ANDHII

The Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII^®) enables RDNs to track nutrition care outcomes and advance evidence-based nutrition practice research.

While RDNs know empirically that nutrition interventions can help prevent pressure ulcers, falls and readmissions, these associations can be difficult to prove. The data collected in electronic health records may help build support for the efficacy of nutrition interventions, but several obstacles stand in the way of collecting and aggregating this data. EHRs don’t always use uniform nutrition terminology, making it difficult to document and track nutritional data. While national efforts towards interoperability of electronic health records continue, it remains difficult to combine data from different practice settings.

ANDHII^® fills that gap by offering secure online data collection from anywhere using familiar nutrition terminology and a format that makes it easy to integrate into practice workflow. The knowledge gained through the collection and analysis of information in ANDHII will add to the evidence base for nutrition practice and help ensure high-quality patient care.

ANDHII has three main components:

• Smart Visits: This component makes it easy for practitioners to describe their nutrition care and patient outcomes using familiar terminology. A powerful and predictive search capability helps practitioners quickly identify appropriate Nutrition Care Process Terminology. Customizable templates help produce narrative progress notes that can be copied to some electronic health records. The Smart Visit component can also generate Patient Trend Reports, including charts and graphs of patient outcomes, dietary intake and the impact of nutrition interventions. Educators can also use smart visits to educate students on the Nutrition Care Process and Terminology or in student-led clinics as a charting system.
• Dietetics Outcomes Registry (DOR): DOR aggregates anonymous data from ANDHII use and makes that data accessible for outcomes research, quality improvement projects and comparative effectiveness research. The powerful and flexible database allows direct-care practitioners in a variety of practice settings (from acute care and private practice to public health nutrition) to enter information about nutrition assessments, diagnosis, interventions, monitoring, evaluation and outcomes. The largest registry dataset employing ANDHII to date is the National Quality Initiative (NQI). Since 2014, credentialed RDNs submit de-identified cases in the NQI for the purpose of profession-wide data aggregation.
• Nutrition Research Informatics: The last ANDHII component is a nutrition-centric data collection and management tool for research. This platform facilitates multisite and even multinational experimental research, allows secure upload of informed consent documentation, and offers a variety of privacy and compliance configurations and automatic conversion of units and time zones. A number of registry studies using ANDHII are currently being conducted. Examples of ANDHII projects include registry studies examining documentation practices of RDNs working in diabetes or breastfeeding care, with COVID-19 patients (the RESTORE Study), or other specialty areas. ANDHII registry studies include evaluation of use of NCPT, documentation quality, nutrition  interventions employed, nutrition diagnosis resolution and changes in patient health outcomes.

More information about ANDHII and how to incorporate it into research and practice is available at ANDHII.org. Collaboration inquiries may be submitted here.