Generated Narrative: StructureDefinition profile-NutritionOrder Name Flags Card. Type Description & Constraints NutritionOrder 0..* NutritionOrder(4.0.1) Diet, formula or nutritional supplement request #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:basedOn 0..* Reference(Cross-version Profile for R5.CarePlan for use in FHIR R4(0.1.0) | CarePlan | Cross-version Profile for R5.NutritionOrder for use in FHIR R4(0.1.0) | NutritionOrder | Cross-version Profile for R5.ServiceRequest for use in FHIR R4(0.1.0) | ServiceRequest) R5: What this order fulfills (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.basedOn #xD; extension:groupIdentifier 0..1 Identifier R5: Composite Request ID (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.groupIdentifier #xD; extension:priority 0..1 code R5: routine | urgent | asap | stat (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.priority Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request. #xD; extension:supportingInformation 0..* Reference(Cross-version Profile for R5.Resource for use in FHIR R4(0.1.0) | Resource) R5: Information to support fulfilling of the nutrition order (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.supportingInformation #xD; extension:performer 0..* (Complex) R5: Who is desired to perform the administration of what is being ordered (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.performer #xD; extension:outsideFoodAllowed 0..1 boolean R5: Capture when a food item is brought in by the patient and/or family (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.outsideFoodAllowed #xD; patient #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:subject 0..1 Reference(Resource) R5: Who requires the diet, formula or nutritional supplement additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference #xD; oralDiet #xD; schedule #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:timing 0..* Timing R5: Scheduled frequency of diet (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.oralDiet.schedule.timing #xD; extension:asNeeded 0..1 boolean R5: Take 'as needed' (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.oralDiet.schedule.asNeeded #xD; extension:asNeededFor 0..1 CodeableConcept R5: Take 'as needed' for x (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.oralDiet.schedule.asNeededFor #xD; supplement #xD; type #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:type 0..1 Reference(Cross-version Profile for R5.NutritionProduct for use in FHIR R4(0.1.0) | Basic) R5: type additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.supplement.type #xD; schedule #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:timing 0..* Timing R5: Scheduled frequency of diet (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.supplement.schedule.timing #xD; extension:asNeeded 0..1 boolean R5: Take 'as needed' (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.supplement.schedule.asNeeded #xD; extension:asNeededFor 0..1 CodeableConcept R5: Take 'as needed' for x (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.supplement.schedule.asNeededFor #xD; enteralFormula #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:deliveryDevice 0..* (Complex) R5: Intended type of device for the administration (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.enteralFormula.deliveryDevice #xD; extension:quantity 0..1 SimpleQuantity(4.0.1) R5: Amount of additive to be given or mixed in (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.enteralFormula.additive.quantity #xD; baseFormulaType #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:baseFormulaType 0..1 Reference(Cross-version Profile for R5.NutritionProduct for use in FHIR R4(0.1.0) | Basic) R5: baseFormulaType additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.enteralFormula.baseFormulaType #xD; additiveType #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:type 0..1 Reference(Cross-version Profile for R5.NutritionProduct for use in FHIR R4(0.1.0) | Basic) R5: type additional types URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.enteralFormula.additive.type #xD; administration #xD; schedule #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:timing 0..* Timing R5: Scheduled frequency of enteral formula (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.enteralFormula.administration.schedule.timing #xD; extension:asNeeded 0..1 boolean R5: Take 'as needed' (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.enteralFormula.administration.schedule.asNeeded #xD; extension:asNeededFor 0..1 CodeableConcept R5: Take 'as needed' for x (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-NutritionOrder.enteralFormula.administration.schedule.asNeededFor #xD; Documentation for this format
Cross-version Profile for R5.NutritionOrder for use in FHIR R4
This cross-version profile allows R5 NutritionOrder content to be represented via FHIR R4 NutritionOrder resources.
Diet, formula or nutritional supplement request
A request to supply a diet, formula feeding (enteral) or oral nutritional supplement to a patient/resident.
Referenced by an Order Request (workflow).
