Date of Meeting: Mar 25, 2024

Topic

Date of Meeting: Mar 25, 2024

Topic

Date of Meeting: Mar 25, 2024

Topic

Date of Meeting: Mar 25, 2024

Topic

Date of Meeting: Mar 25, 2024

Topic

Date of Meeting: May 13, 2024

Topic

Partner Update

• All three partners are engaged, have sent use cases, and Ray sent value sets and SOC codes related to their use cases.

  • AC - Truck Drivers and medical providers

    • Is OCHIN working on burnout and well-being among medical providers? NIOSH is working with others (CMS) on structural measures, admin changes - having a chief wellness officer, having measures to gauge level of burnout, etc. Workgroup charged with creating a roadmap - to align CMS and CDC, Abby and Charlene Wong, Michele schriber - Universal Foundation (CMS) as directed by Dr. Cohen.

    • Ray MDLand is working on burnout and stress.

    • AC is focusing on Truck Drivers

    • How is AC id’ing medical providers? All and any, including health center staff.

    • Are the interventions actually being used?

    • Words - when burnout is used, it is clear that this is systems problem failure at the systems level structre - the system supporting the user has failed. Resilience implies an individual problem.

  • OCHIN - Warehouse workers

  • HCN - Food Service Workers

Associations of physician burnout with organizational electronic health record support and after-hours charting 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068427/pdf/ocab053.pdf

Ray

Ray - get Workforce team involved? Exchange info on this?

H5N1

Dairy farmers, farm workers

Can NACHC help CHCs participate in any CDC initiatives?

1. Communication to members

2. Outreach to clinicians to be mindful in the absence of the ODH

3. Encourage health centers to encourage employers to mitigate risk for workers

Julia

Options to Explore for Industry & Occupation Data Collection

NIOSH is excited about requirements HTI 1 rule, ODH code system & vocabulary, and also it is a big challenge to implement the large I & O value sets.

Testing other mechanisms - NIOSH sister developed the industry & occupation auto-coder tool - machine-learning, API

• Use 6-digit code rather than value sets

• Would like to see if partners who are already collecting free text to practice coding in real time and give physician the chance to validate and use it to provide better care - not after the fact, but in real time during visit. Want to find pilot sites

Ray: Very similar to efforts in SDOH Z-coding from free-text using a Large Language Model (LLM)

David: NIOSH working on adding Occupation & Industry to SDOH models using codes that already exist.

Michelle - NIOCCS tool? Yes, based on that.

Amanda - Would like to see this tested in real time in a clinic - pilot would help

David and co can help set up a demo and NACHC can help find pilots for usability and coding.

Ray can reach out to partners to invite them if it’s ok.

Ray will reach out to partners to get their data

Comms 878-02 IEW CTA2 Communication Strategy 4.30.24.docx

• Journal Club

• PRAPARE

Andrea/Ray

Andrea send deliverable re: Comms plan.

Admin

• Janet Lee

  • is transitioning off; new person is Alleyne, Delon (CDC/PHIC/DPS) <uzp9@cdc.gov>Sustainability

• H5N1

• AP

• David will be out much of June, but is ok for June 3rd.

Andrea/David

Shirley off

Genny off

Date of Meeting: Apr 1, 2024

Topic - Email Updates in Lieu of Meeting

Updates

Data and partners

1. Use cases and data

Communications to dissemination NACHC ODH Implementation Guide

1. Journal Club - NACHC checked with Michele about the idea of holding a Journal Club with ACOEM credit (cross fingers) to discuss Michele’s article in J Occup Environ Med. We would invite participants to talk about the article and make a mention of the Implementation Guide with a link to same.

2. Short videos - NACHC is proposing as part of our Communications Strategy to produce a one-minute animated video and a 30-second animated video to promote the Implementation Guide. We are requesting an amendment to add the media contractor to the budget, which requires time for CDC approval and for NACHC’s procurement process.

Date of Meeting: Mar 25, 2024

Topic

Desired Outcome: A decision (or next steps to a reach a decision) on whether we can co-organize a Journal Club on ODH to help disseminate the NACHC Implementation Guide and CDC Resources.

1. Germ of the idea - Ray and Erica

2. Requirements for bestowing CME at ACOEM?

3. Combining the Journal Club announcement with the intro to go out to ACOEM and NACHC mailing lists

4. Next Steps

Desired Outcome: A decision (or next steps to a reach a decision) on whether we can co-organize a Journal Club on ODH to help disseminate the NACHC Implementation Guide and CDC Resources.

1. Germ of the idea

   1. NACHC has heard that Journal Clubs are a great way to engage people in a subject.

   2. This one could be a pilot for a NACHC-sponsored Journal Club - maybe 4 times a year on different clinical topics

   3. We’d assume that NACHC would be the sponsor but if ACOEM would prefer, that’s also possible.

2. Requirements for bestowing CME at ACOEM?

   1. We need to know what the requirements are and how long a lead time we need in order to find out if we can announce that CE is available.

   2. This group can be the planning committee: It includes an ACOEM member, 2 SMEs, 1 comms person, 1 Project Manager

3. Combining the Journal Club announcement with the intro to go out to ACOEM and NACHC mailing lists

   1. Yes, we’d make the announcement in a blurb on the ACOEM listserv

4. Next Steps

   1. Michele to find out requirements and timeline for CME/CEU

   2. Michele to see if date and time are agreeable June 26 11am - 12pm Eastern (1 hour)

   3. Andrea ask each speaker to introduce facilitate discussion in each section as agreed.

   4. Send the journal article to the participants , put the link to IGuide and AGuide in the emailed invitation

   5. Ray and Michele review the outline below - provide comments and suggestions

   6. Kowalski-Mcgraw M, McLellan RK, Berenji M, Saito K, Green-McKenzie J, Thompson H, Hudson TW 3rd. Electronic Health Records and Occupational Data: A Call for Promoting Interoperability. J Occup Environ Med. 2023 Jul 1;65(7):e520-e526. doi: 10.1097/JOM.0000000000002888. Epub 2023 May 26. PMID: 37235451.

