HL7 FHIR and NCPT

Resources and Terminology Bindings

The Nutrition Care Process Terminology (NCPT) can be effectively represented using HL7 FHIR (Health Level 7 Fast Healthcare Interoperability Resources), a standardized framework for healthcare data exchange that ensures consistent and interoperable documentation across various healthcare systems. Notably, standardized documentation of nutrition care using SNOMED CT is a crucial preliminary step, as structured data is more readily exchanged with the HL7 FHIR standard.

The key components of the NCPT; Assessment, Diagnosis, Intervention, and Monitoring and Evaluation map to specific FHIR resources as follows:

• Nutrition Assessment: The Observation, NotritionOrder, NutritionProduct, NutritionIntake, and Condition resources capture dietary habits, anthropometric measurements, and test results, offering a comprehensive view of the patient’s nutritional status.
• Nutrition Diagnosis: The Condition resource represents nutrition diagnoses, including specific problems, etiologies, and related signs and symptoms.
• Nutrition Intervention: The NutritionOrder, NutritionProduct, Procedure, and CarePlan resources document detailed nutrition care plans, specific interventions, and strategies for managing nutrition-related issues.
• Nutrition Monitoring and Evaluation: The Observation, Goal, Condition, and CarePlan resources are used to track ongoing measurements, monitor progress toward goals, update condition statuses, and review and adjust care plans as needed.

In the context of HL7 FHIR and SNOMED CT, terminology binding defines how clinical data elements are represented within FHIR resources. Each data element in a FHIR resource is linked to a specific value set, which dictates the permissible SNOMED CT codes or concepts for that element.

For example, when recording a patient’s condition in a FHIR resource, the “code” field is bound to a specific SNOMED CT code that accurately represents the condition. This standardized approach ensures that healthcare providers and systems use consistent terminology to describe clinical information across different platforms and contexts.

By adhering to these value sets, FHIR enables precise data exchange and a shared understanding of clinical data elements, enhancing interoperability, supporting efficient healthcare delivery, and contributing to improved patient outcomes.

Recommendations and Detailed Applications

The following pages will provide detailed recommendations for terminology bindings between relevant FHIR resources and SNOMED CT value sets, specifically as they apply to representing the Nutrition Care Process Terminology (NCPT). Each section will outline the application of specific FHIR resources and bindings to support different NCPT components.

• FHIR Resources for Nutrition Assessment and Reassessment
• FHIR Resources for Nutrition Diagnosis
  • Terminology Bindings for Nutrition Diagnosis
• FHIR Resources for Nutrition Intervention
• FHIR Resources for Nutrition Monitoring and Evaluation

What is FHIR?

HL7 FHIR is a modern standard designed to facilitate the exchange of healthcare information electronically. The standard defines resources, i.e. data formats, that can be used to represent data elements in a systematic way across the healthcare continuum. 

• Consistency: With standardized resources and robust semantics, FHIR ensures uniformity in healthcare data representation. This consistency supports accurate data exchange and enables healthcare providers to make informed decisions based on reliable information, ultimately enhancing patient care quality.
• Modularity: FHIR’s flexible architecture allows its resources to be used independently or in combination to meet specific healthcare needs. This modular approach supports adaptability across diverse healthcare contexts, enabling tailored solutions without overhauling entire systems.
• Interoperability: FHIR facilitates seamless data exchange between different healthcare systems and applications, enhancing communication and collaboration among healthcare providers. By standardizing data formats and protocols such as RESTful APIs and JSON/XML, FHIR promotes interoperability, improving patient care coordination and information sharing.
• Standardization: FHIR leverages contemporary web standards to ensure compatibility with existing IT infrastructures. By defining well-structured resources like Patient, Observation, and Medication with clear semantics, FHIR fosters consistency in how healthcare data is represented and interpreted across various systems.
• Scalability: Designed to accommodate evolving healthcare requirements and technological advancements, FHIR is scalable for both current and future healthcare needs. Its flexible architecture and support for extensibility allow healthcare systems to grow and adapt without compromising interoperability or data integrity.

HL7 FHIR plays a crucial role in linking healthcare data with standard terminologies, including SNOMED CT. By integrating FHIR with terminologies like SNOMED CT, a more precise and standardized documentation and communication of clinical information can be achieved. This linkage enhances interoperability by enabling seamless exchange of structured clinical data, supporting accurate clinical decision-making, and promoting continuity of care for patients across various healthcare settings.

Together, FHIR and SNOMED CT facilitate a unified approach to healthcare information management, benefiting both vendors, healthcare providers and patients.