Occupational Data for Health (ODH)

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Occupational Data for Health (ODH) Project

Description

The Occupational Data for Health Data Elements and Structure for Consolidated CDA Social History Section project is a two-phased project. Phase I will define data elements and a standard format for the incorporation of patient-specific work information in the social history section of a C-CDA document. A C-CDA structure for patient work information will be developed that retains the critical relationships among data elements that encompass work information. The ICD-10-CM external cause codes for capturing environmental events and circumstances as the causes of injury and the Occupational Data for Health (ODH) template developed through IHE will form the basis for the conversation. The data elements in the IHE ODH template were designed to include information that can assist in providing patient care. Because not every field will be important for every situation, optionality for some of the data elements will be indicated in the template. The IHE template will be the starting point for Phase I. The project intent is to hold a series of design meetings to fashion an acceptable HL7 version of this template that can be submitted for a Draft for Comment ballot. New entries and value sets related to patient work information will be referenced in the template that is developed. The value sets that are used in the IHE ODH template are already available.

Phase II of this project will be to promote the ODH template as a candidate part of the social history section in C-CDA. The timeline for the next update to C-CDA is not yet determined, so the path to publication of ODH within C-CDA is yet to be determined and this PSS will be updated when that path is clearer. These changes will be applicable to the US realm.

Intent and Need

The project will facilitate the use of work information collected in health information systems, such as electronic health record systems. 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.

Currently, work information collected to facilitate patient care is typically recorded in free text notes and is not described in the same way across records. Therefore it is not easily referenced by care providers over time or when a patient is seen by multiple care providers. In addition, structuring work information would facilitate care by providing a means to review population health based on key factors. When organized as structured and defined data elements, work information could be utilized by the system to assist the provider with recognition and treatment of conditions related to or exacerbated by work, as well as treatment decisions for conditions that are not related to work but can be affected by work, such as diabetes management.

There is regulatory interest and intent to include some ODH data elements in EHR certification criteria (see Office of the National Coordinator for Health IT Interoperability Roadmap, ONC 2017 EHR Certification criteria, and Institute of Medicine report (2014. Capturing social and behavioral domains in electronic health records: Phase 1. Washington, DC: The National Academies Press). There is an opportunity to establish a preferred structure and definition for ODH in a CDA format before the regulatory requirements are put in place and the data are widely captured and shared. Acting now will facilitate interoperable implementation across systems when certification criteria are put in place. Because of the current regulatory requirements to produce a C-CDA document, C-CDA is seen as the de facto place for this template to serve as the preferred structure for ODH.

Providing structure to content about patient work that is sometimes already collected will make it more useful, benefiting both patients and providers. Collection of structured ODH may be accomplished in multiple ways. The simplest mechanism for collecting work information would be by patient data entry, which would be similar to a person providing information for job applications, which are often completed online.

Details

Project Type: Ballot - Comment

Project ID#: 1225

Sponsor WG: Structured Documents (approved 12/29/2015)

Co-sponsor WG: Public Health Emergency Response (approved 8/20/2015)

Co-sponsor WG: Healthcare Standards Integration (approved 1/29/2016)

Artifacts

Date	Artifact type	Artifact link
4/19/2016	ODH Template (updated for ballot)	ODH_for_CCDA_Final_Content_V1.8.docx
3/31/2016	ODH Template (original ballot post)	CDAR2_IG_CCDA_ODH_R1_O1_2016MAY.pdf
2/21/2016	Notification of Intent to Ballot (NIB)	ODH NIB

ODH Project Task Force Past Meetings

Date	Meeting Minutes
4/19/2016