      1. Welcome and introduction (start 3 minutes after the hour)

      2. Abstract and Background, Occupational Medicine Practice and use of EHRS - Dr. Michele Kowalski-Mcgraw (10 min)

      3. Enable recording and retention of the patient’s current or usual occupation, work status, and industry using the US National Institute for Occupational Safety and Health (NIOSH) Occupational Data for Health (ODH) framework, which captures this information in the data-formatting interoperability standards for health information systems - Dr. Katherine Chung-Bridges (10 min)

      4. Collect and maintain industry and occupational information supplied by the patient as protected health information (PHI), which is to be used for the medical care of the patient independent of employer-directed requests for evaluation or surveillance; - Daniel Parras(10 min)

      5. Include standardized fields to capture a patient’s physical, emotional, and cognitive function, with a required minimum set of data elements; - Dr. Raymonde Uy (10 Min)

      6. Record sentinel occupational exposures or risk factors on the problem list, with the capability to use these sentinel risks for later clinical management and decision support. - Dr. Giddel G. Thom (10 min)

      7. Introduce Implementation Guide & Action Guide, how and why it was written - Dr. Raymonde Uy (4 min)

      8. Closeout - how to get CME (3 minutes)

Ray

Look up articles for the “for more information” chat post during the session

Date of Meeting: Mar 4, 2024

Topic

Conferences

1. HCN submitted a session proposal to NACHC’s summer conference CHI

2. Ray is submitting to NCQA Summit with a partner

3. Looking at other places to submit

a.      AOHC

b.      AMIA CIC

VIVE Conference last week – Health IT Industry

1. Met with grads from Stanford who want to address climate in their occupation/workplace

a.      High heat issues –

1. Spreading the word to vendors who are looking at SDOH that ODH exists as a standard – will do during HIMSS as well.

Partners

1. Partners have been given the value sets for their use cases

a.      Example: Truckers – substance use, stimulant use

1. AllianceChicago is in a situation with data structure where it will be easier for them to do the data submission to NACHC and will add in the data elements/codes, and NACHC would do the analysis and exploration.

a.      This was a full network implementation – any one of their users is therefore using athenahealth and has access to the ODH.

Recent focus on Vendors

1. Helping vendors make the ODH model available through their systems.

2. Need to incentivize collection – relation to health equity is one of the keys, reimbursement is the driver.

3. Vendors showed off their cascade – a sub-form that populates under employment status.  They are screening for unemployment as a SDOH factor.

4. Employment Status field is structured in Epic using the ODH template.

5. Health Centers report that they do not get high priority status from vendors so it takes a long time for vendors to implement.  They are not as responsive to CHCs.

6. Newer, smaller vendors are letting customers create, download their own and do their own work w/out vendor.

Submission of Data

1. Late May/Early June

Dissemination Strategy

1. Anything we can do on AOHC - AECOM Michele can work on that.  We have items that we created from projects, can we disseminate through AECOM network? 

2. Michele getting Health Achievement award!! She will credit HCN for the work they did. 

Next Meeting April 1, 2024

Comment period for USCDI v5 is open.

1. Would welcome comments on core data elements

2. David will send their comment on the ODH value sts

Date of Meeting: Feb 5, 2024

Topic

NACHC Updates

• Review of All Partner Meeting slides - three use cases, value sets related to those use cases, journal articles discussing occupation-related injuries for those three user stories.

• Re: OCHIN - once you provide them with the codes, what will they do with them? What is the next step- like: who are these patients and how can we intervene?

  • One of the deliverables NACHC required was a plan for a next step. They will not do a full implementation, but will be set up to share the plan with their leadership and with sister organizations.

• HCN is standing out.

Questions re: Z Codes

• Burnout

  • NIOSH wellbeing group one of this year’s partners is working with med staff and will be looking at burnout

  • Is there an ICD code for burnout - Michele - there are codes but they are so rarely used… look also at mood disorders and anxiety disorders is a good idea.

  • ICD-9 ICD-10 Diagnosis [Using Smart Search]
    V69.8 Z73.0 Burnout of caregiver
    V69.9 Z73.9 Burnout related to life management difficulty
    V69.8 Z73.0+ Encounter for burnout related to life management difficulty

  • Z-73 - burnout 

  • Z56.3 – stressful work schedule 

  • Z56.6 – other physical and mental strain related to work 

Sustainability

• Epic employment update

NACHC has proposed four short, animated videos as the deliverables related to the communications plan. 3 would use the User Stories, and one would go into slightly more depth on the Implementation Guide and NIOSH resources.

Capturing structured employment status? The message that they need to be more comprehensive about capturing it - but they are now aligning with the coding sets from NIOSH and PHINVADS - it was being recorded as different things… They can now find it.

Ray submitted for the NCQA information summit - even though outside of the grant year, but we want to disseminate.

• Showing how we are managing the terminology on ODH

• CHI for the education session

Michelle will do an AECOM session on the importance of research on this.

Date of Meeting: Nov 6, 2023

Topic

Topic Owner

Action Items

Michele’s AAFP Presentation

2 sessions - 2 hours each - didactic and problem-basedlearning session. Session times were not ideal. Used La Casa as case.

Take away - good to have a message of Prevention - so that we don’t find that people are coming for end-stage issues and only finding out then.

Dr. Saito covered legal issues and questions.

Have we reached out to AAMC? on issues around taking the history… they do likely have work as a subject in Bates training materials.

Julia - any contacts at AAMC who might work on projects re: taking history, including work..

Michele will see if she knows anyone at AAMC

ODH Employment Field - Amanda

Amanda, David, gEnny - went to Epic playground with colleague - under Employment Status in SDOH section - maybe initiated by Gravity project? Raymonde: Epic Wheel is the Epric proprietary screening, largely based on PRAPARE and another questionnaire.

In History, under Social economic, it has occupation and employer fields. Occupation field is free text, but employer name is a drop-down list.

With Employer Name you can figure out NAICs codes. Maybe via DOL O*Net

Michele’s Epic instance in her system has the dropdowns but they link to census codes…

Ray to investigate w/our partners

Are they able to find the SDOH or History/Socioeconmic in their Epic (and other) instances.

Can they find it? How deep is it buried in the layers/easy/difficult to find?

Reach out to Amanda if questions.

eCR Challenge

Who participated? AllianceChicago and HCN mentioned that they are working on ODH eCR challenge.

Katie Dodd is NIOSH’s contact for APHL - we could have partners meet re: challenge.

Deadline for submission of evidence and the agency that would do the reporting Nov 17, 2023

Andrea put eCR on agenda for next All Partner meeting.

LinkedIn Live response from Ray’s network.

Colleagues found it and watched! It’s also uploaded to NACHC’s YouTube channel.

Year 2 Final Report - any comments?

The Lessons Learned section was helpful.

We have learned about what clinics can do locally - like the ODH vocabulary… (in contrast to vendor -level). Continue to talk with clinics about opportunities to use this even if it is only the 2-3 digit or API NIOX tool to code it, or even free text. All approaches valid at this point!

Continue to socialize using this info and what would you do with these data - what if you know how many firefighters, farmworkers, etc. Docs get excited about the idea of looking at prevention - helps with addressing burn-out because there IS something they can do pro-actively.

Graphic for rural health bulletin/newsletter

Deadline - 11/8.

Not the ODH Guide

Ray will send by Nov 7, 2023

Charter for Year 6 878-03 ODH NACHC NIOSH Project Charter.docx

Harvest Meeting Monday July 1 still 2pm at our usual meeting time? or are ppl likely to take that whole week off?

yes July 1

Does NACHC owe anything to NIOSH?

