HL7 Nutrition Orders Domain Analysis Model – R2 Food & Medication Preferences HL7 May 2013 Ballot (See links on Nutrition Management page on the HL7 wiki)

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

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

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

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