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12.20 Resource NutritionIntake - Content

Work Group

Compartments: Encounter, Patient, Practitioner, RelatedPerson

A record of intake by a patient. A NutritionIntake may indicate that the patient may be consuming the food (i.e., solid and/or liquid), breastmilk, infant formula, supplements, enteral formula now or has consumed it in the past. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay or through an app that tracks food (i.e., solid and/or liquid), breastmilk, infant formula, supplements, enteral formula consumed. The consumption information may come from sources such as the patient's memory, from a nutrition label, or from a clinician documenting observed intake.

12.20.1 Scope and Usage

This resource is an event 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 event resources.

The NutritionIntake resource, in conjunction with the NutritionProduct resource, is utilized to capture details about the consumption of foods (i.e., solid and/or liquid), supplements, enteral nutrition, and infant formula. Dietitians and other practitioners use the data to calculate how much nutrition a patient has taken in. NutritionIntake represents the event of consuming food (i.e. solid and/or liquid), etc. and NutritionProduct represents the actual food and formula items.

NutritionIntake can also be used to record a person’s intake through the use of food tracking apps (e.g.MyFitnessPal), inpatient hospital consumption or administration, or a student’s meal consumption in a school district.

NutritionIntake can be utilized in many environments where food is served or consumed: hospitals/acute care, meal tracking systems, enteral or supplement in a home setting, outpatient settings, long-term care, etc. NutritionIntake should be general enough to capture intake regardless of country or region.

Parenteral nutrition is out of scope as this ordering is handled through MedicationRequest, thus administration of parenteral nutrition should also be captured through MedicationAdministration.

12.20.2 Boundaries and Relationships

Intake of food (i.e. solid and/or liquid), oral nutritional supplements, enteral nutrition, or infant formula should be recorded using the NutritionIntake resource.
Supplements, such as vitamins, minerals, and herbals, should be recorded using the medication resources
Parenteral nutrition should be recorded using the medication resources

12.20.3 Background and Context

As a dietitian, it is important to be able to know what a person is consuming and/or administered to assess the adequacy of the patient’s intake. Capturing a patient’s intake is important to establish a baseline, determine care, track trends, and see improvement in that patient. Dietitians might use intake data to see patterns, such as when a diabetic patient’s blood glucose is consistently high given the distribution of carbohydrates. Other practitioners have the need to monitor intake as well; for example, a nurse might need to know intake for administering insulin prior to meals, a speech therapist needs this information for ensuring safe administration of food, or a physician may need to ensure a patient fluid restriction is consistent with recommendations.

Having intake documented within its own resource allows for consistency in documentation across multiple disciplines and settings. In some instances, the Observation resource has been extended to capture intake; while this allows for a quick way to document intake, the Observation resource does not provide all the detail necessary, such as capturing energy and nutrients (including vitamins, minerals, carbohydrates, etc.). Previous implementation attempts of using the Observation resource have noted this is cumbersome and has required too many extensions without being able to document all the necessary details tied to ingredients in food (i.e., solid and/or liquid) products.