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class
oralDiet.exists() or supplement.exists() or enteralFormula.exists()
exists(f:oralDiet) or exists(f:supplement) or exists(f:enteralFormula)
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
R5: `NutritionOrder.basedOn` (new:Reference(CarePlan,NutritionOrder,ServiceRequest))
Element `NutritionOrder.basedOn` has a context of NutritionOrder based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.basedOn` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
R5: `NutritionOrder.groupIdentifier` (new:Identifier)
Element `NutritionOrder.groupIdentifier` has a context of NutritionOrder based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.groupIdentifier` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: routine | urgent | asap | stat (new)
R5: `NutritionOrder.priority` (new:code)
Element `NutritionOrder.priority` has a context of NutritionOrder based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.priority` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: Information to support fulfilling of the nutrition order (new)
R5: `NutritionOrder.supportingInformation` (new:Reference(Resource))
Element `NutritionOrder.supportingInformation` has a context of NutritionOrder based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.supportingInformation` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: Who is desired to perform the administration of what is being ordered (new)
R5: `NutritionOrder.performer` (new:CodeableReference(CareTeam,Practitioner,PractitionerRole,RelatedPerson,Patient,Organization))
Element `NutritionOrder.performer` has a context of NutritionOrder based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.performer` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: Capture when a food item is brought in by the patient and/or family (new)
R5: `NutritionOrder.outsideFoodAllowed` (new:boolean)
Element `NutritionOrder.outsideFoodAllowed` has a context of NutritionOrder based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.outsideFoodAllowed` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Identifiers assigned to this order by the order sender or by the order receiver.
The Identifier.type element can be to indicate filler vs. placer if needed. This is explained in further detail [here](http://hl7.org/fhir/R4/servicerequest.html#notes).
Instantiates FHIR protocol or definition
The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.
Note: This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
Instantiates external protocol or definition
The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.
This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.
The URL pointing to a protocol, guideline, orderset or other definition that is adhered to in whole or in part by this NutritionOrder.
draft | active | on-hold | revoked | completed | entered-in-error | unknown
The workflow status of the nutrition order/request.
Typically the system placing the order sets the status to "requested". Thereafter, the order is maintained by the receiver that updates the status as the request is handled. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Codes identifying the lifecycle stage of the nutrition order.
proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Indicates the level of authority/intentionality associated with the NutrionOrder and where the request fits into the workflow chain.
When resources map to this element, they are free to define as many codes as necessary to cover their space and will map to "proposal, plan or order". Can have multiple codes that map to one of these. E.g. "original order", "encoded order", "reflex order" would all map to "order". Expectation is that the set of codes is mutually exclusive or a strict all-encompassing hierarchy.
Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain.
This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
Codes indicating the degree of authority/intentionality associated with a nutrition order.
.moodCode (nuances beyond PRP/PLAN/RQO would need to be elsewhere)
The person who requires the diet, formula or nutritional supplement
The person (patient) who needs the nutrition order for an oral diet, nutritional supplement and/or enteral or formula feeding.
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
R5: Who requires the diet, formula or nutritional supplement additional types
R5: `NutritionOrder.subject` additional types from child elements (display, identifier, reference, type)
Element `NutritionOrder.subject` is mapped to FHIR R4 element `NutritionOrder.patient` as `SourceIsBroaderThanTarget`. The mappings for `NutritionOrder.subject` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `NutritionOrder.subject` with unmapped reference targets: Group.
Literal reference, Relative, internal or absolute URL
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
The encounter associated with this nutrition order
An encounter that provides additional information about the healthcare context in which this request is made.
.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
Date and time the nutrition order was requested
The date and time that this nutrition order was requested.
Who ordered the diet, formula or nutritional supplement
The practitioner that holds legal responsibility for ordering the diet, nutritional supplement, or formula feedings.
List of the patient's food and nutrition-related allergies and intolerances
A link to a record of allergies or intolerances which should be included in the nutrition order.
Information on a patient's food allergies and intolerances to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.