Poll for kickoff

Date of Meeting: Sep 25, 2023

Topics

Year 3 approach

SOW for partners

Open

Year 2 Close Out Year 2

• Promotion of Implementation/Action Guide LinkedIn Live on October

@Raymonde Uy

@Andrea Price (Deactivated)

@David Blackley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@England Lucinda (Unlicensed)

Shirley Burton

Data - Raymonde is working on getting 1) the number of Essential Workers using NIOSH crosswalk and 2) the number of Essential Workers based on the vaccine phases.

Funding - NIOSH has committeed the funds and completed the transfer form to CSTLTS. Tech Review and authorizing doc. Hoping for Round 2 Sept 1. Technical Review: No response required.

David’s thoughts on priorities, activities, etc.

HCN seems to be in the forefront, although are using 2-digit industry and occupation codes rather than full - good to continue to do that; if they are able to stretch to the 3-digit code and keep us apprised of progress, that would be helpful. Raymonde - good one-year goal.

Focus on one vs. keep going with all three $240K

The podcast showed their momentum, do they have other activities in the works; would they be interested in telling another story via podcast?

Helping to get step-wise instruction for the other two (NACHC will have Action and Implementation Guides for review soon).

More focus and depth in data collection and expanding on how they use the data - and translating it into public/population health action.

Raymonde - There should be a clinical use case as an output - esp if all three networks are involved.

Julia - Does it add to our knowledge/progress to continue with data collection vs other activities?

What would we like to see?

• If they are capable in one chc to collect at the 2-digit level at minimum or 3-digit level, collecting the major categories for industry and occupation and employment status for those patients. Demonstrate that it is possible for a few hundred patients and report on what did and didn’t work.

  • 1st Continuation of the capability that HCN built - they are on the path towards 3-digit, more granular collection, but 6-9 months at the Major Category level would still be important progress. The lift is heavy, so the individual institution has to do that - and they can help others.

  • 2nd Take the data, analyze it and decide how to leverage it for pop health decisions. If people can see the application of it in a clinical use case, they will be more likely to want to implement. Answers the question: what is the clinical value - what is an example of clinical value of collecting and using ODH?

IEW vs/and ODH? Collection of high quality structured ODH work information in a variety of use cases.

• Partners could be the ones to decide the area of interest - they could work on EW (and SDOH), but also could work on other risk fronts.

• Now that we have the ability, it is easy to crosswalk to EW.

• Among those who experienced and tracking long-covid outcomes over time. Did people have to change jobs? Did many change industries/occupations as a result of (code for long-covid).

Julia suggests checking with each partner to gauge their interest level, desire to go into a third year.

@Raymonde Uy

@David Blackley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@England Lucinda (Unlicensed)

Shirley Burton

July 19 1pm Harvest Meeting welcome - David suggested that his Division Director might say a few introductory words - we’d like to put that person’s name on agenda? Is that confirmed?

Data will be coming in 7/31/2023, NACHC will be receiving, inputting data and creating dashboards; will provide a brief final report that includes the third partner, HCN.

Action Guide is in review and edits - short, includes Implementation Guide but has step by step instructions for integrating ODH into EHR.

Partner Implementation Slides - Partners are working on Harvest slides, so have not updated these.

@Raymonde Uy

@Andrea Price (Deactivated)

@David Blackley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed) (on vacation)

@Genny Luensman (Unlicensed)

@England Lucinda (Unlicensed) (not present)

Shirley Burton

Conferences

Feedback/Followup from conferences?

AMIA CIC - slide deadline was last week, they were submitted. Next week Wed May 24, will be in Chicago starting Tuesday May 23.

• contains data from partners; there is one partner (HCN) who is waiting for DUA to clear, so full project data set will be available after they submit.

Ray will send full slide set

Funding News? We aim to wrap up our work, want to let partners know.

• Likely need to wrap up the project. Final word won’t come until August if there is funding left over. Looks unlikely that another year will ensue. Sometimes funding comes in September or October when it is agency funds.

David will pass the word to Janet - a description of the work, the workplan - on to his Division for their wish list.

Implementation Guide & Dissemination (in formatting - Andrea finding out ETA).

Year 1 Final Report sent in to NIOSH TMs.

Update on Partners:

Single slides: Year 2 IEW Partner Implementation Slides - IEW - Identifying Essential Workers - Confluence (atlassian.net)

Full slides for All Partners Calls: 2023-05-17 All Partners call slides.pptx

Where is AllianceChicago in terms of implementing I & O data

Two site names:

• University of Wyoming - Wyoming (rural)

• Heartland Alliance Health - Chicago, IL (urban)

Ray - Where is AllianceChicago in terms of implementing I & O data?

Serendipitous results

Daniel Parras at HCN has been speaking with Epic on system…

HCN asked for translations into Spanish for value sets, Ray sent them and cc’d the Epic team.

@Julia Skapik (Deactivated)

@Andrea Price (Deactivated)

@David Blackley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@England Lucinda (Unlicensed)

Shirley Burton

Admin Project Funding Project Year 3 - CSTLTS Year 6

• NIOSH had not built in funds for a Year 6 extension; we discussed what NACHC might do in a Year 3 of this project. If there is funding left in the Division, it can be transferred to the agency to use for continuation. If other projects are trying to spend down carryover, the new dollars may go unspent.

• Similar projects, NACHC has proposed that we 1) roll out to other sites; 2) improvements; 3) data extracts to look at different outcomes; 4) examine data quality.

• NACHC has proposed to collect ODH on other projects, example, one on CVD.

• Rationales for integration into all work:

  • SDOH

  • Health Equity is a priority for President Biden

• [2:15 PM] Blackley, David (CDC/NIOSH/RHD/SB)

  1. Employment and job characteristics: Access to stable and fulfilling work with equitable pay. This domain includes wages, work schedules, workload, job security, safety, working conditions and environments, workplace accommodations, access to benefits including paid leave and health insurance, work/life balance, unemployment, and underemployment.

   

  [2:22 PM] Blackley, David (CDC/NIOSH/RHD/SB)

  Deering, Amanda (CDC/NIOSH/RHD/SB) <ums1@cdc.gov> health scientist (informatics)

   

Julia

Partner Progress through March 2023

Year 2 IEW Partner Implementation Slides

Andrea

For Michele - wanting to spread Epic instance to UCSD, can we get info from HCN on how they are doing on that implementation.

OCHIN builds custom structures within Epic (vs SMART on FHIR, which costs because Epic charges). We do not know if one instance is generalizable to other networks. They may not have built it to scale implementation.

NACHC can facilitate this discussion - UCSD says “We’ll wait for Epic to roll it out.” It would be helpful to have information from the implementers.

https://nachc.atlassian.net/browse/IEW878YR02-100

Data Dashboards

Open

AC is captures occupation and industry reported much more than OCHIN.

NACHC is working with the partners to improve data. Referring them back to the Guide would help for Employment Status - there are only 3 bins in the Guide. Employed, Unemployed, not in the workforce. That is a next step. Helpful for health centers to see what is coming in, reflecting back to them what they are getting so they can see a reflection of what is coming.