12.20.4 References to this Resource

Implements: Event
Resource References: Goal and itself

Structure

Name	Flags	Card.	Type	Description & Constraints
NutritionIntake	TU		DomainResource	Record of intake by a patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External identifier
instantiatesCanonical		0..*	canonical(Definition)	Instantiates FHIR protocol or definition
instantiatesUri		0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(NutritionOrder \| CarePlan \| ServiceRequest)	Fulfils plan, proposal or order
partOf	Σ	0..*	Reference(NutritionIntake \| Procedure \| Observation)	Part of referenced event
status	?!Σ	1..1	code	preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Binding: EventStatus (Required)
statusReason		0..*	CodeableConcept	Reason for current status Binding: ClinicalImpression Status Reason (Example)
code	Σ	0..1	CodeableConcept	Code representing an overall type of nutrition intake Binding: Diet Codes (Preferred)
subject	Σ	1..1	Reference(Patient \| Group)	Who is/was consuming the food (i.e. solid and/or liquid)
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with NutritionIntake
occurrence[x]	Σ	0..1		The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed
occurrenceDateTime			dateTime
occurrencePeriod			Period
recorded	Σ	0..1	dateTime	When the intake was recorded
reported[x]		0..1		Indicates if this is a reported rather than a primary record. Can also indicate the source that provided the information about the consumption
reportedBoolean			boolean
reportedReference			Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization \| Group)
nutritionItem	C	0..*	BackboneElement	The nutrition product intended for consumption and/or administration + Rule: If nutritionItem is present then SHALL have at least one of nutritionItem.type or nutritionItem.nutritionProduct[x]
type	Σ	0..1	CodeableConcept	The type of food (i.e. solid or liquid) product Binding: Food Type Codes (Example)
nutritionProduct	Σ	0..1	CodeableReference(NutritionProduct)	A product used for nutritional purposes (e.g. food or supplement) Binding: Types of Edible Substances (Preferred)
consumedItem		0..*	BackboneElement	What nutrition item was consumed
schedule		0..1	Timing	Scheduled frequency of consumption
amount	Σ	0..1	SimpleQuantity	Quantity of the specified food (i.e. solid and/or liquid)
rate[x]	Σ	0..1		Rate of enteral feeding administration
rateQuantity			Quantity
rateRatio			Ratio
totalIntake		0..*	BackboneElement	Nutrients and/or energy contained in the intake
nutrient		1..1	CodeableReference(Substance)	Type of nutrient consumed in the intake Binding: Nutrient Codes (Example)
amount		1..1	SimpleQuantity	Total amount of nutrient consumed
energy		0..1	SimpleQuantity	Total energy consumed in kilocalories or kilojoules
notConsumed		0..1	boolean	Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed
notConsumedReason		0..1	CodeableConcept	Reason the nutrition item was not consumed Binding: Reasons for why a food item was not consumed (Example)
performer		0..*	BackboneElement	Who performed the intake and how they were involved
function		0..1	CodeableConcept	Type of performer Binding: Procedure Performer Role Codes (Example)
actor		1..1	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam \| Patient \| Device \| RelatedPerson \| Group)	Who performed the intake
location		0..1	Reference(Location)	Where the intake occurred
derivedFrom		0..*	Reference(Any)	Additional supporting information
reason		0..*	CodeableReference(Condition \| Observation \| DiagnosticReport \| DocumentReference)	Reason for why the food (i.e. solid and/or liquid) is /was consumed Binding: Condition/Problem/Diagnosis Codes (Example)
note		0..*	Annotation	Further information about the consumption
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<NutritionIntake xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External identifier --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|
   ChargeItemDefinition|ClinicalUseDefinition|EventDefinition|Measure|
   MessageDefinition|ObservationDefinition|OperationDefinition|PlanDefinition|
   Questionnaire|Requirements|SubscriptionTopic|TestPlan|TestScript) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(NutritionIntake|Observation|Procedure) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <code><!-- 0..1 CodeableConcept Code representing an overall type of nutrition intake --></code>
 <subject><!-- 1..1 Reference(Group|Patient) Who is/was consuming the food (i.e. solid and/or liquid) --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with NutritionIntake --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed --></occurrence[x]>
 <recorded value="[dateTime]"/><!-- 0..1 When the intake was recorded -->
 <reported[x]><!-- 0..1 boolean|Reference(Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Indicates if this is a reported rather than a primary record.  Can also indicate the source that provided the information about the consumption --></reported[x]>
 <nutritionItem>  <!-- 0..* The nutrition product intended for consumption and/or administration -->
  <type><!-- 0..1 CodeableConcept The type of food (i.e. solid or liquid) product --></type>
  <nutritionProduct><!-- 0..1 CodeableReference(NutritionProduct) A product used for nutritional purposes (e.g. food or supplement) --></nutritionProduct>
  <consumedItem>  <!-- 0..* What nutrition item was consumed -->
   <schedule><!-- 0..1 Timing Scheduled frequency of consumption --></schedule>
   <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity of the specified food (i.e. solid and/or liquid)  --></amount>
   <rate[x]><!-- 0..1 Quantity|Ratio Rate of enteral feeding administration --></rate[x]>
   <totalIntake>  <!-- 0..* Nutrients and/or energy contained in the intake -->
    <nutrient><!-- 1..1 CodeableReference(Substance) Type of nutrient consumed in the intake --></nutrient>
    <amount><!-- 1..1 Quantity(SimpleQuantity) Total amount of nutrient consumed --></amount>
    <energy><!-- 0..1 Quantity(SimpleQuantity) Total energy consumed in kilocalories or kilojoules --></energy>
   </totalIntake>
  </consumedItem>
  <notConsumed value="[boolean]"/><!-- 0..1 Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed -->
  <notConsumedReason><!-- 0..1 CodeableConcept Reason the nutrition item was not consumed --></notConsumedReason>
 </nutritionItem>
 <performer>  <!-- 0..* Who performed the intake and how they were involved -->
  <function><!-- 0..1 CodeableConcept Type of performer --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) Who performed the intake --></actor>
 </performer>
 <location><!-- 0..1 Reference(Location) Where the intake occurred --></location>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) Reason for why the food (i.e. solid and/or liquid) is /was consumed --></reason>
 <note><!-- 0..* Annotation Further information about the consumption --></note>
</NutritionIntake>