.outboundRelationship[typeCode=RSON].target[classCode=OBS, moodCode=EVN]
Order-specific modifier about the type of food that should be given
This modifier is used to convey order-specific modifiers about the type of food that should be given. These can be derived from patient allergies, intolerances, or preferences such as Halal, Vegan or Kosher. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.
Information on a patient's food preferences that inform healthcare personnel about the food that the patient should receive or consume.
Medical, cultural or ethical food preferences to help with catering requirements.
.outboundRelationship [typeCode =COMP], target [classCode=PROC, moodCode=EVN, code=NutritionModificationType]
Order-specific modifier about the type of food that should not be given
This modifier is used to convey Order-specific modifier about the type of oral food or oral fluids that should not be given. These can be derived from patient allergies, intolerances, or preferences such as No Red Meat, No Soy or No Wheat or Gluten-Free. While it should not be necessary to repeat allergy or intolerance information captured in the referenced AllergyIntolerance resource in the excludeFoodModifier, this element may be used to convey additional specificity related to foods that should be eliminated from the patient’s diet for any reason. This modifier applies to the entire nutrition order inclusive of the oral diet, nutritional supplements and enteral formula feedings.
Information on a patient's food allergies, intolerances and preferences to inform healthcare personnel about the type of foods that the patient shouldn't receive or consume.
Codes used to indicate the type of food that should NOT be given to the patient.
Diet given orally in contrast to enteral (tube) feeding.
oralDiet .outboundRelationship [typeCode =COMP], target [classCode=SPLY, moodCode=RQO, code=OralDietSupplyType]
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Type of oral diet or diet restrictions that describe what can be consumed orally
The kind of diet or dietary restriction such as fiber restricted diet or diabetic diet.
Codes used to indicate the type of diet being ordered for a patient.
The time period and frequency at which the diet should be given. The diet should be given for the combination of all schedules if more than one schedule is present.
R5: `NutritionOrder.oralDiet.schedule.timing` (new:Timing)
Element `NutritionOrder.oralDiet.schedule.timing` has a context of NutritionOrder.oralDiet.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.oralDiet.schedule.timing` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: `NutritionOrder.oralDiet.schedule.asNeeded` (new:boolean)
Element `NutritionOrder.oralDiet.schedule.asNeeded` has a context of NutritionOrder.oralDiet.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.oralDiet.schedule.asNeeded` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: `NutritionOrder.oralDiet.schedule.asNeededFor` (new:CodeableConcept)
Element `NutritionOrder.oralDiet.schedule.asNeededFor` has a context of NutritionOrder.oralDiet.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.oralDiet.schedule.asNeededFor` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
Identifies specific times when the event occurs.
In a Medication Administration Record, for instance, you need to take a general specification, and turn it into a precise specification.
A set of rules that describe when the event is scheduled.
Many timing schedules are determined by regular repetitions.
if there's a duration, there needs to be duration units
duration.empty() or durationUnit.exists()
not(exists(f:duration)) or exists(f:durationUnit)
if there's a period, there needs to be period units
not(exists(f:period)) or exists(f:periodUnit)
f:duration/@value >= 0 or not(f:duration/@value)
f:period/@value >= 0 or not(f:period/@value)
If there's a periodMax, there must be a period
not(exists(f:periodMax)) or exists(f:period)
If there's a durationMax, there must be a duration
durationMax.empty() or duration.exists()
not(exists(f:durationMax)) or exists(f:duration)
If there's a countMax, there must be a count
not(exists(f:countMax)) or exists(f:count)
If there's an offset, there must be a when (and not C, CM, CD, CV)
offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))
If there's a timeOfDay, there cannot be a when, or vice versa
not(exists(f:timeOfDay)) or not(exists(f:when))
Length/Range of lengths, or (Start and/or end) limits
Either a duration for the length of the timing schedule, a range of possible length, or outer bounds for start and/or end limits of the timing schedule.
A total count of the desired number of repetitions across the duration of the entire timing specification. If countMax is present, this element indicates the lower bound of the allowed range of count values.
If you have both bounds and count, then this should be understood as within the bounds period, until count times happens.
Repetitions may be limited by end time or total occurrences.