If we have industry, why don’t we have data for occupation?

Jayson

Andrea to check - is HCN able to send data? Ask Jayson if we need to do anything to unblock this.

Implementation Guide

• In editing & proofing

• Ray will approve, then it goes to formatting, then dissemination.

Andrea

Conferences

• P&I session in March, Washington, DC

• ACOEM in April 17, Philadelphia, PA

• AMIA CIC in May 24 in Chicago - Genny, Julia, Katherine Chung-Bridges, Ray

Julia

Harvest Meeting - Can you all make it on July 19 at 1pm? Partners are already scheduled to meet at that time.

Andrea

Block off 1.5 hours.

@Raymonde Uy

@Andrea Price (Deactivated)

@David Blackley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@England Lucinda (Unlicensed)

Shirley Burton

NACHC Updates

• Implementation Status https://nachc.atlassian.net/l/cp/Wa5hUW8v

• Status of incoming data from partners

• Data Dashboard format

Ray

NIOSH Updates

CDC NIOSH Team

Conferences

• P&I session in March, Washington, DC

• ACOEM in April, Philadelphia, PA

• AMIA CC in April, Houston, TX

Ray

@Raymonde Uy

@Andrea Price (Deactivated)

@David Blackley (Unlicensed)

@Burton Shirley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@England Lucinda (Unlicensed)

Shirley Burton

Update on Partner progress

• Data

• Implementation

@Raymonde Uy

Implementation Guide is now complete, NACHC is charged with disseminating it. NACHC will send it to our partners, notify HL7 and put it in NACHC newsletter. Would NIOSH like to contribute categories or contacts?

• Genny wants to review IG doc before NACHC finalizes it.

@Raymonde Uy

Conferences and Presentations:

March - NACHC Policy & Issues Forum

April - ACOEM Conference

Speakers for ACOEM (or P&I?)have had issues - HCN lead Dr. Chung may not be ablet to come so it might be Daniel Parras. Ray will confirm.

Deadline for AMIA CIC was last November, for AMA main conference has been extended. This was not in NIOSH budget, so they’d have to discuss if anyone from NIOSH could attend.

@Raymonde Uy

@Raymonde Uy

@Andrea Price (Deactivated) - has a conflict

@David Blackley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@England Lucinda (Unlicensed)

Shirley Burton

Recent Activities

• Implementation Guide

• Data

Ray

Last change to comment on IG

data update noted.

NIOSH speaker for P&I?

Ray

None from CDC.

3 speakers finalization:

1. Samantha Burch, OCHIN

2. Ray Uy, NACHC

3. Daniel Parras, HCN

Admin: Move Monday meeting 2/20 because of President’s Day. Change cadence to monthly?

Ray

@Andrea Price (Deactivated) , move next meeting to Feb 27, 2023

Meeting cadence will start from that meeting. Possibly once / month

@Julia Skapik (Deactivated)

@Genny Luensman (Unlicensed)

@Raymonde Uy

@Kowalski-Mcgraw Michele (Unlicensed)

@England Lucinda (Unlicensed)

@Andrea Price (Deactivated)

Shirley Burton

@David Blackley (Unlicensed)

@Crystal Nwachuku (Deactivated)

Potential Technical Solution from discussion with another partner.

• Large vocabulary for industry and occupation; for them, as part of MyChart or using kiosk software could put out a link so the patient could enter the industry, occupation, and employment status, and bring them back to the EHR, carrying the patient identifier with it. Could NACHC suggest it to the partners for consideration?

• The vocabulary is in both English and Spanish

@Raymonde Uy will bring this up on our next All Partner call (Andrea to create agenda for meeting date).

Any thoughts, feedback from kickoff Meeting 11/30/2022?

2022-11-30 IEW Y2 Kick-Off Meeting Agenda & Notes - IEW - Identifying Essential Workers - Confluence (atlassian.net)

Michele is working with AEOCOM on how to separate out the privacy issues for patients who are also employees.

Techniques for helping patients become more willing to share employment information.

• The HCN script sheet

• Have training for people - ODH is for health, the patient needs to understand it is not related to insurance, etc., and that it is to help with health.

All

@Raymonde Uy will be speaking with OCHIN - it was to give live in October, but Ray will be getting a better grasp on timeline and roadblocks.

• Where the patient is an OCHIN employee, it causes an error.

@Raymonde Uy will ask about a contact for privacy issues for patients on next call with OCHIN.

Status of Implementation Guide revision based on Genny’s comments

Raymonde

• Genny suggests opening navigation page and look at headings to look at the structure and proofread.

Admin - Contracting is in process with the partners.

Andrea

• Done

Did AMIA Clinical Informatics Conference write to Genny and Michele for disclosures?

Raymonde

Yes, done.

ACOEM notification date?

Michele will ask.

Next meeting will be January 9th.

@Genny Luensman (Unlicensed)

@Raymonde Uy

@Kowalski-Mcgraw Michele (Unlicensed)

@Andrea Price (Deactivated)

@David Blackley (Unlicensed)

F/U from AMIA

Letter to ONC

Michele

Status of Implementation Guide

Final Report

Charter

Status of Evaluation and Outcomes Plan

Conversation with AllianceChicago

They have gotten approval for their instance of EPIC to include the ODH. This was a challenge that has taken almost one year to

Epic - Check to see if our partners can go to Epic customer conference(s) to show what they are doing and let others know.

NACHC has gone the farthest to implement, what’s the next step?

Schedule a follow-up with the participants of the Epic meeting from October. The Epic team was the team charged with building the Occ Med, can ask if they can id the Epic teams that develop/integrate the work definitions for primary care.

• Michele will check with the Epic folks and work with Andrea to schedule the meeting.

ACOEM Conference abstract acceptance notices? No news.

Admin

• Contracting with partners is in process

• Kick-off Wednesday November 30, 2:30pm

@Julia Skapik (Deactivated)

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@Raymonde Uy

Shirley Burton

@England Lucinda (Unlicensed)

@Andrea Price (Deactivated) (tentative)

@David Blackley (Unlicensed)

@Crystal Nwachuku (Deactivated)

Update from Janet Lee re: finalizing the revised plan for FY23.

David

• Kathy submitted the revised budget.

• Everything is good from NIOSH perspective.

We would like to have more details about what the clinics did as far as employment status, in order to address the need for real-world implementation to support inclusion in USCDI.

Genny

HCN asked for a webinar from NACHC/NIOSH “that provides training on” ODH/work information, to help to “overcome barriers between patients and staff/providers.” Is this still of interest?

Genny

• AllianceChicago/HCN has a webinar series in January - could incorporate training webinar.

• Consider recorded or shorter trainings?

Discussion of Kick Off

1. Date: November 14 2pm to 3:30pm (we’d extend our regular meeting). Some NACHC team members may be at PCA/HCCN

2. Review Draft Agenda - Can David provide a welcome?

Andrea, Ray, Crystal

• Ask partners to send detailed description of what options are available to users for reach data element

Genny will be at AMIA November 7.

