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Nutrition Informatics Blog

Food Allergies - Following the Patient

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Post by Lindsey B. Hoggle MS, RD. As the U.S. healthcare system converts to digital with the use of Electronic Health Records (EHRs), there are a few key points all Academy members should know. Even if you do not use an EHR in your area of practice, allergies may come across your desk as health care data is modeled to “follow the patient.”

In order to establish a standard way to document and use food allergy information in health information technology, the Academy’s Nutrition Informatics Committee (NIC) Interoperability and Standards Sub-Committee has championed development of allergy standards critical to accurate reporting of food allergies. A huge thanks goes to Academy member Elaine Ayres (Past Chair of the NIC and the NIC Sub-Committee) and Dr. Russell Leftwich for keeping this work as a priority and moving forward within the Health Level Seven (HL7) arena.

The key takeaways are this:

  1. All allergies should be grouped together in an EHR, as both food and medication allergies have similar potential for negative impact on the patient.
  2. The standards for such digital messages are under development but should be available in the near future.
  3. It is critical for food allergies to be documented and sent via HL7 version 2 messages from the EHR to the Food and Nutrition Information Systems so that Food Service does not serve foods containing the allergen.
  4. Food allergies should be included with medication allergies as the data is sent from a provider/facility to another provider/facility and/or to the patient. These standards are evolving.

I have included a more detailed description of the present work underway for those of you following the development of health standards.

  • V3 Allergy and Intolerance Clinical Models, This project will support the exchange of electronic allergy and intolerance clinical information. The scope of such information includes a variety of adverse reactions to medications, food or other substances as reported or observed conditions usually encountered in healthcare. The domain also includes the development, maintenance and reconciliation of an allergy and intolerance records and the list from known information sources. Allergy and intolerance states such as “no known allergy”, or “allergy resolved” are included. Interactions to be tested will include queries of an EHR-S for allergy and intolerance records/list information as well as adverse reaction information, the creation of messages and sending the allergy and intolerance information to another system and to create a report of allergy and intolerance information to be sent to regulatory bodies. No specific codes or value sets have been developed for the allergy and intolerance domain and this would be a part of the developmental work necessary for this project. A follow-on project for the development of template(s) and an implementation guide is planned.
  • HL7 Version 3 Domain Analysis Model: Allergy and Intolerance, Release 1 The Allergy and Intolerances Domain Analysis Model is broad, and is intended to unify a number of international models designed to deal with the documentation and interoperability of allergy and intolerance conditions. The use cases and models were developed with two goals in mind. The first is to provide examples a number of common clinical scenarios related to allergy and intolerance conditions. The second goal of the project was to highlight the fact that allergies and intolerances are not just related to drugs but should include food, device and environmental allergies and intolerances.

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