If present, indicates that the count is a range - so to perform the action between [count] and [countMax] times.
How long this thing happens for when it happens. If durationMax is present, this element indicates the lower bound of the allowed range of the duration.
For some events the duration is part of the definition of the event (e.g. IV infusions, where the duration is implicit in the specified quantity and rate). For others, it's part of the timing specification (e.g. exercise).
Some activities are not instantaneous and need to be maintained for a period of time.
If present, indicates that the duration is a range - so to perform the action between [duration] and [durationMax] time length.
s | min | h | d | wk | mo | a - unit of time (UCUM)
The units of time for the duration, in UCUM units.
The number of times to repeat the action within the specified period. If frequencyMax is present, this element indicates the lower bound of the allowed range of the frequency.
If no frequency is stated, the assumption is that the event occurs once per period, but systems SHOULD always be specific about this
Event occurs up to frequencyMax times per period
If present, indicates that the frequency is a range - so to repeat between [frequency] and [frequencyMax] times within the period or period range.
Indicates the duration of time over which repetitions are to occur; e.g. to express "3 times per day", 3 would be the frequency and "1 day" would be the period. If periodMax is present, this element indicates the lower bound of the allowed range of the period length.
If present, indicates that the period is a range from [period] to [periodMax], allowing expressing concepts such as "do this once every 3-5 days.
The units of time for the period in UCUM units.
If one or more days of week is provided, then the action happens only on the specified day(s).
If no days are specified, the action is assumed to happen every day as otherwise specified. The elements frequency and period cannot be used as well as dayOfWeek.
Specified time of day for action to take place.
When time of day is specified, it is inferred that the action happens every day (as filtered by dayofWeek) on the specified times. The elements when, frequency and period cannot be used as well as timeOfDay.
An approximate time period during the day, potentially linked to an event of daily living that indicates when the action should occur.
When more than one event is listed, the event is tied to the union of the specified events.
Timings are frequently determined by occurrences such as waking, eating and sleep.
Real world event relating to the schedule.
The number of minutes from the event. If the event code does not indicate whether the minutes is before or after the event, then the offset is assumed to be after the event.
BID | TID | QID | AM | PM | QD | QOD | +
A code for the timing schedule (or just text in code.text). Some codes such as BID are ubiquitous, but many institutions define their own additional codes. If a code is provided, the code is understood to be a complete statement of whatever is specified in the structured timing data, and either the code or the data may be used to interpret the Timing, with the exception that .repeat.bounds still applies over the code (and is not contained in the code).
BID etc. are defined as 'at institutionally specified times'. For example, an institution may choose that BID is "always at 7am and 6pm". If it is inappropriate for this choice to be made, the code BID should not be used. Instead, a distinct organization-specific code should be used in place of the HL7-defined BID code and/or a structured representation should be used (in this case, specifying the two event times).
Code for a known / defined timing pattern.
Class that defines the quantity and type of nutrient modifications (for example carbohydrate, fiber or sodium) required for the oral diet.
.participation[typeCode=PRD].role[classCode=MANU], manufacturedFoodKind
The nutrient that is being modified such as carbohydrate or sodium.
Codes for types of nutrients that are being modified such as carbohydrate or sodium.
The quantity of the specified nutrient to include in diet.
Class that describes any texture modifications required for the patient to safely consume various types of solid foods.
.inboundRelationship [typeCode =COMP], target [classCode=PROC, moodCode=EVN, code=DietTextureModificationType]
Code to indicate how to alter the texture of the foods, e.g. pureed
Any texture modifications (for solid foods) that should be made, e.g. easy to chew, chopped, ground, and pureed.
Codes for food consistency types or texture modifications to apply to foods.
Concepts that are used to identify an entity that is ingested for nutritional purposes
The food type(s) (e.g. meats, all foods) that the texture modification applies to. This could be all foods types.
Coupled with the `texture.modifier`; could be (All Foods).
Codes for types of foods that are texture-modified.
.participation[typeCode=PRD].role[classCode=MANU], manufacturedFoodKind; .code
The required consistency of fluids and liquids provided to the patient
The required consistency (e.g. honey-thick, nectar-thick, thin, thickened.) of liquids or fluids served to the patient.
