactivea food or medication preference from the Master List • Do we need to include something to indicate why it was removed or deleted – “At request of patient”, No longer relevant, etc?

6. Preferences Information/Data Model Required Data Elements: • Entered by – e.g., Connie Chow RD • Entered Date/Time • Reported/Requested by • Who stated the preference and wanted it added/modified or removed?  Patient/Family/Other Provider via some history • Preference Type – e.g., Food or Medication/Drug • Positive or Negative • Reason – e.g. , like, dislike, religious, side effects of meds, moral • Preference Details • Meal schedule/frequency – e.g., breakfast only or Breakfast/Lunch/Dinner • Quantity – optional (2 sugars and 2 creamers) • FoodType – kind or category of food e.g., beverages or Vegetables • FoodItem – specific food item, e.g. broccoli, sugar, creamer \ • (no idea where the coded list will come from here??? – local codes???) • FoodTrait – attributes of foods such as spicy or temperature (hot/cold) • Preferences Description/Note – free text to describe the request or refusal • ?? – not sure what to call this but it is about classifying the preference to be a permanent one or one specific to the encounter/admission.