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Section 1c: FHIR®
Section 3: Implementation Guides

HL7 FHIR® Profile: Occupational Data for Health (ODH), Release 1

DESCRIPTION

This Implementation Guide contains profiles 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 Occupational 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.

See the specification at http://hl7.org/fhir/us/odh/STU1.2

 

ALTERNATIVE NAMES

HL7 FHIR® Profile: Occupational Data for Health (ODH), Release 1 may also go by the following names or acronyms:

ODH

BENEFITS

  • Enables 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
  • Allows for modeling ODH in a way so that it supports diagnosis, treatment, research and surveillance of work-related injury and illness

IMPLEMENTATIONS/CASE STUDIES

  • Centricity Practice Solutions
  • AllianceChicago

 

DEVELOPMENT BACKGROUND

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. The model is not designed for other purposes, but could be used for other purposes if the needs are supported by this model. The scope of the work information includes:

  • Employment Status
  • Retirement Date
  • Combat Zone Period
  • Past or Present Job for the patient or a household member, which includes:
    • Past or Present Job Occupation
    • Past or Present Job Industry
    • Work Classification
    • Work Schedule, which includes:
      • Weekly Work Days
      • Daily Work Hours
    • Job Duties
    • Occupational Hazard
    • Employer name
    • Employer address
    • Related Subject
    • Start/End Dates
  • Usual Work of the patient or a household member, which includes:
    • Usual Occupation
    • Usual Industry
    • Usual Occupation Duration
    • Related Subject (when it is Usual Work of a household member of the person) 
    • Start Date

Release 1.1 adds support for two additional value sets to document a more detailed occupation (Occupation ONETSOC Detail (ODH)) and industry (Industry NAICS Detail (ODH)). This .dot release also updates IsCurrentJob, which has been changed to be a boolean extension rather than a component.

Release 1.2 Updates were made primarily to address issues identified for Vital Records Death Reporting use of the specification and associated errata. The changes entailed:

  1.  Enabling the ability to express Occupation and Industry as a coded value using the existing value sets and adding to the possible value set slices the 2018 CDC Census Occupation and the 2018 CDC Census Industry.
  2.  Removing the unintended constraint to require a coded value.
  3.  Clarifying the use of the valueCadeableConcept.text for narrative expression of Occupation and Industry where a coded value does not yet exist.
  4.  Clarifying the use of dataAbsentReason when these values are not known.
  5.  Removing the requirement for effectivePeriod as dates are not captured by all systems that need to document work information (e.g. Vital Records)
  6.  Clean up of residual attributes not used for work information (Interpretation, reference range)

 

RELATED DOCUMENTS

HL7 FHIR® Profile: Occupational Data for Health (ODH), Release 1

STU DOCUMENTS

HL7 FHIR® Implementation Guide: Clinical Data Exchange (CDex), Release 1- US Realm See the standard at http://hl7.org/fhir/us/odh/STU1.2. (Submit Feedback on STU)
HL7 FHIR® Profile: Occupational Data for Health (ODH), Release 1 - US Realm See the standard at http://hl7.org/fhir/us/odh/STU1.1. (Submit Feedback on STU)
HL7 FHIR® Profile: Occupational Data for Health (ODH), Release 1 Please see the resource detail for link and download instructions. Expiration Jan 2022

ADDITIONAL DETAILS

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. Work-related conditions are often first brought to the attention of a primary care provider. Some conditions related to exposure to hazards in the workplace can have a long latency, requiring knowledge of a person’s work history for recognition, diagnosis, and treatment. The recognition of new conditions related to previously unknown workplace hazards has often come from astute clinicians, which requires knowledge of the patient’s work. ONC has indicated recognition of the value of work information for health care. The incorporation of ODH into Electronic Health Records (EHRs) and other health IT systems presents an opportunity to improve health in relation to work. ODH provides a structure and standardization for work information that can be used across systems to take advantage of system tools for clinical decision support, population health, and public health. Research has been conducted and guidance is available to support clinicians, and the use of ODH by health IT systems can support identification of patients that would benefit the most from this knowledge.

TOPICS

  • Clinical Quality
  • Medical Records
  • Patient Administration
  • Patient Care
  • Patient Referral
  • Public Health
  • Terminology

BALLOT TYPE

  • STU

STATUS DATE

2020-01-13

RESPONSIBLE WORK GROUP

Public Health

PRODUCT TYPE

  • Implementation Guide

STAKEHOLDERS

  • Clinical and Public Health Laboratories
  • Clinical Decision Support Systems Vendors
  • EHR, PHR Vendors
  • Emergency Services Providers
  • Health Care IT Vendors
  • Healthcare Institutions
  • Lab Vendors
  • Local and State Departments of Health
  • Quality Reporting Agencies
  • Standards Development Organizations (SDOs)

FAMILY

  • FHIR

CURRENT STATE

  • Active

REALM

  • US Realm