Request for NIOSH to review charter - Andrea will send when drafted and internal review is complete

Andrea, Ray, Crystal

Julia and Ray to review Charter, then Kathy, then NIOSH TMs.

Status of ODH Podcast and Information Sheet

• NACHC is creating a landing page with the link to the video, audio, transcript and 2-pager. Should be up by week of Oct 17, 2022

• 2 pager is being translated into Spanish and will be added to landing page.

• The podcast will be promoted via NACHC social media, newsletters, etc.

Andrea, Crystal

@Raymonde Uy

@Genny Luensman (Unlicensed)

@David Blackley (Unlicensed)

@Kowalski-Mcgraw Michele (Unlicensed)

@Andrea Price (Deactivated)

Shirley Burton

@Crystal Nwachuku (Deactivated)

Status of abstract submissions

Status of two-pager on Dairy FarmWorkers and Status of Podcast

Status of funding

Award was in the NOA last week.

Data Status

Genny talking with AC about a webinar - Fred Rachman AC reached out about that.

Agenda for ODH in Epic meeting 10/3

Rescheduling the meeting on Code Sets

crystal is working rescheduling with Genny

@Raymonde Uy

@Kowalski-Mcgraw Michele (Unlicensed)

@Genny Luensman (Unlicensed)

@Andrea Price (Deactivated)

Shirley Burton

@David Blackley (Unlicensed)

Status of conference abstract drafts/submissions

• HIMSS - Genny, Julia, Dr. Chung from HCN. It is ready to go. Deadline is Sep 12, 2022

• AOHC - Dr. Chung, Genny, Julia or AllianceChicago depending on time conflict given that this overlaps with HIMSS.

Which track?

• Clinical occupational environmental track

Raymonde

Julia to approve title - Julia is out sick, so communications are slowing down.

Status of data for 3 partners

• AC cannot provide until end of September

• OCHIN - data was sent 7/29/222 see 8/22/22 email from Seren

• HCN - has just gotten access to SFTP and will upload data

Raymonde

Agenda for meeting regarding integration of ODH in Epic

Desired Outcome: Better understanding of the goal of integrating ODH into Epic, how implementation could progress in Epic instances.

1. Introductions

2. Description of this project what we hope to accomplish

3. What are the opportunities for integrating ODH into Epic

   1. partners talk about any barriers

Notes - OCHIN cannot make it Oct 3; go ahead and update them afterwards, include them on a follow-up if/when we have one.

Epic Steering Committee (User group?) met on Tuesday.

Genny - is this a good time to add other users? Michele - this is the start of a conversation to introduce Epic to what we are trying to do.

Julia - we can invite the Epic reps to the Epic user group.

Date: October 3

Andrea & All - agenda?

Status of Podcast

Andrea

Genny - Do we have what the person said vs. what gets recorded?

• Depends on the partner.

• None are doing patient input, so it is staff who records it.

• We would need to do a validation check.

Year 2 Funding

NACHC has not received a NOA.

Funding has been split into two rounds, round 2 NOAs are still outstanding.

Round 3 NOAs will be shared no later than Aug 31, 2022

AOHC Conference 2023 Occ Med in Philadelphia Mid-April 16-19 2023, abstract deadline end of Sept.

American Occupational Health Conference | ACOEM

Can Dr. Chung speak on a panel about the dairy farmers?

Ray will send the info to NIOSH for review by Sep 9, 2022

This conference is more clinically oriented as opposed to informatics. Michelle Whitt and Michele Kowalski-Mcgraw will be there.

Speakers:

HIMSS Abstract April 17, 2023 - April 21, 2023 in Chicago

https://www.himss.org/global-conference/attend-about

HIMSS Call for Proposals due Sep 12, 2022 . Usually an educational session per Ray.

This should also be cleared. Genny will be at HIMSS.

Speakers: Raymonde and Genny

AllianceChicago’s industry and coding scheme

AC uses Athena One. Other two partners are using Epic.

NACHC is meeting with AllianceChicago at CHI.

Sites that implemented towards end of CoAg Year

When will we have data from partners?

Meeting with partners who are or will be Epic users

HCN and OCHIN.

Could include others who use EPIC and want to include ODH. There is a steering committee at Epic re: Occ Med, which is being missed in current record. We’d be meeting with Epic reps.

NACHC Staff at CHI

NACHC staff in Chicago at CHI from Aug 26 to 31.

AMIA - Genny, Shirley are going.

Year 2 Funding

David

CDC has submitted everything as expected. NOA was released but NACHC has not received it yet. NACHC Contracts team is checking.

Set up Kick Off Meeting.

USCDI Data Elements

Genny

Occupation and occupation industry are officially in USCDI.

Starts next year - per RAY when V3 goes into effect. At that time, each of the partners will put in requests to their EHR vendors to include the new elements.

Voluntary attestation in 2023.

https://www.healthit.gov/isa/taxonomy/term/3381/uscdi-v3

Set up call with AllianceChicago about their coding? Aiming too high and broad or misunderstanding of terms - has to be a call, difficult to mark up the spreadsheet.

Set up a meeting with Michelle and her Epic contact with Dr. Chung at HCN.

• Describe who ODH can be implemented w/in epic

• SDOH impact on V2 coding

Set up call between Genny and AllianceChicago to provide feedback on the coding.

AMIA Submission Status

Michelle

Ray’s submission had positive reviews and feedback, but the scientific program committee rejected the submission. He will resubmit to AMIA CIC 2023 (Chicago, IL May 23-25, 2023) and HIMSS.

Evaluation - Final Report

David

Offer of TA from Shirley to working with the contractees on their evaluation.

NACHC delayed the first pull until partners have a larger amount of data.

Set up an IEW kickoff, ask Shirley to review Data Request Form

David Blackley

Looks like it will be $240 - he will submit TR

We can start to think about how to tweak the budget and plan.

CDC NIOSH had expectations that the tools would be easy for sites to use - this project revealed that it was not as they thought. Julia - 1st year is often about expectation-setting as well as admin.

Spread and scale is easier after y1.

If EHR does not have native support for a change, it takes a lot more time - when it is new data collection into the mix, it is an exponential layer of work.

Wants to work directly with the partners, providing TA

By the end of year 2, we can ask how feasible is it to extend to another site?

Revision: He will have to ask us to respond to response required because he has to in making this change - he has to check that off. The workplan can stay the same with Julia’s new line about implementing the full ODH.

Don’t need to revise plan, just budget for same activities.

Harvest Meeting

Jul 11, 2022 from 2pm to 4pm

End of the year meeting - Focusing on the partner experience and lessons learned. Each partner will present their own data. Discussion and steps for scale and spread at the end.

2022-07-11 IEW Harvest Meeting Partner Slide Template.pptx

David will give the CDC welcome.

USCDI decision? ONC is still working on it. (Julia)

What are the next steps as part of summary of Harvest Meeting - discussion of how to align with the ODH granularity for future?

