College of Occupational Medicine encourages stage 3 job history criteria
The American College of Occupational and Environmental Medicine (ACOEM) is encouraging physicians, IT vendors and the government to expand the collection of a patient’s occupational information in electronic medical records.
In comments on stage 3 meaningful use criteria, the ACOEM praised the Office of the National Coordinator’s recommendation to include a patient’s occupation and industry as a stage 3 criteria.
ACOEM President Karl Auerbach, MD, wrote that a person’s health “can affect their ability to work safely and productively, and in turn their jobs can affect their health.” Patient occupational data collected in a more standardized way through EHRs, Auerbach said, “will prove valuable both for clinical management and for future epidemiologic investigations, including investigation into the causes of cancer and other chronic disabling conditions.”
“Since occupational health risk, personal health risk and disease burden and socioeconomic status disadvantage have been found to cluster, health system knowledge of occupation enhances the individual provider’s capability to target those most in need of care,” said Auerbach, a professor of emergency medicine at the University of Rochester Medical Center.
Auerbach said that while a lot of EHR vendors have developed occupational medicine specific EHR systems, “EHRs for general group health have not typically included features related to a patient’s work life, such as data fields to code a patient’s occupational risks or work capacity.”
The ACOEM also recommended that certified EHRs come with functionalities letting providers document and share information on a patient’s work ability or restrictions, similar to information used in workers compensation and disability insurance determinations. And ACOEM suggested that in future meaningful use criteria, the ONC should consider use cases for recording “additional information about the clinician’s reason for giving the specific set of restrictions or activity prescription,” based on a physical exam or other evaluations.
Auerbach said that collecting basic industry and occupational information is feasible for providers, “and can be accomplished by administrative personnel without increasing the burden of clinicians,” who “can then probe for further occupational detail when relevant to the clinical context.”
Many other health organizations have weighed in on stage 3 meaningful use criteria, including the American Medical Association and HIMSS.