Codes used to represent the consistency of fluids and liquids provided to the patient.
.code (Not differentiated from dietTextureModificationType in HL7 v3)
Instructions or additional information about the oral diet
Free text or additional instructions or information pertaining to the oral diet.
Free text dosage instructions can be used for cases where the instructions are too complex to code.
Oral nutritional products given in order to add further nutritional value to the patient's diet.
.outboundRelationship [typeCode =COMP], target [classCode=SPLY, moodCode=RQO, code=SUPPLEMENT]
The kind of nutritional supplement product required such as a high protein or pediatric clear liquid supplement.
Codes for nutritional supplements to be provided to the patient.
.participation[typeCode=PRD].role[classCode=MANU], manufacturedFoodKind; .code (NutritionalSupplementType)
R5: `NutritionOrder.supplement.type` additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/NutritionProduct)) additional types from child elements (reference)
Element `NutritionOrder.supplement.type` is mapped to FHIR R4 element `NutritionOrder.supplement.type` as `SourceIsBroaderThanTarget`. The mappings for `NutritionOrder.supplement.type` do not cover the following types: CodeableReference. The mappings for `NutritionOrder.supplement.type` do not cover the following types based on type expansion: reference.
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
Product or brand name of the nutritional supplement
The product or brand name of the nutritional supplement such as "Acme Protein Shake".
The time period and frequency at which the supplement(s) should be given. The supplement should be given for the combination of all schedules if more than one schedule is present.
R5: `NutritionOrder.supplement.schedule.timing` (new:Timing)
Element `NutritionOrder.supplement.schedule.timing` has a context of NutritionOrder.supplement.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.supplement.schedule.timing` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: `NutritionOrder.supplement.schedule.asNeeded` (new:boolean)
Element `NutritionOrder.supplement.schedule.asNeeded` has a context of NutritionOrder.supplement.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.supplement.schedule.asNeeded` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: `NutritionOrder.supplement.schedule.asNeededFor` (new:CodeableConcept)
Element `NutritionOrder.supplement.schedule.asNeededFor` has a context of NutritionOrder.supplement.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.supplement.schedule.asNeededFor` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
The amount of the nutritional supplement to be given.
Instructions or additional information about the oral supplement
Free text or additional instructions or information pertaining to the oral supplement.
Feeding provided through the gastrointestinal tract via a tube, catheter, or stoma that delivers nutrition distal to the oral cavity.
.outboundRelationship [typeCode =COMP], target [classCode=SPLY, moodCode=RQO, code=FORMULA]
R5: Intended type of device for the administration (new)
R5: `NutritionOrder.enteralFormula.deliveryDevice` (new:CodeableReference(DeviceDefinition))
Element `NutritionOrder.enteralFormula.deliveryDevice` has a context of NutritionOrder.enteralFormula based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.enteralFormula.deliveryDevice` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: Amount of additive to be given or mixed in (new)
R5: `NutritionOrder.enteralFormula.additive.quantity` (new:Quantity[SimpleQuantity])
Element `NutritionOrder.enteralFormula.additive.quantity` has a context of NutritionOrder.enteralFormula based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.enteralFormula.additive.quantity` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
The type of enteral or infant formula such as an adult standard formula with fiber or a soy-based infant formula.
Codes for type of enteral formula to be administered to patient.
.participation[typeCode=PRD].role[classCode=MANU], manufacturedFoodKind; .code (NutritionalFormulaType)
R5: `NutritionOrder.enteralFormula.baseFormulaType` additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/NutritionProduct)) additional types from child elements (reference)
Element `NutritionOrder.enteralFormula.baseFormulaType` is mapped to FHIR R4 element `NutritionOrder.enteralFormula.baseFormulaType` as `SourceIsBroaderThanTarget`. The mappings for `NutritionOrder.enteralFormula.baseFormulaType` do not cover the following types: CodeableReference. The mappings for `NutritionOrder.enteralFormula.baseFormulaType` do not cover the following types based on type expansion: reference.