Organizations may have been more focused on where would they fit this into their workflow and data warehouse. If the ideal is patient-input data, what can they do to get there? What are the barriers? Care message?

Genny will be joining but is officially off -

Review Data Dictionary

Genny can put notes in the spreadsheet - might be best to do as a discussion with Ray/Julia.

Occupation/Industry are not clearly delineated - need more understanding. Industry is the business. The linkages were intended to be optional support - maybe they were using them more as a mandate?

Really needs to be a discussion - if structured this way, the AC results cannot be used outside of AC. AC can make a shift; we can work with them, so let’s start with the spreadsheet. Genny will start with high level comments and then we can see where to go with the questions and who can help resolve.

AMIA Conference

FMX

Michele will be at the meeting.

Michele - CME module due July 27 for FMX - do we want to integrate info from this project in this? 1-3 hours.

Year 5 Plan

As far as NACHC knows, NACHC is to wait until the NOA is issued to respond to the Technical Review. NACHC revised the budget to $125; now we need to review the plan and re-size it.

David and team needs to respond to revised plan with the Technical Review by July 11. It is this formal TR that goes back to NACHC. The bottom line could change.

Harvest Meeting

Jul 11, 2022 from 2 to 4pm

Crystal

@Crystal Nwachuku (Deactivated)
will send the slide show to David prior to the Harvest Meeting on July 11 so he can write his introduction based on what is there.

Training Products Call /Training Materials

Genny/Ray

Julia: To what extent are we capturing usual vs. current occupation?

Genny: In COVID, it seemed that current was more important. But both are important.

• Genny suggests allowing entry for multiple jobs.

Alliance Chicago Code Sets and ODH Data Elements

Ray

Admin/Next Year Funding and Work Plan

Andrea

Last Genny heard, we did not get COVID funding. Genny suggests emailing David since he will be in and out of the office over the next couple weeks.

Suggestions for Improving Code Sets

Shannon/Genny/Ray

Genny suggests incorporating occupational groups because selecting an occupational role based solely on industry may be limiting. What if the patient's occupational role does not fall under the selected industry?

• After selecting the industry, data entry person/patient would select the occupational group and then the occupational role. 

Another suggestion from Genny: If patients provide employer information, EHR may automatically select the industry (employer database)?

• Most likely not possible per Shannon. Many patients hesitate to provide an employer name.

• No publicly available database per Ray.

• Genny says you can maybe look online.

Genny will send info to clarify definition for unemployed.

Harvest Meeting

Jul 11, 2022 from 2 to 4pm

Crystal

New date is confirmed. The Harvest Meeting will be held on July 11th from 2 to 4pm EST.

Other Meetings

Crystal

• Brief check in with partners later today, about mapping code sets.

• Training products call

  • Crystal is working on setting this up to discuss training products with the partners at the end of May/early June.

  • Genny sent a few questions to NACHC to discuss with partners and guide the conversation.

• Last all partners call before the Harvest Meeting

  • Will be scheduled for mid-late June.

Next Year Funding and Work Plan

David

David tried to submit the technical review using the dashboard but not sure about the follow up. 

Work plan for carryover activities?

Code Sets

Ray/Genny

Ray shared the industry/job role drop-downs from AllianceChicago. Genny mentioned, for example, that janitors may fall under several industry choices. Need to be careful about this. Occupational roles are not necessarily unique to a certain industry. 

Genny also explained that if the information is collected on paper and then entered by someone else, context may be lost. Industry/role entered by the data entry person may not reflect the patients actual occupation. How are we validating this data? 

• Julia suggests using patient portals, texting, and other methods that allow for direct patient data entry. Depends on vendor product, etc.

• Ray mentioned that major barriers are staffing and EHR implementation.

Article

Genny

https://onlinelibrary.wiley.com/doi/10.1002/ajim.23361

Genny shared this article from a separate group in NIOSH. May be good to review.

NIOSH Debrief Questions

Julia

NACHC-NIOSH 4-25 meeting debrief with notes

• Ideally, the ODH data should be integrated into the EHR data warehouse but there are several challenges. Need to figure out a way to integrate the data without impacting the day to day performance of the EHR.

• The partners may not be moving at the expected speed, in terms of implementation. Everyone is playing catch up due to staff shortages/COVID.

• OCHIN is using the entire list.

• Julia and Ray: Interested in broader projects related to patient-entered data.

• FHIR app: Creating an app just for this dataset is not as useful. Makes more sense for a wide range of patient-entered data that would be linked to the EHR.

• Cultural anxiety and structural inequity may cause patients to be hesitant with sharing their employment info. Partners need to be careful with their language/choice of words when speaking to patients.
  
  

  • Michele suggests targeted staff instruction/training. Ray agrees.

  • NACHC planned on using the experience from the pilot health centers to create new training materials for all centers.

Admin

Carryover - NACHC may be able to continue some of the work using carryover funds if available.

Year 2 funding priorities:

• continue to get data extracts quarterly

• continuous quality improvement on existing build - goal is to enable the search function that supports the entire hierarchy - if they don't have the ability now, what are their plans to do this?

• Support patient-generated data - what are their plans to do this?

• Where are the challenges, what can we do to help overcome?

Resources for Patient-Generated Capture of Industry and Occupation

1. Patient-Generate Health Data (HealthIT.gov)

2. Guide to Integrate Patient-Generated Digital Health Data into Electronic Health Records in Ambulatory Care Settings

Training Materials 

Health Choice Network Training Slides for IEW Project

La Casa English Intake Form

La Casa Spanish Intake Form

LaCasa_IEW_Industry_And_Occupational_Roles_03.15.2022 (1).xlsx

• help care team to id how to stay healthy in the workplace based on what kind of job/workplace you are in

• How to help future patients get better care based on what you tell us

Harvest Meeting Jun 30, 2022  11am to 1pm

Julia/Andrea

• Purpose of meeting

• Participants and invitations

• David to give welcome?

Possible dates:

Monday, July 11th 2pm-4pm

• Top choice

Thursday, July 14th 11am-1pm

Tuesday, July 19th 1pm-3pm

USCDI Comments

NACHC will be responding to USCDI with a letter

Value Sets

14-Digit codes on ?FINVADS?  Friday 10am call - or by email.  FINVADS Hot Topics → ODH → downloadable spreadsheets with crosswalks supplied.  Genny has a conflict but Lauren could make the 10am call.

All Partners Call on 4/25

Meeting Page: 2022-04-25 IEW All Partner Call with CDC Meeting notes - IEW - Identifying Essential Workers - Confluence (atlassian.net) 

Identifying Essential Workers - Ray

Partner slides 2022-04-25 IEW All Partner Call with CDC Meeting notes

Michele can help on the podcast, be interviewed.  The writer can help the partners elaborate on the stories.

Conferences

AMIA Submission?  They have not announced yet.

NACHC FOM/IT - the NACHC team will talk about bundling SDOH with ODH.

