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Assure HIT Standards for Occupational Health Data Exchanges

PHDSC collaborated with the CDC National Institute for Occupational Safety and Health (NIOSH) to establish implementation standards that ensure consistent capture and use of occupation information.

The activities for this project included:

  • Conducting an analysis of current representation of Occupational Health (OH) data across existing interoperability standards;
  • Developing proposal(s) for the Integrating the Healthcare Enterprise (IHE) 2012-2013 development cycle to assure consistent representation of OH data across IHE interoperability standards;
  • Update existing IHE Profiles to enable consistent representation of OH data
  • Developing a template for representing occupational risk factors for utilizing occupation and industry demographic data within Clinical Document Architecture (CDA) documents.

In Fall 2012, PHDSC analyzed the current representation of occupational health data across existing interoperability standards. The analysis assessed the general use cases for including occupation health data in CDA document standards for clinical notes. It identified current templates defined within IHE profiles to represent the occupation health data and assessed the modeling to support the envisioned use cases for the information.

Based on the assessment, a preferred modeling for the data was envisioned and a brief project proposal was developed to describe the changes needed to develop new CDA templates, which better addressed the data modeling requirements and allowed representation of occupation health data to be harmonized across all the IHE profiles. This approach developed a set of defined occupation health data templates which could be used within the industry and across various standards development initiatives to achieve a consistent and more complete representation of occupation health data.

A change proposal was submitted to IHE to propose a template to represent occupational data for health (ODH). The template was designed to be a sub-section of the existing Social History section template. Incorporating the new ODH template as an optional sub-section makes it possible for all documents which currently include a Social History section, to easily begin using the new template as soon as they are ready. The single ODH template will ensure any documents which begin recording occupation and industry information, will consistently represent the data in an interoperable, standard format. Establishing a standard representation for exchanging OH data enables clinicians and patients to use/re-use OH in their healthcare communications.

The new ODH section template was designed to be a subsection within the Social History section, the location currently specified for occupation information in standard CDA documents. The data includes employment status, Usual Occupation and Industry, and History of Occupation.

The Change Proposal introducing the ODH template takes advantage of new work being done to introduce template versioning and takes advantage of the template version mechanism to include the new optional ODH sub-section in the Social History section. Versioning of the Social History section template will make it possible to make this improvement without having to change existing document templates that include a Social History section.

More information about the project activities can be found at the project wiki pages at https://wiki.phdsc.org/index.php/NIOSH