Incorporating Occupational Information in Electronic Health Records: Letter Report by Linda Hawes Clever

Author:Linda Hawes Clever
Language: eng
Format: epub
Tags: ebook, book
Publisher: The National Academies Press
Published: 2014-08-20T00:00:00+00:00

Technical considerations The level of detail needed to alert a clinician about a health risk may be relatively coarse, such as “organic solvent” or “noise.” However, to be useful epidemiologically, more detail is needed. Occupation paired with industry does not by itself identify a specific exposure, because different employers may use different chemicals or processes for the same task. Physical hazards may be easier to classify based on job title (such as radiation technician), but these, too, will often require specific questioning before a causal association can be established.

Clinicians in general are unfamiliar with the names or contents of many chemical substances to which workers are exposed. Worker-entered data on their own occupational exposures may be quite broad but, given certain health conditions, may be sufficient to prompt further questions. One initial step may be to ask patients if they have been exposed to hazardous toxins where the association with disease has been well documented (e.g., lead, asbestos) or if they are required to use personal protective equipment, which would indicate exposure risks identified by the employer. Furthermore, workers in workplaces covered by OSHA rules have the right to request information about the chemicals to which they have been exposed. OSHA requires employers to provide their employees, on request, with Material Safety Data Sheets on hazardous chemicals (29 CFR 1910.1200(b)(4)(ii)).

Existing information sources on exposures could be linked to EHRs; however, their value for clinical use needs to be assessed because they are not designed for use by a busy clinician. Standards do exist for context-aware information retrieval (e.g., HL7 [2007]), though this functionality requires that information in the EHR be structured and standardized using codes. These same codes can link exposure information to occupations in the work history as well as clinical decision support. In the short term, it may be useful to provide clinicians with links to general resources, such as the Haz-Map website or the poison control center phone number.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.