Product or brand name of the enteral or infant formula
The product or brand name of the enteral or infant formula product such as "ACME Adult Standard Formula".
Type of modular component to add to the feeding
Indicates the type of modular component such as protein, carbohydrate, fat or fiber to be provided in addition to or mixed with the base formula.
Codes for the type of modular component such as protein, carbohydrate or fiber to be provided in addition to or mixed with the base formula.
N/A (not differentiated from NutritionalFormulaType in HL7 v3)
R5: `NutritionOrder.enteralFormula.additive.type` additional types (CodeableReference(http://hl7.org/fhir/StructureDefinition/NutritionProduct)) additional types from child elements (reference)
Element `NutritionOrder.enteralFormula.additive.type` is mapped to FHIR R4 element `NutritionOrder.enteralFormula.additiveType` as `SourceIsBroaderThanTarget`. The mappings for `NutritionOrder.enteralFormula.additive.type` do not cover the following types: CodeableReference. The mappings for `NutritionOrder.enteralFormula.additive.type` do not cover the following types based on type expansion: reference.
Product or brand name of the modular additive
The product or brand name of the type of modular component to be added to the formula.
Amount of energy per specified volume that is required
The amount of energy (calories) that the formula should provide per specified volume, typically per mL or fluid oz. For example, an infant may require a formula that provides 24 calories per fluid ounce or an adult may require an enteral formula that provides 1.5 calorie/mL.
How the formula should enter the patient's gastrointestinal tract
The route or physiological path of administration into the patient's gastrointestinal tract for purposes of providing the formula feeding, e.g. nasogastric tube.
Codes specifying the route of administration of enteral formula.
Formula feeding instruction as structured data
Formula administration instructions as structured data. This repeating structure allows for changing the administration rate or volume over time for both bolus and continuous feeding. An example of this would be an instruction to increase the rate of continuous feeding every 2 hours.
See implementation notes below for further discussion on how to order continuous vs bolus enteral feeding using this resource.
.outboundRelationship [typeCode =COMP], target [classCode=SBADM, moodCode=RQO]
The time period and frequency at which the enteral formula should be delivered to the patient.
R5: Scheduled frequency of enteral formula (new)
R5: `NutritionOrder.enteralFormula.administration.schedule.timing` (new:Timing)
Element `NutritionOrder.enteralFormula.administration.schedule.timing` has a context of NutritionOrder.enteralFormula.administration.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.enteralFormula.administration.schedule.timing` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: `NutritionOrder.enteralFormula.administration.schedule.asNeeded` (new:boolean)
Element `NutritionOrder.enteralFormula.administration.schedule.asNeeded` has a context of NutritionOrder.enteralFormula.administration.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.enteralFormula.administration.schedule.asNeeded` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
R5: `NutritionOrder.enteralFormula.administration.schedule.asNeededFor` (new:CodeableConcept)
Element `NutritionOrder.enteralFormula.administration.schedule.asNeededFor` has a context of NutritionOrder.enteralFormula.administration.schedule based on following the parent source element upwards and mapping to `NutritionOrder`. Element `NutritionOrder.enteralFormula.administration.schedule.asNeededFor` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
The volume of formula to provide to the patient per the specified administration schedule.
Speed with which the formula is provided per period of time
The rate of administration of formula via a feeding pump, e.g. 60 mL per hour, according to the specified schedule.
Ratio is used when the quantity value in the denominator is not "1", otherwise use Quantity. For example, the Ratio datatype is used for "200 mL/4 hrs" versus the Quantity datatype for "50 mL/hr".
Upper limit on formula volume per unit of time
The maximum total quantity of formula that may be administered to a subject over the period of time, e.g. 1440 mL over 24 hours.
Formula feeding instructions expressed as text
Free text formula administration, feeding instructions or additional instructions or information.
Comments made about the {{title}} by the requester, performer, subject or other participants.
This element SHALL NOT be used to supply free text instructions for the diet which are represented in the `.oralDiet.instruction`, `supplement.instruction`, or `enteralFormula.administrationInstruction` elements.