I don't understand why the Nutrition Informatics Committee is 'hidden' under the CNM DPG. I think if we are looking for involvement, it should become it's own DPG. There is no doubt that it will grow!

Krista, thanks for your comment. To clarify, the ADA Nutrition Informatics Committee and the Food and Nutrition Informatics Subunit of the CNM DPG are two different entities. The idea of a Nutrition Informatics DPG was proposed a couple years ago, but the feeling at the time, which was reinforced by the 2007 Nutrition Informatics Survey, was that informatics crosses over all areas of dietetics practice. Of course, as more and more RDs and DTRs move into jobs specifically in informatics, the need for a unique DPG may develop.

I agree with Krista. By the time folks understand that there is a need we will have been "left behind" once again. Psychology and Nursing have already surpassed us. I would like to see emphasis areas broadened to patient interaction. So far, the emphasis seems to be on administrative functions. Those are important but I would like to see RD's involved in telemedicine and telehealth. Online diabetes intervention is my area of expertise.

Linda, Thanks for your comments. We would love to hear more about your work in online diabetes education, as it is critical for dietetic practitioners to appreciate the wealth of opportunities at their fingertips.ADA has engaged significant resources in the area of nutrition informatics for some time. The November Jounal has an article entititled:A Decade of Work Coming Together..." which outlines some of the work in this area. In addition, there is a second article in the same month that outlines the work ADA has been completing in the area of the HITECH Act. The December Journal interviews folks like you--working in unique areas of informatics practice. The Nutition Informatics Committee has a hefty list of tasks to complete over the next few years. The nusing community have been awesome champions of nutrition informatics since it's inception. We welcome suggestions, and will be highlighting some of this work in the weeks to come. Please continue to share. Lindsey

I am struggling to incorporate NCP into our EHR system. I know the IDNT is available but trying to get someone in our IT department to activate and see if we have any premade screens. In the meantime our team of RDs have created many of our own templates specific to each disease state we may see in a SOAP format. Converting to ADI is going to be a very long process with constructing our templates with the IDNT codes. I really don't see much guidance for outpatient. I see how this helps inpatient documentation to go faster but I have a lot more education and counseling to do. It is a very big project to do this-we need sample notes for outpatient settings that bill MNT to insurance. Throw in the need to meet Medicare reguirements, diabetes program recognition requirements, EAL and now medical/health care home it's a lot to figure out what to document.

Julie, Thanks for your comment. You echo what many professionals across health care are trying to work through. I wish there was a simple answer. The good part is that ADA has multiple resources (EHR Toolkit)--which can be purchased online. While this is a tremendous amount of work, once your work process is established electronically, your ability to compile data, evaluate effectiveness and impact health care increases exponentially. Comparing notes on DPG list serves (such as CNM) also has been helpful to others in your position. Good Luck and let us know about your progress. Lindsey

Julie, It's exciting that you're wanting to be involved in your facility's EMR work. You'll need to educate yourself on how clinical systems are designed and used. It's a sure recipe for disaster when "premade" screens and templates are used out of the box. Make sure you have someone help you with workflow analysis, information needs assessment and current system capabilities. When working with EMRs, I rarely see the need for RDs to have different data entry screens depending on medical diagnosis, so am not sure what you're describing there. When it comes to outpatient, if you are part of a larger facility with its own billing and finance components, you need to contact them to make sure that billing software is interfaced with your work. Remember that an EMR is very, very rarely "one big program"; typically, facilities will purchase products from 2 or more vendors depending on the needs for each department and group. Find the folks in your facility in each area that you need to share information flow and discuss how to make sure that happens! Regards, pam

Would someone be able to expand on this topic: "...diet order standards through HL7..with increased emphasis on participation in HL7 for standards..."? Are you looking to incorporate the nutrition data into a CCD (Continuity of Care Document)?

Paul, thanks for your question. The following reply is from Margaret Dittloff, MS, RD, Chair of the Nutrition Informatics Committee's sub-group on Interoperability: Yes! ADA has provided comments at ONC and S&I framework meetings in an effort to get food allergies, diet and nutrition care information included in structured documents such as the CCD. ADA is also actively participating in a number of HL7 work groups including orders & observations, patient care, clinical statement, and vocabulary. In January at the HL7 International meeting, we submitted (and had accepted) a project to develop a domain analysis model for diet and nutrition orders that will form the basis of HL7 version 3 modeling and messages for nutrition orders in the future. This work falls under the purview of HL7’s Orders & Observations committee with co-sponsors in both Pharmacy and Patient Care work groups. The Patient Care work group is currently working on a similar project to define and refine what data will be included in care plans that are exchanged among systems. Nutrition absolutely needs to be included! Any RDs who are interested in participating in these initiatives can go the HL7 website (www.hl7.org) and participate in the work group meeting conference calls, or you can help the Nutrition Informatics Committee by volunteering to review and comment on the materials being developed. Being at the table as healthcare standards for interoperability are developed is critical. But, we have a long way to go.