Michele will be speaking at May 3 at AOHC.

NACHC Update 

• Partners

• Data 

• AllianceChicago is integrating -  and occupation & industry she has an export for O*NET and NAICS codes

Note - the higher-level hierarchies might mask the more specific choices that are below the top level heading. It was designed to help the person entering the data to find who they are - use as suggested.

Have them follow the guide as much as possible and find out any implementation challenges - try to do it the way the guide says and identify issues as we go.

• CDC NIOSH really needs this implementation of the vocabulary of industry and occupation tested - not about working around the process but improving it.

Julia - We'll be speaking with the partners; we speak with them regularly.

Deliverables for NACHC SOW

we are on #4 and 5,

A6 OHCIN is there? we do this at the end in harvest meeting

A7 - 

The CARES act requires the patient to confirm their employer - USCDI V3. It was posted to ACEOM web site. NACHC is also drafting a document to submit comments.

AP put on agenda for Harvest Meeting - prep.

Genny will share USCDI comments

Presentations/Conferences

See where we are with partners at the end of month.

FMX - not accepted to present at FMX, so propose an article for Am Journ Fam Med - description of ODH and intent.

Position Statements by organizations would also be a good effort - does NACHC work with other organizations that have position statements.   

PM&R Practice? No they don't collect - orthopedics - mostly in free text or not at all.

Ray submitted for AMIA panel in DC, there will be an email asking for the co-presenters to fill out the forms.

USCDI V3 webinar Friday Apr 8, 2022 - to present issues on which we are hoping they will comment, showing them occupation and industry elements.  Ray has slides.   Noon Eastern, speakers getting on earlier.  

@Raymonde Uy to send the slides to Genny 

Publications

NACHC Update

Health centers dealing with delayed care workload

Updating vendor products in EHR.  Example: EPIC customers are planning upgrades this spring/summer.

NIOSH Update

Meetings

AECOM 2023 Michele will be presenting May 3 AECOM 2022.

@Kowalski-Mcgraw Michele (Unlicensed) has proposed for family medicine but has not heard back. FMX.  

HL7 in May - Is NIOSH balloting for ODH?

Genny - has been collecting changes that could be made.  Can do a mini-implementation guide on ODH for a specific use case - using a smaller number of elements. Here's one way of doing the ODH guide if you cannot do all of the questions in your context.  A Guide on how to implement the standard.  Hoping to ballot in September - in the Public Health workgroup.

@Julia Skapik (Deactivated) slide template for partners for All Partner call on 4/25/22. 

Topics:

1. How many patients have data in the new occupational health domains you implemented? What proportion of patients does this represent of those in the project (okay to use patients in a specific intake workflow if desired)

2. What data capture challenges if any have been reported by the sites? Have you made any or do you plan any modifications to respond to these?

3. Are there any use cases your sites have in which they intend to create queries or other flags to identify patients at risk for occupational health related risks?

Publications

• Public Health Reports 

• AECOM  journal JOEM -

• American Family Medicine

• Journal of Clinical Informatics

1.x patients entered info in their records in this time period, when data was missing it was most often y, descriptive statistics - what we see when we try to collect data at scale in a non-clinical interview setting.  Not the model itself, but how we get to the person seeing the patient.

2. Specs for an informatics publication; data experience of gathering, challenges, for how many patients were our partners easily able to capture data, quality of the data as it comes in - how much utility is there in the data at present? What are health centers doing to improve? how easy was it for health centers to get their data accurately into the model? 

JOEM - Challenges and facilitators in collecting data and reporting it to NACHC - how NACHC collects and analyses.

Work will start with the person entering data into the EHR... what were the challenges.

3 - Probability of status of essential worker.  Pre: project: how much of their data had employment information Post project: how much data now exists?

Future: if there is another surge, MMWR article could describe how partners are using this model to id essential workers quickly.

Audiences: who needs to hear what ideas?  What do we want them to do with this information?

Admin

Julia has jury duty Mar 28, 2022 

Lauren has accepted a new position end of April 29th.   @David Blackley (Unlicensed) will be the lead, Shirley, Genny technical monitoring and support as SME, Michele will be on.  Will be working on vaccine injury and compensation.

Working on funding future years.

Friday April 29 David is out; Lauren's last day.

Not may 3rd.

Monday April 25 at 2pm for All Partners call 

Andrea will send a note for the All Partners Call. 

AllianceChicago

Recruit and engage

Create plan to implement, implement

HCN

Implement in CHC, train staff

OCHIN

Recruit and engage

Get approval from collaborative, solve tech challenges

Partner Update

Updates from Alliance, OCHIN and HCN

1. Where your team is with the implementation of the three primary occupational health elements: employment status, industry/employer and job category/role.

2. We would also get a sense from you when you can deploy these elements into a health center for end users.

AllianceChicago

Based on the contract execution date, we are currently working on recruiting our pilot health centers. We have 2 CHCs that we will be speaking with in the coming week who are very interested. Once the site is confirmed, we will meet with them to assess the feasibility of the ODH data elements and get a sense of the implementation timeline. We anticipate meeting the 4/30 (delayed deadline) for the 1^st set of deliverables.

We have noted in Confluence that we capture employment status and current occupation (can be dropdown or free text) and we will follow up with NACHC once the site is confirmed.

HCN

After evaluating the feasibility of implementing the IEW project at HCN, we have recruited one of our hosted health centers (as well as identified a project champion at the health center).  We are working to finalize our EMR system optimization to be able to capture the following occupational health elements:

(1) adding the “Not in Labor Force” employment status (the only one we did not have already captured in the EMR)

(2) adding in 20 high-level NAICS codes and descriptions to a new “Current Industry” field,

(3) incorporating “Employer” data capturing into the health centers workflow (Employer name, address, city, state, zip)

(4) adding in 98 of the Minor Group SOC codes and descriptions to a new “Patient Occupational Role” field that will also be able to keep a record of past employment.

On February 25^th we had our Kick off call with the health center and the following plan was discussed;

1. HCN to complete the system optimization by March 9th

2. HCN to create training material by March 10th

3. Train the trainer will be conducted before March 16^th

4. March 16^th the health center plan to deploy training to all front desk staff

OCHIN

One health center member is excited about this implementation and committed to engaging. They have started documenting employers and employment information they hadn’t previously been documenting in our existing fields.

We currently have registration fields for employer (discrete), employment status (discrete) and occupation (free text) as well as a social history section for occupation (free text).

We met with our analysts and got confirmation that it would be possible to add optional registration field for occupation (discrete) and industry (discrete). We would have to add this at the collaborative level, so we would need to have some collaborative wide conversations about whether that was agreeable to everyone. If we can get enough approval it could probably be implemented fairly quickly (May is the best case scenario). There are some challenges with how to switch from free text to a list (what would happen with existing data, etc.), so that is the biggest barrier other than the need to make the change at a collaborative level. Of course if Epic made it available automatically that would be great. 