JSON Template

{
  "resourceType" : "NutritionIntake",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "instantiatesCanonical" : ["<canonical(Definition)>"], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "basedOn" : [{ Reference(CarePlan|NutritionOrder|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(NutritionIntake|Observation|Procedure) }], // Part of referenced event
  "status" : "<code>", // R!  preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "code" : { CodeableConcept }, // Code representing an overall type of nutrition intake
  "subject" : { Reference(Group|Patient) }, // R!  Who is/was consuming the food (i.e. solid and/or liquid)
  "encounter" : { Reference(Encounter) }, // Encounter associated with NutritionIntake
  // occurrence[x]: The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "recorded" : "<dateTime>", // When the intake was recorded
  // reported[x]: 
     Indicates if this is a reported rather than a primary record.  Can also indicate the source that provided the information about the consumption. One of these 2:
  "reportedBoolean" : <boolean>,
  "reportedReference" : { Reference(Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) },
  "nutritionItem" : [{ // The nutrition product intended for consumption and/or administration
    "type" : { CodeableConcept }, // The type of food (i.e. solid or liquid) product
    "nutritionProduct" : { CodeableReference(NutritionProduct) }, // A product used for nutritional purposes (e.g. food or supplement)
    "consumedItem" : [{ // What nutrition item was consumed
      "schedule" : { Timing }, // Scheduled frequency of consumption
      "amount" : { Quantity(SimpleQuantity) }, // Quantity of the specified food (i.e. solid and/or liquid) 
      // rate[x]: Rate of enteral feeding administration. One of these 2:
      "rateQuantity" : { Quantity },
      "rateRatio" : { Ratio },
      "totalIntake" : [{ // Nutrients and/or energy contained in the intake
        "nutrient" : { CodeableReference(Substance) }, // R!  Type of nutrient consumed in the intake
        "amount" : { Quantity(SimpleQuantity) }, // R!  Total amount of nutrient consumed
        "energy" : { Quantity(SimpleQuantity) } // Total energy consumed in kilocalories or kilojoules
      }]
    }],
    "notConsumed" : <boolean>, // Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed
    "notConsumedReason" : { CodeableConcept } // Reason the nutrition item was not consumed
  }],
  "performer" : [{ // Who performed the intake and how they were involved
    "function" : { CodeableConcept }, // Type of performer
    "actor" : { Reference(CareTeam|Device|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) } // R!  Who performed the intake
  }],
  "location" : { Reference(Location) }, // Where the intake occurred
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) }], // Reason for why the food (i.e. solid and/or liquid) is /was consumed
  "note" : [{ Annotation }] // Further information about the consumption
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:NutritionIntake;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External identifier
  fhir:instantiatesCanonical  ( [ canonical(ActivityDefinition|ChargeItemDefinition|ClinicalUseDefinition|EventDefinition|
  Measure|MessageDefinition|ObservationDefinition|OperationDefinition|
  PlanDefinition|Questionnaire|Requirements|SubscriptionTopic|TestPlan|
  TestScript) ] ... ) ; # 0..* Instantiates FHIR protocol or definition
  fhir:instantiatesUri  ( [ uri ] ... ) ; # 0..* Instantiates external protocol or definition
  fhir:basedOn  ( [ Reference(CarePlan|NutritionOrder|ServiceRequest) ] ... ) ; # 0..* Fulfils plan, proposal or order
  fhir:partOf  ( [ Reference(NutritionIntake|Observation|Procedure) ] ... ) ; # 0..* Part of referenced event
  fhir:status [ code ] ; # 1..1 preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for current status
  fhir:code [ CodeableConcept ] ; # 0..1 Code representing an overall type of nutrition intake
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who is/was consuming the food (i.e. solid and/or liquid)
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter associated with NutritionIntake
  # occurrence[x] : 0..1 The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed. One of these 2
    fhir:occurrence [  a fhir:dateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
  fhir:recorded [ dateTime ] ; # 0..1 When the intake was recorded
  # reported[x] : 0..1 Indicates if this is a reported rather than a primary record.  Can also indicate the source that provided the information about the consumption. One of these 2
    fhir:reported [  a fhir:boolean ; boolean ]
    fhir:reported [  a fhir:Reference ; Reference(Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]
  fhir:nutritionItem ( [ # 0..* The nutrition product intended for consumption and/or administration
    fhir:type [ CodeableConcept ] ; # 0..1 The type of food (i.e. solid or liquid) product
    fhir:nutritionProduct [ CodeableReference(NutritionProduct) ] ; # 0..1 A product used for nutritional purposes (e.g. food or supplement)
    fhir:consumedItem ( [ # 0..* What nutrition item was consumed
      fhir:schedule [ Timing ] ; # 0..1 Scheduled frequency of consumption
      fhir:amount [ Quantity(SimpleQuantity) ] ; # 0..1 Quantity of the specified food (i.e. solid and/or liquid) 
      # rate[x] : 0..1 Rate of enteral feeding administration. One of these 2
        fhir:rate [  a fhir:Quantity ; Quantity ]
        fhir:rate [  a fhir:Ratio ; Ratio ]
      fhir:totalIntake ( [ # 0..* Nutrients and/or energy contained in the intake
        fhir:nutrient [ CodeableReference(Substance) ] ; # 1..1 Type of nutrient consumed in the intake
        fhir:amount [ Quantity(SimpleQuantity) ] ; # 1..1 Total amount of nutrient consumed
        fhir:energy [ Quantity(SimpleQuantity) ] ; # 0..1 Total energy consumed in kilocalories or kilojoules
      ] ... ) ;
    ] ... ) ;
    fhir:notConsumed [ boolean ] ; # 0..1 Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed
    fhir:notConsumedReason [ CodeableConcept ] ; # 0..1 Reason the nutrition item was not consumed
  ] ... ) ;
  fhir:performer ( [ # 0..* Who performed the intake and how they were involved
    fhir:function [ CodeableConcept ] ; # 0..1 Type of performer
    fhir:actor [ Reference(CareTeam|Device|Group|Organization|Patient|Practitioner|PractitionerRole|
  RelatedPerson) ] ; # 1..1 Who performed the intake
  ] ... ) ;
  fhir:location [ Reference(Location) ] ; # 0..1 Where the intake occurred
  fhir:derivedFrom  ( [ Reference(Any) ] ... ) ; # 0..* Additional supporting information
  fhir:reason  ( [ CodeableReference(Condition|DiagnosticReport|DocumentReference|Observation) ] ... ) ; # 0..* Reason for why the food (i.e. solid and/or liquid) is /was consumed
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Further information about the consumption
]

