Finnish PHR Nutrition Profiles
Nutrition profiles define data contents of the nutrition measurements self-made by citizen.
All nutrition profiles defined in this Finnish PHR Implementation Guide constrain and extend FHIR® Observation resource. The FHIR Observation resource is not profiled directly. The Finnish PHR Nutrition Profiles are based on the FHIR STU3 Nutrition profile for the FHIR Observation resource.
Finnish PHR Nutrition Base profile defines profiled elements used in all nutrition observations. This base profile can not be used as a resource instance, it is a base definition for other nutrition profiles.
The profiles based on the Finnish PHR Nutrition Base profile:
- Finnish PHR Fluid Intake profile: Finnish PHR profile for observation used in oral fluid intake measurements.
- Finnish PHR Macronutrient Intake profile: Finnish PHR profile for observation used in macronutrient intake measurements.
- Finnish PHR Calorie Intake profile: Finnish PHR profile for observation uset in calorie intake measurements.
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Finnish PHR Nutrition Base profile
Finnish PHR Nutrition Base Profile for FHIR® Observation defines profiled elements used in all other Finnish PHR profiles derived from this profile. This base profile can not be used as a resource instance, it is a base definition (abstract) for other Finnish PHR nutrition related profiles.
A full list of the extensions, constraints and a structured definition of this profile can be found in Simplifier. There are also different views of the profile (details, mappings, table, XML, JSON).
Mandatory elements for all Finnish PHR Nutrition profiles
Mandatory elements table for Finnish PHR Nutrition Base profile
| Content |
Name in structure |
Description / Type of information |
| Language |
language |
Language with which the observation has been stored in Kanta PHR.
Language SHALL be chosen from the FHIR languages ValueSet. |
| Narrative |
text |
A text summary of the observation.
SHALL include all content for a human to understand the essential clinical and business information of the observation.
A narrative guide will be provided for each of the derived profiles. |
| Unique identifier |
identifier |
At least one globally unique identifier has to be provided for the observation, in addition other identifiers may be given as well.
This identifier may be used to uniquely identify the observation if the application doesn't receive an id for the observation provided by Kanta PHR. |
| Status |
status |
The status of the observation.
Only completed observations are stored in Kanta PHR, thus the status SHALL always be 'final' (from FHIR Observation Status ValueSet). |
| Category of the observation |
category |
Indicates to what category the observation belongs to.
All nutrition related data SHALL have the category 'nutrition' (from Finnish PHR Observation Category ValueSet). |
| Code of the observation |
code |
Determines what the observation is (ie. the amount of fluid intake, calorie intake etc.). Codes are allowed only from the LOINC code system.
The exaxt code(s) to be used will be determined in the derived profile for each different kind of an observation. |
| Subject of the observation |
subject |
Who this observation is about. The reference SHALL be to a Patient resource stored in Kanta PHR (that conforms to the Finnish PHR Patient profile). |
| Time for observation |
effective[x] |
Clinically relevant time or time-period for observation.
The precision of time will vary depending on what kind of an observation is in question. For example in some cases, the time for the observation may include the exact date and time when the observation was made. In other cases, only the date will be stored. In some cases, a time-period may be given. |
| Storing date |
issued |
The date and time the observation was stored in Kanta PHR. |
| Who is responsible for the observation |
performer |
This may be the same as the subject, or this may be another person for example when someone is using Kanta PHR on behalf of the subject. The reference SHALL be to a Patient resource stored in Kanta PHR (that conforms to the Finnish PHR Patient profile). |
Optional elements for all Finnish PHR Nutrition profiles
Optional elements table for Finnish PHR Nutrition Base profile
| Content |
Name in structure |
Type of information |
| Actual result |
value[x] |
Includes the observation result, for example in a calorie intake observation the actual amount of calories.
The unit of measurement that SHALL be used will be determined in the derived profiles for each different type of observation. |
| Interpretation |
interpretation |
The assessment made based on the result of the observation, for exapmle whether the result is normal or abnormal, or high or low. If a coding is provided, the code SHALL be from FHIR Observation Interpretation ValueSet. |
| Comments about the result |
comment |
May include for example statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result. |
Optional elements table for Finnish PHR Medication Statement profile
| Content |
Name in structure |
Description / Type of information |
| Application that created or updated the observation |
extension:
creatingApplication |
Is used to represent information about the application (id and name) that created or updated the resource. See the definition for the Finnish PHR Application Information extension.
Kanta PHR platform will fill in this data automatically to each stored observation (if the application has entered some data in this extension, it will be overwitten). |
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Finnish PHR Fluid Intake Profile
Finnish PHR profile for FHIR® Observation used in oral fluid intake measurements.
The profile is based on the Finnish PHR Nutrition Base profile. This profile alone does not describe all the elements needed and most of the elements are visible only in base profile. This profile describes changes to the base profile and the implementers must also familiarize himself with the base profile.
A full list of the extensions, constraints and a structured definition of this profile can be found in Simplifier. There are also different views of the profile (details, mappings, table, XML, JSON).
