ODH FHIR IG Proposal

Occupational Data for Health (ODH) FHIR IG

Owning work group name

Public_Health_Work_Group

Committee Approval Date:

ODH Resource was approved 11/30/2017

Implemenation Guide (ODH as profiles) was approved _______________.

Contributing or Reviewing Work Groups

• Patient Administration
• Orders & Observations
• Health Standards Integration
• Clinical Quality Initiative

FHIR Development Project Insight ID

1290

Scope of coverage

The Occupational Data for Health (ODH) FHIR IG 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
  • Work Classification
  • 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

IG Purpose

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.

The incorporation of self-reported ODH into Electronic health records (EHRs) and other IT healthcare systems provides an opportunity to improve health in relation to work. ODH has not been broadly recognized as a social determinate of health and has not yet been a priority for inclusion in IT healthcare systems in a structured way that fully supports direct patient care and occupational public health activities.

Though research has been conducted and guidance is available to support clinicians, the IT healthcare systems they work in are unable to efficiently identify patients that would benefit the most from this knowledge.

This project seeks to address this gap of system and awareness by modeling ODH in a way so that it supports diagnosis, treatment, research and surveillance of work-related injury and illness.

Content location

http://build.fhir.org/ig/HL7/us-odh/index.html

Proposed IG realm and code

us/odh

Maintenance Plan

PH does intend to continue to support this initiative under support of NIOSH.

Short Description

This IG covers the specific data that covers past or present jobs, usual work, employment status, retirement date and combat zone period for the subject. It also includes the past or present jobs and usual work of other household members.

Long Description

This Implementation Guide contains guidance, new logical models, profiles and extensions to implement support for Occupational Data for Health (ODH). ODH is primarily designed to facilitate clinical care, including population health; ODH also can be used to support public health reporting, population health, and similar value-based care. ODH is not designed to support billing activities. This STU Ballot for the Occupational Data for Health (ODH) Implementation Guide (IG) is sponsored by the National Institute of Safety and Health (NIOSH), a federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is a part of the Centers for Disease and Prevention (CDC). The project to define ODH was done with a group representing a variety of stakeholders including NIOSH subject matter experts, epidemiologists, occupational health providers, and vendors.

Involved parties

The Occupational Data for Health (ODH) Implementation Guide (IG) sponsored by the National Institute of Safety and Health (NIOSH), a federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH is a part of the Centers for Disease and Prevention (CDC). The project to define ODH was done with a group representing a variety of stakeholders including NIOSH subject matter experts, epidemiologists, occupational health providers, and vendors.

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)
• HL7 FHIR ODH (presented as a FHIR Resource) on May 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

IG Relationships

This IG 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

STU for the September 2018 ballot.

Normative for January 2019 ballot.

When IG Proposal Is Complete

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