Changes from both R4 and R4B

This resource did not exist in Release R4

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
NutritionIntake	TU		DomainResource	Record of intake by a patient Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	External identifier
instantiatesCanonical		0..*	canonical(Definition)	Instantiates FHIR protocol or definition
instantiatesUri		0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(NutritionOrder \| CarePlan \| ServiceRequest)	Fulfils plan, proposal or order
partOf	Σ	0..*	Reference(NutritionIntake \| Procedure \| Observation)	Part of referenced event
status	?!Σ	1..1	code	preparation \| in-progress \| not-done \| on-hold \| stopped \| completed \| entered-in-error \| unknown Binding: EventStatus (Required)
statusReason		0..*	CodeableConcept	Reason for current status Binding: ClinicalImpression Status Reason (Example)
code	Σ	0..1	CodeableConcept	Code representing an overall type of nutrition intake Binding: Diet Codes (Preferred)
subject	Σ	1..1	Reference(Patient \| Group)	Who is/was consuming the food (i.e. solid and/or liquid)
encounter	Σ	0..1	Reference(Encounter)	Encounter associated with NutritionIntake
occurrence[x]	Σ	0..1		The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed
occurrenceDateTime			dateTime
occurrencePeriod			Period
recorded	Σ	0..1	dateTime	When the intake was recorded
reported[x]		0..1		Indicates if this is a reported rather than a primary record. Can also indicate the source that provided the information about the consumption
reportedBoolean			boolean
reportedReference			Reference(Patient \| RelatedPerson \| Practitioner \| PractitionerRole \| Organization \| Group)
nutritionItem	C	0..*	BackboneElement	The nutrition product intended for consumption and/or administration + Rule: If nutritionItem is present then SHALL have at least one of nutritionItem.type or nutritionItem.nutritionProduct[x]
type	Σ	0..1	CodeableConcept	The type of food (i.e. solid or liquid) product Binding: Food Type Codes (Example)
nutritionProduct	Σ	0..1	CodeableReference(NutritionProduct)	A product used for nutritional purposes (e.g. food or supplement) Binding: Types of Edible Substances (Preferred)
consumedItem		0..*	BackboneElement	What nutrition item was consumed
schedule		0..1	Timing	Scheduled frequency of consumption
amount	Σ	0..1	SimpleQuantity	Quantity of the specified food (i.e. solid and/or liquid)
rate[x]	Σ	0..1		Rate of enteral feeding administration
rateQuantity			Quantity
rateRatio			Ratio
totalIntake		0..*	BackboneElement	Nutrients and/or energy contained in the intake
nutrient		1..1	CodeableReference(Substance)	Type of nutrient consumed in the intake Binding: Nutrient Codes (Example)
amount		1..1	SimpleQuantity	Total amount of nutrient consumed
energy		0..1	SimpleQuantity	Total energy consumed in kilocalories or kilojoules
notConsumed		0..1	boolean	Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed
notConsumedReason		0..1	CodeableConcept	Reason the nutrition item was not consumed Binding: Reasons for why a food item was not consumed (Example)
performer		0..*	BackboneElement	Who performed the intake and how they were involved
function		0..1	CodeableConcept	Type of performer Binding: Procedure Performer Role Codes (Example)
actor		1..1	Reference(Practitioner \| PractitionerRole \| Organization \| CareTeam \| Patient \| Device \| RelatedPerson \| Group)	Who performed the intake
location		0..1	Reference(Location)	Where the intake occurred
derivedFrom		0..*	Reference(Any)	Additional supporting information
reason		0..*	CodeableReference(Condition \| Observation \| DiagnosticReport \| DocumentReference)	Reason for why the food (i.e. solid and/or liquid) is /was consumed Binding: Condition/Problem/Diagnosis Codes (Example)
note		0..*	Annotation	Further information about the consumption
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<NutritionIntake xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External identifier --></identifier>
 <instantiatesCanonical><!-- 0..* canonical(ActivityDefinition|
   ChargeItemDefinition|ClinicalUseDefinition|EventDefinition|Measure|
   MessageDefinition|ObservationDefinition|OperationDefinition|PlanDefinition|
   Questionnaire|Requirements|SubscriptionTopic|TestPlan|TestScript) Instantiates FHIR protocol or definition --></instantiatesCanonical>
 <instantiatesUri value="[uri]"/><!-- 0..* Instantiates external protocol or definition -->
 <basedOn><!-- 0..* Reference(CarePlan|NutritionOrder|ServiceRequest) Fulfils plan, proposal or order --></basedOn>
 <partOf><!-- 0..* Reference(NutritionIntake|Observation|Procedure) Part of referenced event --></partOf>
 <status value="[code]"/><!-- 1..1 preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown -->
 <statusReason><!-- 0..* CodeableConcept Reason for current status --></statusReason>
 <code><!-- 0..1 CodeableConcept Code representing an overall type of nutrition intake --></code>
 <subject><!-- 1..1 Reference(Group|Patient) Who is/was consuming the food (i.e. solid and/or liquid) --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter associated with NutritionIntake --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed --></occurrence[x]>
 <recorded value="[dateTime]"/><!-- 0..1 When the intake was recorded -->
 <reported[x]><!-- 0..1 boolean|Reference(Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) Indicates if this is a reported rather than a primary record.  Can also indicate the source that provided the information about the consumption --></reported[x]>
 <nutritionItem>  <!-- 0..* The nutrition product intended for consumption and/or administration -->
  <type><!-- 0..1 CodeableConcept The type of food (i.e. solid or liquid) product --></type>
  <nutritionProduct><!-- 0..1 CodeableReference(NutritionProduct) A product used for nutritional purposes (e.g. food or supplement) --></nutritionProduct>
  <consumedItem>  <!-- 0..* What nutrition item was consumed -->
   <schedule><!-- 0..1 Timing Scheduled frequency of consumption --></schedule>
   <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity of the specified food (i.e. solid and/or liquid)  --></amount>
   <rate[x]><!-- 0..1 Quantity|Ratio Rate of enteral feeding administration --></rate[x]>
   <totalIntake>  <!-- 0..* Nutrients and/or energy contained in the intake -->
    <nutrient><!-- 1..1 CodeableReference(Substance) Type of nutrient consumed in the intake --></nutrient>
    <amount><!-- 1..1 Quantity(SimpleQuantity) Total amount of nutrient consumed --></amount>
    <energy><!-- 0..1 Quantity(SimpleQuantity) Total energy consumed in kilocalories or kilojoules --></energy>
   </totalIntake>
  </consumedItem>
  <notConsumed value="[boolean]"/><!-- 0..1 Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed -->
  <notConsumedReason><!-- 0..1 CodeableConcept Reason the nutrition item was not consumed --></notConsumedReason>
 </nutritionItem>
 <performer>  <!-- 0..* Who performed the intake and how they were involved -->
  <function><!-- 0..1 CodeableConcept Type of performer --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) Who performed the intake --></actor>
 </performer>
 <location><!-- 0..1 Reference(Location) Where the intake occurred --></location>
 <derivedFrom><!-- 0..* Reference(Any) Additional supporting information --></derivedFrom>
 <reason><!-- 0..* CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) Reason for why the food (i.e. solid and/or liquid) is /was consumed --></reason>
 <note><!-- 0..* Annotation Further information about the consumption --></note>
</NutritionIntake>

