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This proposal addresses the inadequate and inconsistent CDA templates for exchanging occupational data in the healthcare setting. By enhancing standards, it aims to improve information exchange, support clinical decision-making, and advance public health surveillance.
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Occupation Health Data Encoding Brief Profile Proposal for 2012/13 presented to the Patient Care Coordination (PCC) Planning Committee Lisa R. Nelson October, 2012
The Problem • The CDA templates for exchanging occupational data for health (ODH) are inadequate and inconsistent across existing document standards • negative impact on information exchange and interoperability • The IHE CDA templates that include ODH represent only occupation and industry and in an inconsistent manner • Templates do not maintain occupation and the associated industry together when multiple entries are enabled, and don’t specify inclusion of other needed info about Employer and work location • Standard encoding of patient’s occupations offers care benefits: • Consistently representing ODH in interoperability standards will facilitate structuring of ODH in EHRs and enable clinicians and patients to use/re-use ODH in their healthcare communications • links to clinical decision–support tools that could improve the health care and safety of individuals. • Advances for public health surveillance in order to provide a better understanding of occupational illness and injury.
Use Case • Patient worked for 20 years as a Plant Operating Technician at the lead battery manufacturing plant. Since retirement 2 years ago, the patient has been working part-time as a cook in the family restaurant and also working as a Certified Nursing Assistant at the local long-term care nursing facility. • This occupation and industry information data structures need to support representation of scenarios like this unambiguously and consistently across the health information ecosystem of documents. • Data structures also need to evolve to include encoding standards for information such as employer and other data such as exposures that may represent risk assessments.
Proposed Standards & Systems Define new templates representing new versions or alternative templates for:
Discussion • Level of development effort: Moderate to Minor • Modeling review and assessment of usage/versioning issues in PCC • Close coordination and information sharing expected with QRPH domain • Profile editor: Lisa Nelson • Organizational support • Public Health Data Standards Consortium • NIOSH • Profile development within PCC essential for success • Affects CDA template repository and template usage • Achieve greater consistency across all CDA documents