Posted by Lindsey Hoggle, MS, RDN, PMP
The spectrum of nutrition implementation in Electronic
Health Records (EHR) is both vast and highly inconsistent. A recent member wrote reporting that as a
private practice RDN, the physician’s office she worked for did not want her to
document in their record; they simply scanned her nutrition care note in and
uploaded it into the EHR. So what do you
say to that?
- Data that is scanned into an EHR is seldom
"re-usable" by the EHR because the data is not stored as structured (think
Excel spreadsheet, where you can identify data by columns and rows) nor does it
occur along side of existing and future data already in the EHR
(weights/heights in a scanned document will not show up on the graph of the
- If the provider is reporting via Electronic
Clinical Quality Measures (eCQM), additional documentation via mandated codes
may help provide better reporting data.
The Academy has been working for over 2 years to map and submit the
Nutrition Care Process Terminology –or MCPT (previously the IDNT) to now
mandated clinical terminologies in the United States –both SNOMED-CT
(Systematized Nomenclature of Medicine Clinical Terms) and LOINC (Logical Observation Identifiers Names and
Codes). These "mapping" spreadsheets
should be used by your EHR vendor to assure nutrition care lands on the same
Care Plan as other professionals in the EHR. The mapping spreadsheets are
available via the 2014 version of the eNCPT.
- Nutrition Data can now be included in
"transitions of care" documents between facilities – once the HL7 Draft Standard Consolidated Clinical
Document Architecture (C-CDA) Release 2 is put into operation. That means that their patient on a diet
modifications can have that data arrive at the hospital on their next
- Nutrition content in Health Care Information
Technology Standards of the future can include "Clinical Decision Support" – or
the ability to put nutrition care on the same option list of medications.
- Sharing patient data with the patient and across
all episodes of care is a requirement of both the Meaningful Use
Medicare/Medicaid EHR Financial Incentive program and will be an important part
of performance indicators on quality care.
I could go on with other points; the take-away
is that nutrition advocacy comes with the territory of practicing nutrition
care. We have made great progress but
the need for constant advocacy will continue.
Please share any stories you have!