JSON Template

{
  "resourceType" : "NutritionIntake",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External identifier
  "instantiatesCanonical" : ["<canonical(Definition)>"], // Instantiates FHIR protocol or definition
  "instantiatesUri" : ["<uri>"], // Instantiates external protocol or definition
  "basedOn" : [{ Reference(CarePlan|NutritionOrder|ServiceRequest) }], // Fulfils plan, proposal or order
  "partOf" : [{ Reference(NutritionIntake|Observation|Procedure) }], // Part of referenced event
  "status" : "<code>", // R!  preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
  "statusReason" : [{ CodeableConcept }], // Reason for current status
  "code" : { CodeableConcept }, // Code representing an overall type of nutrition intake
  "subject" : { Reference(Group|Patient) }, // R!  Who is/was consuming the food (i.e. solid and/or liquid)
  "encounter" : { Reference(Encounter) }, // Encounter associated with NutritionIntake
  // occurrence[x]: The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed. One of these 2:
  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "recorded" : "<dateTime>", // When the intake was recorded
  // reported[x]: 
     Indicates if this is a reported rather than a primary record.  Can also indicate the source that provided the information about the consumption. One of these 2:
  "reportedBoolean" : <boolean>,
  "reportedReference" : { Reference(Group|Organization|Patient|Practitioner|
   PractitionerRole|RelatedPerson) },
  "nutritionItem" : [{ // The nutrition product intended for consumption and/or administration
    "type" : { CodeableConcept }, // The type of food (i.e. solid or liquid) product
    "nutritionProduct" : { CodeableReference(NutritionProduct) }, // A product used for nutritional purposes (e.g. food or supplement)
    "consumedItem" : [{ // What nutrition item was consumed
      "schedule" : { Timing }, // Scheduled frequency of consumption
      "amount" : { Quantity(SimpleQuantity) }, // Quantity of the specified food (i.e. solid and/or liquid) 
      // rate[x]: Rate of enteral feeding administration. One of these 2:
      "rateQuantity" : { Quantity },
      "rateRatio" : { Ratio },
      "totalIntake" : [{ // Nutrients and/or energy contained in the intake
        "nutrient" : { CodeableReference(Substance) }, // R!  Type of nutrient consumed in the intake
        "amount" : { Quantity(SimpleQuantity) }, // R!  Total amount of nutrient consumed
        "energy" : { Quantity(SimpleQuantity) } // Total energy consumed in kilocalories or kilojoules
      }]
    }],
    "notConsumed" : <boolean>, // Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed
    "notConsumedReason" : { CodeableConcept } // Reason the nutrition item was not consumed
  }],
  "performer" : [{ // Who performed the intake and how they were involved
    "function" : { CodeableConcept }, // Type of performer
    "actor" : { Reference(CareTeam|Device|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) } // R!  Who performed the intake
  }],
  "location" : { Reference(Location) }, // Where the intake occurred
  "derivedFrom" : [{ Reference(Any) }], // Additional supporting information
  "reason" : [{ CodeableReference(Condition|DiagnosticReport|DocumentReference|
   Observation) }], // Reason for why the food (i.e. solid and/or liquid) is /was consumed
  "note" : [{ Annotation }] // Further information about the consumption
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:NutritionIntake;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External identifier
  fhir:instantiatesCanonical  ( [ canonical(ActivityDefinition|ChargeItemDefinition|ClinicalUseDefinition|EventDefinition|