The Finnish PHR Fluid Intake Profile constrains the Finnish PHR Nutrition Base Profile as follows:
Mandatory elements for Finnish PHR Fluid Intake
Mandatory elements table for Finnish PHR Fluid Intake profile
| Content |
Name in structure |
Description / Type of information |
| Code for fluid intake |
code |
A fluid intake observation SHALL have the code 8999-5 Fluid intake oral Estimated from the LOINC code system (from the Finnish PHR Nutrition ValueSet). |
| Time for observation |
effectiveDateTime |
Clinically relevant time for the observation. |
| Actual result |
valueQuantity |
The measured amount of fluid intake. SHALL always be provided with the unit of measurement ml. |
Finnish PHR Fluid Intake Profile Narrative guide
Narrative SHALL contain following mandatory information taken from the elements of the resource instance:
- Code: <Observation.code.coding.display>(<Observation.code.coding.code>)
- Time: <Observation.effectiveDateTime>
- Result: <Observation.valueQuantity.value><Observation.valueQuantity.unit>
Narrative SHOULD contain following optional information if given in the resource instance:
- Interpretation: <Observation.interpretation.coding.display> (<Observation.interpretation.coding.code>)
- Comment: <Observation.comment>
- Method: <Observation.method>
- Device: <Observation.device>
- Reference range: <Observation.referenceRange>
If element is missing from resource, it shall not be mentioned in narrative.
Example:
Code: Fluid intake oral Estimated (8999-5)
Time: 18.11.2018 12:03
Result: 230 ml
Examples of Finnish PHR Fluid Intake resources in Simplifier
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Finnish PHR Macronutrient Intake Profile
Finnish PHR profile for FHIR® Observation used in macronutrients intake measurements.
The profile is based on the Finnish PHR Nutrition Base profile. This profile alone does not describe all the elements needed and most of the elements are visible only in base profile. This profile describes changes to the base profile and the implementers must also familiarize himself with the base profile.
A full list of the extensions, constraints and a structured definition of this profile can be found in Simplifier. There are also different views of the profile (details, mappings, table, XML, JSON).
The Finnish PHR Macronutrient Intake Profile constrains the Finnish PHR Nutrition Base Profile as follows:
Mandatory elements for Finnish PHR Macronutrient Intake
Mandatory elements table for Finnish PHR Macronutrient Intake profile
| Content |
Name in structure |
Type of information |
| Code for macronutrient intake |
code |
All the codes are from the LOINC code system, all the allowed codes can be found in Finnish PHR Macronutrition Value Set.
One of the following codes SHALL be given:
9059-7 Carbohydrate intake Estimated
9060-5 Carbohydrate intake Measured
9066-2 Fat intake Estimated
9067-0 Fat intake Measured
9079-5 Protein intake Estimated
9080-3 Protein intake Measured |
| Time for observation |
effectiveDateTime |
Clinically relevant time for the observation. |
| Actual result |
valueQuantity |
The amount of macronutrient intake. SHALL always be provided with the unit of measurement g. |
Finnish PHR Macronutrient Intake Profile Narrative Guide
Narrative SHALL contain following mandatory information taken from the elements of the resource instance:
- Code: <Observation.code.coding.display>(<Observation.code.coding.code>)
- Time: <Observation.effectiveDateTime>
- Result: <Observation.valueQuantity.value><Observation.valueQuantity.unit>
Narrative SHOULD contain following optional information if given in the resource instance:
- Interpretation: <Observation.interpretation.coding.display> (<Observation.interpretation.coding.code>)
- Comment: <Observation.comment>
- Method: <Observation.method>
- Device: <Observation.device>
- Reference range: <Observation.referenceRange>
If element is missing from resource, it shall not be mentioned in narrative.
Example:
Code: Carbohydrate intake Measured (9060-5)
Time: 17.05.2019 21:00
Result: 300 g
Examples of Finnish PHR Macronutrient Intake resources in Simplifier
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Finnish PHR Calorie Intake Profile
Finnish PHR profile for FHIR® Observation used in calorie intake measurements.
The profile is based on the Finnish PHR Nutrition Base profile. This profile alone does not describe all the elements needed and most of the elements are visible only in base profile. This profile describes changes to the base profile and the implementers must also familiarize himself with the base profile.
A full list of the extensions, constraints and a structured definition of this profile can be found in Simplifier. There are also different views of the profile (details, mappings, table, XML, JSON).
The Finnish PHR Calorie Intake Profile constrains the Finnish PHR Nutrition Base Profile as follows:
Mandatory elements for Finnish PHR Calorie Intake
Mandatory elements table for Finnish PHR Calorie Intake profile
| Content |
Name in structure |
Type of information |
| Code for calorie intake |
code |
A calorie intake observation SHALL have the code 9052-2 Calorie intake total from the LOINC code system (from the Finnish PHR Nutrition ValueSet). |
| Time for observation |
effectiveDateTime |
Clinically relevant time for the observation. |
| Actual result |
valueQuantity |
The amount of the calorie intake. SHALL always be provided with the unit of measurement kcal. |
Finnish PHR Calorie Intake Profile Narrative Guide
Narrative SHALL contain following mandatory information taken from the elements of the resource instance:
- Code: <Observation.code.coding.display>(<Observation.code.coding.code>)
- Time: <Observation.effectiveDateTime>
- Result: <Observation.valueQuantity.value><Observation.valueQuantity.unit>
Narrative SHOULD contain following optional information if given in the resource instance:
- Interpretation: <Observation.interpretation.coding.display> (<Observation.interpretation.coding.code>)
- Comment: <Observation.comment>
- Method: <Observation.method>
- Device: <Observation.device>
- Reference range: <Observation.referenceRange>
If element is missing from resource, it shall not be mentioned in narrative.
Example:
Code: Calorie intake total (9052-2)
Time: 17.05.2019 21:00
Result: 1800 kcal
Examples of Finnish PHR Macronutrient Intake resources in Simplifier
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