OccupationalDataforHealth FHIR Resource Proposal

OccupationalDataforHealth

Owning work group name

Public Health_work_group_(PHWG)

Committee Approval Date:

11/30/2017

Contributing or Reviewing Work Groups

• Patient_Administration
• Orders & Observations WG
• Healthcare Standards Integration
• Clinical Quality Initiative

FHIR Resource Development Project Insight ID

1290

Scope of coverage

The Occupational Data for Health (ODH) FHIR resource covers information about a patient’s work or a patient's family member's work. ODH is designed for the social history section of a medical record, to facilitate clinical care in most/all disciplines and delivery environments. ODH also can be used to support public health reporting, population health activities, clinical decision support, and similar value-based care. ODH is not designed to support billing activities. The scope of the work information includes:

• Employment status
• Retirement status
• Combat Zone or Hazardous Duty Work
• Past or Present Occupation for the patient or a family member which includes
• Past or Present Industry
• Compensation and Sector Employment Type
• Work Schedule, including
• Weekly Work Days
• Daily Work Hours
• Job Duties
• Occupational Exposures
• Employer name
• Employer address
• Related Subject
• Usual Occupation of the patient or a family member which includes
• Usual Industry
• Usual Occupation Duration
• Related Subject

RIM scope

• ACT: Observation (ClassCode=OBS and descendants)
• ACT: Observation (Code=ObservationType)

Resource appropriateness

The majority of adults in the U.S. spend more than half their waking hours at work. Therefore health and work are inextricably inter-related. For example, the management of chronic conditions requires taking the patient’s work environment into consideration. Furthermore, the recognition of new conditions related to previously unknown workplace hazards has often come from astute clinicians, which requires knowledge of the patients’ work-setting. ONC has indicated recognition of the value of work information for health care.

Expected implementations

This resource is expected to be implemented by clinical systems of all settings. Since a likely mechanism for collecting work information would be by patient data entry, the resource may be implemented by Personal Health Record systems. Systems supporting quality metrics and population health may also implement this resource.

Content sources

• HL7 CDA® R2 Implementation Guide: Social History Occupational Data Health, Release 1 (January 2018 Ballot)
• IHE CDA Content Modules
• HL7 V2.9 or V2.10 updates (in progress)
• HL7 Work and Health Functional Profile

Example Scenarios

• Diabetes management affected by rotating shift
• Population prevention and testing activities due to potential for increased substance exposure or take-home exposure (e.g. lead) associated with occupation (e.g. house painter)
• Stress factors associated with retirement status
• Long shifts associated with judgement
• Recognition of asthma related to the workplace environment
• Recognition of cancer related to exposure to an occupational hazard during a previous job

Resource Relationships

This resource is expected to be referenced within FHIR profiles to incorporate patient’s work information. Such profiles may include those related to:

• Quality measures
• Public health reporting (e.g. vital records, cancer, case reporting)
• Encounter summaries

This resource refers to the following other resources:

• The Observation Resource for the actual observations
• The RelatedPerson Resource for work or occupations related to the patient’s family
• The Organization Resource for Employer name and address information
• The Author extension for documentation of the person that recorded the patient’s work information

Timelines

We expect that this resource will be ready for inclusion in the next Ballot (R4).

gForge Users

lfourquet

When Resource Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org