  Measure|MessageDefinition|ObservationDefinition|OperationDefinition|
  PlanDefinition|Questionnaire|Requirements|SubscriptionTopic|TestPlan|
  TestScript) ] ... ) ; # 0..* Instantiates FHIR protocol or definition
  fhir:instantiatesUri  ( [ uri ] ... ) ; # 0..* Instantiates external protocol or definition
  fhir:basedOn  ( [ Reference(CarePlan|NutritionOrder|ServiceRequest) ] ... ) ; # 0..* Fulfils plan, proposal or order
  fhir:partOf  ( [ Reference(NutritionIntake|Observation|Procedure) ] ... ) ; # 0..* Part of referenced event
  fhir:status [ code ] ; # 1..1 preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for current status
  fhir:code [ CodeableConcept ] ; # 0..1 Code representing an overall type of nutrition intake
  fhir:subject [ Reference(Group|Patient) ] ; # 1..1 Who is/was consuming the food (i.e. solid and/or liquid)
  fhir:encounter [ Reference(Encounter) ] ; # 0..1 Encounter associated with NutritionIntake
  # occurrence[x] : 0..1 The date/time or interval when the food (i.e. solid and/or liquid) is/was consumed. One of these 2
    fhir:occurrence [  a fhir:dateTime ; dateTime ]
    fhir:occurrence [  a fhir:Period ; Period ]
  fhir:recorded [ dateTime ] ; # 0..1 When the intake was recorded
  # reported[x] : 0..1 Indicates if this is a reported rather than a primary record.  Can also indicate the source that provided the information about the consumption. One of these 2
    fhir:reported [  a fhir:boolean ; boolean ]
    fhir:reported [  a fhir:Reference ; Reference(Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]
  fhir:nutritionItem ( [ # 0..* The nutrition product intended for consumption and/or administration
    fhir:type [ CodeableConcept ] ; # 0..1 The type of food (i.e. solid or liquid) product
    fhir:nutritionProduct [ CodeableReference(NutritionProduct) ] ; # 0..1 A product used for nutritional purposes (e.g. food or supplement)
    fhir:consumedItem ( [ # 0..* What nutrition item was consumed
      fhir:schedule [ Timing ] ; # 0..1 Scheduled frequency of consumption
      fhir:amount [ Quantity(SimpleQuantity) ] ; # 0..1 Quantity of the specified food (i.e. solid and/or liquid) 
      # rate[x] : 0..1 Rate of enteral feeding administration. One of these 2
        fhir:rate [  a fhir:Quantity ; Quantity ]
        fhir:rate [  a fhir:Ratio ; Ratio ]
      fhir:totalIntake ( [ # 0..* Nutrients and/or energy contained in the intake
        fhir:nutrient [ CodeableReference(Substance) ] ; # 1..1 Type of nutrient consumed in the intake
        fhir:amount [ Quantity(SimpleQuantity) ] ; # 1..1 Total amount of nutrient consumed
        fhir:energy [ Quantity(SimpleQuantity) ] ; # 0..1 Total energy consumed in kilocalories or kilojoules
      ] ... ) ;
    ] ... ) ;
    fhir:notConsumed [ boolean ] ; # 0..1 Flag to indicate if the food (i.e. solid and/or liquid) was refused or otherwise not consumed
    fhir:notConsumedReason [ CodeableConcept ] ; # 0..1 Reason the nutrition item was not consumed
  ] ... ) ;
  fhir:performer ( [ # 0..* Who performed the intake and how they were involved
    fhir:function [ CodeableConcept ] ; # 0..1 Type of performer
    fhir:actor [ Reference(CareTeam|Device|Group|Organization|Patient|Practitioner|PractitionerRole|
  RelatedPerson) ] ; # 1..1 Who performed the intake
  ] ... ) ;
  fhir:location [ Reference(Location) ] ; # 0..1 Where the intake occurred
  fhir:derivedFrom  ( [ Reference(Any) ] ... ) ; # 0..* Additional supporting information
  fhir:reason  ( [ CodeableReference(Condition|DiagnosticReport|DocumentReference|Observation) ] ... ) ; # 0..* Reason for why the food (i.e. solid and/or liquid) is /was consumed
  fhir:note  ( [ Annotation ] ... ) ; # 0..* Further information about the consumption
]

