NutritionOrder — Nutritional prescription
The hospital or outpatient diet order in FHIR. Texture, restrictions, exclusions, schedule, nutrient targets, oral supplementation: the dietitian's full toolkit.
Purpose of the resource
NutritionOrder is the formal diet prescription for a patient during inpatient care, home hospitalisation or outpatient care. It follows the Request pattern (intent, priority, status, occurrence) shared with MedicationRequest and ServiceRequest.
It can describe up to three simultaneous feeding modes: oral (meal tray), enteral (nasogastric tube, jejunostomy) and supplementation (oral nutritional supplements).
Key fields
| Field | Type | Cardinality | Role |
|---|---|---|---|
identifier | Identifier[] | 0..* | Business identifiers of the prescription. |
instantiatesCanonical | canonical[] | 0..* | Reference to a PlanDefinition (nutritional protocol). |
status | code | 1..1 | draft | active | on-hold | revoked | completed | entered-in-error | unknown. |
intent | code | 1..1 | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option. |
priority | code | 0..1 | routine | urgent | asap | stat. |
subject | Reference(Patient | Group) | 1..1 | Subject. |
encounter | Reference(Encounter) | 0..1 | Context. |
dateTime | dateTime | 1..1 | Issue date. |
orderer | Reference(Practitioner | PractitionerRole) | 0..1 | Prescriber. |
allergyIntolerance | Reference(AllergyIntolerance)[] | 0..* | Allergies to honour. |
foodPreferenceModifier | CodeableConcept[] | 0..* | Preferences (vegetarian, kosher, halal). |
excludeFoodModifier | CodeableConcept[] | 0..* | Exclusions. |
outsideFoodAllowed | boolean | 0..1 | Family-brought food permitted. |
oralDiet | BackboneElement | 0..1 | Oral diet (type, texture, fluids, nutrient targets). |
supplement | BackboneElement[] | 0..* | Oral nutritional supplements. |
enteralFormula | BackboneElement | 0..1 | Enteral feeding (tube). |
JSON example
{
"resourceType": "NutritionOrder",
"id": "example-diabetic-diet",
"identifier": [{
"system": "http://example.org/ordering-system",
"value": "NO-2026-001"
}],
"status": "active",
"intent": "order",
"subject": { "reference": "Patient/example" },
"encounter": { "reference": "Encounter/example" },
"dateTime": "2026-05-15T08:00:00Z",
"orderer": { "reference": "Practitioner/example-dietitian" },
"excludeFoodModifier": [{
"coding": [{
"system": "http://snomed.info/sct",
"code": "227493005",
"display": "Cashew nut"
}]
}],
"oralDiet": {
"type": [{
"coding": [{
"system": "http://snomed.info/sct",
"code": "160670007",
"display": "Diabetic diet"
}]
}],
"schedule": {
"repeat": {
"boundsPeriod": {
"start": "2026-05-15T08:00:00Z"
},
"frequency": 3,
"period": 1,
"periodUnit": "d"
}
},
"texture": [{
"modifier": {
"coding": [{
"system": "http://snomed.info/sct",
"code": "228053002",
"display": "Easy to chew food"
}]
}
}]
}
}Oral, enteral, supplement
- oralDiet — meal tray. Typical fields:
type,schedule,nutrient,texture,fluidConsistencyType,instruction. - supplement — oral nutritional supplements (ONS) prescribed on top of the standard meal.
- enteralFormula — tube-administered formula:
baseFormulaType,additive,caloricDensity,routeOfAdministration,administration(schedule, rate, quantity).
Common pitfalls
- Allergies copied as free text — reference AllergyIntolerance for traceability.
- Missing texture for a dysphagic patient — major clinical risk.
- Indeterminate schedule — always state frequency and bounds.
- Confusion supplement / enteralFormula — supplement is oral; enteralFormula is tube-fed.
Related resources
- NutritionProduct — referenced catalogue.
- AllergyIntolerance.
- MedicationRequest — drug analogue.
- CarePlan — global care plan.
- FHIR R5 hub.