The Academy of Nutrition and Dietetics (AND) defines nutrition informatics as: “the effective retrieval, organization, storage and optimum use of information, data and knowledge for food and nutrition related problem solving and decision making.”
Definition: The AND also says, “Informatics is supported by the use of information standards, information processes and information technology.” (Nutrition Informatics)
Wikipedia offers a similar definition of informatics as follows: “Informatics includes the science of information, the practice of information processing, and the engineering of information systems. Informatics studies the structure, algorithms, behavior, and interactions of natural and artificial systems that store, process, access and communicate information.”
The movement towards an electronic health record (EHR), along with ongoing forces to improve patient safety and operational efficiencies, drive a push towards informed decision-making powered by healthcare technologies.
In the earliest years of food and nutrition software, food and nutrition managers may have focused on applying software to automate repetitive processes, save labor, and improve accuracy. Today, the benefits of automation continue. But hospital food service software offers much more.
The ADA lists these areas for application of nutrition informatics:
- Foodservice systems management
- Inventory management systems
- Educational/instructional/data intake
- Nutrient analyses
- Nutrition research
- Clinical nutrition care
- Reimbursement for nutritional care
Making Informed Decisions
The focus of software and nutrition technology has taken a leap forward with informatics, with powerful tools for mining a wealth of data and processing it in ways that help managers make well-informed decisions. This requires:
- Collecting and storing data, as in a patient records database
- Applying information models for querying the data and using algorithms (formulas and logic in computer programming) to generate meaningful information
- Creation of standards and systems to support meaningful use of information
An example of informatics is the nutrition screening process. Here, software accesses a wealth of patient information stored in a nutrition database, such as diagnosis, laboratory values, diet order, and more. While we know this data is relevant to nutritional status and future plans of care, data is not enough. The science of nutrition informatics steps in when we:
- Designate standards to identify what data mean, or what is out of range
- Apply algorithms or mathematical scoring models to quantify nutrition risk
- Access the data as part of a system to identify patients who may benefit from nutritional intervention
- Make well-informed decisions that affect healthcare outcomes for patients
A further application of informatics identifies trends and opportunities, allowing the manager to improve systems and processes. HACCP is an excellent example, as one of the seven steps of HACCP is to validate the food safety system. If you collect food temperatures routinely and house this data electronically, later you can use software to report on trends and associations. This can pinpoint areas of the food service operation where system refinements may be warranted, or measure the success of food safety initiatives already in place.
Informatics applies to quality management in food and nutrition services as well. Satisfaction ratings and survey data can be mined and transformed to determine trends, associations, needs, and opportunities.
In the nutrition arena, nutrient data lays a relevant foundation for informatics. How do you apply the basics of a nutrient database to meaningful menu planning and personalized patient care? When the patient menu software calls on the nutrient database, applying rules to ensure optimal nutrient intake, we are again in the realm of informatics.
Informatics has applications to all aspects of food service management and nutritional care. According to the ADA, the basic model requires applying standards, processes, and technologies to data. The outcome is information, the kind of information that supports sound decisions.
The EHR & Clinical Nutritional Care
According to the ADA: “Health care accrediting agencies call for using aggregate data to pursue opportunities for improvement and redesigning information-related processes to improve efficiency and effectiveness, as well as patient safety and quality of patient care, treatment and services. Information can be maintained as paper record or as electronic health information. While the form (paper or electronic) is not mandated the ability to capture and analyze data is more powerful when the net in which data is captured is as broad as possible. This is generally most effectively accomplished electronically.”
The HITECH Act of 2009 promotes standardized data formats to help make the EHR a reality. Shared health data under a secure, uniform platform for exchanging data is essential for healthcare informatics. It in essence aggregates the data required to serve any single patient or group of patients effectively with informatics-driven services.
HL7 standards for the electronic exchange of healthcare data are key to data aggregation and functionality of full-blown informatics systems.
ADA Standardized Language
Standardized Language for nutritional care developed by the American Dietetic Association is an important foundation for common communications among healthcare professionals as well. The ADA offers standardized language used for nutrition diagnoses and nutrition interventions. There are 62 diagnoses, falling into three categories: Intake, Clinical, or Behavioral-Environmental. Interventions may take the form of: Food and/or Nutrient Delivery, Nutrition Education, Nutrition Counseling, or Coordination of Nutrition Care. According to Health Project Partners, “Creating a nationally recognized nomenclature is critical to the processing of patient information from one data point to another and has timely application to nutrition care.”
The ADA formed a Nutrition Informatics Work Group in 2007, and the Clinical Nutrition Management Dietetic Practice Group of the ADA has a Food and Nutrition Informatics subunit.
Vision Software is a leader and innovator in healthcare informatics, having pioneered the first real time interface for A/D/T, order entry, laboratory, and pharmacy data in 1987, and the first nutrition risk screening system in 1991. At Vision, we believe in informatics… it’s more than just software™.