Changes from both R4 and R4B

This resource did not exist in Release R4

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

12.20.5.1 Terminology Bindings

Path	ValueSet	Type	Documentation
NutritionIntake.status	EventStatus	Required	Codes identifying the lifecycle stage of an event.
NutritionIntake.statusReason	ClinicalImpressionStatusReason	Example	Example codes indicating the reason why a ClinicalImpression is on hold or stopped. Note that these are in no way complete and might not even be appropriate for some uses.
NutritionIntake.code	DietCodes	Preferred	Codes that can be used to indicate the type of food being ordered for a patient. It includes codes from SNOMED CT where concept is Dietary Regime (182922004) and its sub-concepts, Enteral Feeding (229912004) and its sub-concepts, Mixed Breast Milk and Bottle Feeding (35011000087100), Breast Milk Feeding (1297276008), Bottle Feeding of Patient (40043006).
NutritionIntake.nutritionItem.type	FoodTypeCodes	Example	This value set represents codes for types of foods and is provided as a suggestive example. It include codes from SNOMED CT where concept is-a 255620007 (Foods (substance)).
NutritionIntake.nutritionItem.nutritionProduct	TypesOfEdibleSubstances	Preferred	This value set represents codes for types of edible substances. It include codes from SNOMED CT where concept 762766007 Edible Substance (substance) and its sub-concepts, Infant Formula (412413001) and its sub-concepts, Enteral and Supplement Feeds (346415002) and its sub-concepts, Water (11713004), Potable Water (890302005) and its sub-concepts, and Tap Water (444923006).
NutritionIntake.nutritionItem.consumedItem.totalIntake.nutrient	NutrientCodes	Example	NutrientModifier : Codes for types of nutrients that are being modified such as carbohydrate or sodium. This value set includes codes from SNOMED CT where concept is-a 226355009 (Nutrients(substance)), and the concepts for Sodium, Potassium and Fluid. This is provided as a suggestive example.
NutritionIntake.nutritionItem.notConsumedReason	ReasonsFoodItemNotConsumed	Example	This value set represents codes for types of edible substances and is provided as a suggestive example. It include codes from SNOMED CT where concept is-a 762766007 Edible Substance (substance).
NutritionIntake.performer.function	ProcedurePerformerRoleCodes	Example	This example value set defines the set of codes that can be used to indicate a role of a procedure performer.
NutritionIntake.reason	ConditionProblemDiagnosisCodes	Example	Example value set for Condition/Problem/Diagnosis codes.

