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Nutrition Informatics Blog

Confused about Health Privacy and Security with EHRs?

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Posted by: Lindsey B Hoggle, MS, RDN, PMP

Questions about "HIPAA", health care privacy and security always require considerable time to answer. As the United States adopts and uses electronic health records and other sources of health information technology, multiple parameters should be used to evaluate risk. While data breeches involving credit cards allow for an easier recovery—such as credit monitoring and issuance of a new credit card, health data breeches are complicated. If private, very personal data that could be used to discriminate against individuals is erroneously accessed or shared—it cannot be "called back", "replaced" or "corrected". As privacy and security standards and policies are tightened, there is a great "one stop shop" for privacy and security of health data using EHRs. Members should also check their local, state level laws on health data policies as these pre-empt any national requirements. For more information, go to: Health Information Privacy, Security, and Your EHR.

Nutrition Informatics Education via the 10x10

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Posted by Lindsey B Hoggle, MS, RDN, PMP

This past May 7, the fifth Academy 10x10 Education Course in Informatics launched! Twenty students are enrolled in the only nutrition focused 10x10 program. Here are some interesting statistics about this program:

  • Ninety (90) students have passed the course in the first four years.
  • Students from over 32 states have participated (including Alaska and Hawaii) plus Canada, Puerto Rico and Germany!
  • Several of the positions held by students include: clinical, food service management, community, systems analysts and developers of health care software.
  • Each student authors a short project (either one they have or intend to implement or a conceptual one).
  • All students may receive graduate credit if they complete the Oregon Health and Sciences exam for this course (which includes a nominal fee).
  • The Foundation of the Academy of Nutrition and Dietetics has awarded over $40,000 in educational grants to students taking the 10x10!

Not ready for the 10x10 but want to investigate how nutrition informatics covers all areas of practice for nutrition?

Preview the HIMSS Town Hall Series for a snapshot of nutrition informatics: Nutrition Informatics 101, Nutrition Informatics Delphi Study, and Meaningful Use in Action-Exploring the Possibility of Nutrition Informatics.

Look for an upcoming Certificate in Nutrition Informatics and be sure to join the 1,136 members on the Nutrition Informatics Community of Interest by logging in with your Academy User ID and password.

And lastly, Congratulations to Marty Yadrick, MBI, MS, MBA, RDN, FADA, Past-President of the Academy for completing his Masters of Biomedical Informatics after taking the 10x10 and now serving as an instructor for the AMIA/Academy 10x10!!

Foundation Grants for AMIA 10x10 Education Program

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The FIFTH offering of the popular biomedical informatics program - Academy/AMIA 10x10 Education Program begins on May 7, 2014! This year, the Academy of Nutrition and Dietetics Foundation continues to offer grants to Academy members.  Read first the details about the Academy's offering of the Program and if interested in applying for a Foundation Grant, please complete the 2014 Application for Foundation Grants for the Academy/AMIA 10x10 by April 18, 2014. 

Meaningful Use: Data Integrity vs Data Specificity

(What is Nutrition Informatics, Clinical Nutrition, Professional Education, HITECH Overview and Updates) Permanent link

Submitted by John W. Snyder, DTR, RD

While working to implement the Health Level 7 (HL7) Role Code terminology set used to define the relationship to patient for family medical history, a question came up regarding how to map the end-user “pick-list” selections to HL7 terms. The vendor had not provided a full copy of the terminology set based on terms contained in OID 2.16.840.1.113883.5.111 and asked the following question:

What is the difference between “Son/Daughter” and “Natural Son/Daughter”?

The HL7 Role Code terminology set works as follows:

·   Child (Level 1)

  Son (Level 2)

oNatural Son (Level 3)

oAdopted Son (Level 3)

oFoster Son (Level 3)

oStep Son (level 3)

  Daughter (Level 2)

oNatural Daughter (Level 3)

oAdopted Daughter (Level 3)

oFoster Daughter (Level 3)

oStep Daughter (Level 3)


In an ideal world, all electronic health record systems (EHR-S) would provide users every possible selection, and users would select the correct value. The reality is that providing users with 80+ different types of relationships to select from when entering family history information is perhaps not realistic, and the Centers for Medicare & Medicaid Services has not mandated a level of specificity that all EHR-S must achieve for certification. This means we must map data selected by an end-user to a value in a terminology set.

In the above example, mapping a generic to a more specific (eg, Son/Daughter→Natural Son/Daughter) is not considered a good practice, because it creates invalid data. In this particular case, mapping Son/Daughter to Natural Son/Daughter has only about a 25% chance of accuracy. Mapping from the more specific to a generic (eg, Natural Son/Daughter→Son/Daughter) is an acceptable practice, because downstream it does not invalidate data even though it removes specificity.

The goal of gathering this information is to populate Summary of Care/Continuity of Care documents for interoperability, provide meaningful use data to the government via the Quality Reporting Document Architecture standard, research, and likely some other uses I have not thought to include. In all of these uses, it is necessary to consider sacrificing data specificity as an industry best practice in order to maintain data integrity/validity needs. 


Member Comment Requested: EHR/PHR Nutrition Best Practices Implementation Guide

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Post by Lindsey Hoggle MS, RD:

A dedicated group of over 20 members have been working through the summer to create an "EHR/PHR Nutrition Best Practices Implementation Guide" in time for release by FNCE2013. Due to additional clarification that is needed in certain areas prior to the release, a DRAFT copy for comment has been posted to the Nutrition Informatics Community of Interest at To comment, login using your login and password, download a copy and follow the directions in the document to send comments for the Final copy. This guide was prepared after many members have requested additional information on EHR implementations which are underway as a result of the HITECH EHR Medicaid/Medicare Incentive Program. See to read more about HITECH.

This EHR/PHR Best Practices Guide will utilize recent experiences to help dietitians who are at different stages of EHR implementation at their facility across many areas of care. It is intended to be an add on to the EHR Tool Kit offered at Shop The final Guide will be available at no charge to members on the Eatright online shop. Plans are underway for CPE credit for the Guide. We hope you will participate!

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Member Comment Requested: EHR/PHR Nutrition Best Practices Implementation Guide

11/2/2013 9:54:34 AM
Lindsey, I am interested in reviewing this document but am unable to access it even when logged ... more »

Member Comment Requested: EHR/PHR Nutrition Best Practices Implementation Guide

11/2/2013 8:29:21 AM
the webauthor link isn't working

An Informatics Solution to Productivity Tracking

10/31/2013 7:16:49 AM
Is it possible to share this tool with us?

An Informatics Solution to Productivity Tracking

10/16/2013 8:49:19 AM
Can you share? I would like to be able to share with intern how sites are tracking.

Who needs standards? In Health Care?

7/9/2013 9:13:00 AM
I couldn't agree more. Margaret and Elaine, along with other subject matter experts, are doing a fan... more »

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