Path

ValueSet

Type

Documentation

NutritionIntake.status

EventStatus

Required

Codes identifying the lifecycle stage of an event.

NutritionIntake.statusReason

ClinicalImpressionStatusReason

Example

Example codes indicating the reason why a ClinicalImpression is on hold or stopped. Note that these are in no way complete and might not even be appropriate for some uses.

NutritionIntake.code

DietCodes

Preferred

Codes that can be used to indicate the type of food being ordered for a patient. It includes codes from SNOMED CT icon where concept is Dietary Regime (182922004) and its sub-concepts, Enteral Feeding (229912004) and its sub-concepts, Mixed Breast Milk and Bottle Feeding (35011000087100), Breast Milk Feeding (1297276008), Bottle Feeding of Patient (40043006).

NutritionIntake.nutritionItem.type

FoodTypeCodes

Example

This value set represents codes for types of foods and is provided as a suggestive example. It include codes from SNOMED CT icon where concept is-a 255620007 (Foods (substance)).

NutritionIntake.nutritionItem.nutritionProduct

TypesOfEdibleSubstances

Preferred

This value set represents codes for types of edible substances. It include codes from SNOMED CT icon where concept 762766007 Edible Substance (substance) and its sub-concepts, Infant Formula (412413001) and its sub-concepts, Enteral and Supplement Feeds (346415002) and its sub-concepts, Water (11713004), Potable Water (890302005) and its sub-concepts, and Tap Water (444923006).

NutritionIntake.nutritionItem.consumedItem.totalIntake.nutrient

NutrientCodes

Example

NutrientModifier : Codes for types of nutrients that are being modified such as carbohydrate or sodium. This value set includes codes from SNOMED CT icon where concept is-a 226355009 (Nutrients(substance)), and the concepts for Sodium, Potassium and Fluid. This is provided as a suggestive example.

NutritionIntake.nutritionItem.notConsumedReason

ReasonsFoodItemNotConsumed

Example

This value set represents codes for types of edible substances and is provided as a suggestive example. It include codes from SNOMED CT icon where concept is-a 762766007 Edible Substance (substance).

NutritionIntake.performer.function

ProcedurePerformerRoleCodes

Example

This example value set defines the set of codes that can be used to indicate a role of a procedure performer.

NutritionIntake.reason

ConditionProblemDiagnosisCodes

Example

Example value set for Condition/Problem/Diagnosis codes.

12.20.5.2 Constraints

UniqueKey

Level

Location

Description

Expression

nin-1

Rule

NutritionIntake.nutritionItem

If nutritionItem is present then SHALL have at least one of nutritionItem.type or nutritionItem.nutritionProduct[x]

(type.exists() or nutritionProduct.exists())

12.20.6 Notes:

12.20.7 Search Parameters

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
code	token	Returns statements of this code of NutritionIntake	NutritionIntake.code	21 Resources
date	date	Date when patient was taking (or not taking) the medication	NutritionIntake.occurrence.ofType(dateTime) \| NutritionIntake.occurrence.ofType(Period)	26 Resources
encounter	reference	Returns statements for a specific encounter	NutritionIntake.encounter (Encounter)	29 Resources
identifier	token	Return statements with this external identifier	NutritionIntake.identifier	65 Resources
nutrition	token	Return intakes for a specific consumed item	NutritionIntake.nutritionItem.nutritionProduct.concept
patient	reference	Returns statements for a specific patient.	NutritionIntake.subject.where(resolve() is Patient) (Patient)	65 Resources
source	reference	Who or where the information in the statement came from	(NutritionIntake.reported as Reference) (Practitioner, Group, Organization, Patient, PractitionerRole, RelatedPerson)
status	token	Return statements that match the given status	NutritionIntake.status
subject	reference	The identity of a patient, animal or group to list statements for	NutritionIntake.subject (Group, Patient)