Q: What is the lift to implement ODH for IT?  

A: Depends on the vendor and their contract structure, agreements for the change, software engineers, designers

these partners were chose because they have inhouse expertise to make these changes. OCHIN has total control over their instance, but they have competing priorities. Same with the other two.

Abstract AMIA Proposal for Panel

Abstract is moving through the NIOSH side.  

The abstract is due Mar 9, 2022. 

Funding Plan 

NACHC will draft a plan for next year and submit in case continuation funding can be found.  Build on this work and ask partners to scale and spread beyond pilot sites.

There is no funding coming from COVID projects; if funding comes from program funding, it's more likely to be in the range of $50,000 to $100,000.   This would be a difficult level if NACHC were to fund the partners but could push some of the work forward.

Meetings

schedule an all partners call with CDC.

Partner Updates re: IT systems

Julia - We have spoke with 2 of 3 partners re: their systems.  They are not sanguine about collecting the exact data, but may be close.  We will be speaking with OCHIN, the 3rd partner.

Updated Value Sets

Ray sent the 3rd value sets with the pairing. Does NIOSH have feedback?

Action Items from last meeting

Admin

• Contracts - 2 of 3 contracts are completed. The third has been sent for signature and OCHIN is reviewing.

• Continuation funding.

• AMIA March 9 deadline for abstracts for the November meeting

• Next meeting 

Review of Action Items from Previous Meeting

For review

UCSD v3

ACOEM

ACOEM preferred essential worker project to advocate for immunizations

FHIR app

to send the FHIR app one-pager to Michele Jan 24, 2022 

Agenda for 1/27 Design Meeting

Intro and Welcome    5 min

Intro from @Brewer Lauren (Unlicensed) and @Kowalski-Mcgraw Michele (Unlicensed) 15 min

Draft IG content:      5 min

• Employment status harmonization  – UDS/PRAPARE, ODH, operational CHC 15 min 

• Industry  10 min

  • Multiple entries/jobs

• Employer  10 min

• Occupation  10 min

• Hazards 10 min

Implementation approaches: clarifications and questions: 10min

• Feasibility and constraints in collecting these data above

Adjourn 

How do we create multiple entries for one person with multiple jobs (as a common procedure)

• acceptable level: at least major FTE job

• Most times, ppl enter two jobs w/a comma between them.

• proposal to create branching - 

  • a. this is my job: xyz

  • b. I also have another job:

    • this is my job #2: abc

 edit https://nachc.atlassian.net/l/c/uga0fCzW page to reflect Julia's agenda to the left Jan 24, 2022 

Employment Status in ODH

Options in ODH

• Employed

• Not employed

• Not in labor force

In UDS - captures status and additionally,

• f/t  and p/t are expressed in terms of number of hours because definition varies

• contractor

  • self-employed is in work classification

• not in labor force

Use the employment status in PRAPARE

From UDS Guidelines

Raymonde Uy

Work Schedule | 74159-5 | 2.16.840.1.114222.4.11.7130

Weekly Work Days | 74106-3 | N/A

Daily Work Hours | 87512-0 | N/A

Work Classification | Paid work, self-employed | "When a person earns a salary or wage working for himself or herself, rather than working for someone else."

Identifying Employment Type and Calculating FTEs
The following describes the basis for determining someone’s employment type for purposes of reporting on FTEs:
• One full-time equivalent (FTE = 1.00) describes personnel who worked the equivalent of full-time for one full year. Each health center defines the number of hours for “full-time” work and may define it differently for different positions.
• The FTE is based on employment contracts for providers and other personnel.
• In some health centers, different positions have different definitions of full time. Positions with different time expectations should be calculated on whatever they have as a base for that position. Some positions, per employment contracts, consider working 36 hours per week full time and would be considered 1.00 FTE. In this case, an 18-hour-per-week personnel would be considered 0.50 FTE regardless of whether other personnel in other positions work 40-hour weeks.
• The FTE of personnel receiving full-time benefits for the full year would be considered full-time = 1.00 FTE.
• Hourly personnel with no or reduced benefits who work more than full-time (i.e., overtime) will have an FTE greater than 1.00.
• For personnel who are not paid for full leave (i.e., vacation, holidays, and sick benefits), the effective FTE is calculated by dividing worked hours by adjusted full-time hours (full-time hours minus paid time off hours that full-time personnel receive).

Use employment contracts to determine FTE. For example, a physician hired as a full-time personnel who, per their employment contract, is only required to work four 9-hour sessions (36 hours) per week, is considered full-time.

Review of Action Items from Previous Meeting

Implementation Guide

Community Health ODH Implementation - IEW - Identifying Essential Workers - Confluence (atlassian.net)

Julia

Raymonde

Review

Privacy of Occupation? Registration here means the process by which chc staff, part of the team is covered by HIPAA.  Patient-entered information is okay, too.

We can ask partners what their CHCs are doing - tablet that patient fills in or clipboard that is abstracted by MA onto EHR.

Design Meeting on Jan 27, 2022 

We have an update meeting on Jan 24, 2022 

We'd have a break in Raymonde's section for Lauren to talk

• Lauren has slides that describe the extensions

Michele would do an intro on background

• ACOEM proposal?

  • work with health centers that meat packing, migrant farm workers, industrial farming, agricultural workers - large industrial employment-based. Another meeting with Kathy - 4pm to have KM explain ideas to Julie

    • CHCs could work with employers - they trust the health center

• Deadline 

Review of Action Items from Previous Meeting

Progress on Clinical Architecture 

Genny and Lauren were on the CA call last week but they have since updated the NAICs codes and relationships; and CA can show that to you on Friday  Dec 17, 2021 during our weekly call if Genny and Lauren can attend and comment.  Lauren is available, Michelle can attend.

CA now has this so that other clients can use this.  If NACHC reaches out to other terminology vendors, they can also use this with their clients.

We are creating the slide templates for partners.

We are polling for times for December kickoff and January design meeting.  And to confirm the correct people to be on the call.

• NIOSH TMs have slides; Lauren will share on screen. (Can't post to the Confluence).

• 13 minutes presentation.

AP check to see if Michelle was on the poll

@Julia Skapik (Deactivated) 

@Raymonde Uy (Unlicensed) 

@Morgan Campbell (Deactivated) 

Review of Action Items from Previous Meeting

Dates and Times Scheduled

Tuesdays at ~2pm, outside of scheduled Governance calls

Every other week at 2pm Eastern

@Kathleen McNamara (Deactivated)

@Hasna Soulhi

@Andrea Price Old Account (Deactivated)

Lauren Brewer, MPH, BSN - Lead
LCDR US Public Health Service
Surveillance Branch
Respiratory Health Division
National Institute for Occupational Safety and Health (NIOSH)
Centers for Disease Control and Prevention (CDC)

Shirley Burton - Public Health (did not hear the specialty)

Katelynn Dodd - Epi 

Megan Early CSTLS CoAg Projectd Officer for 1802 Administration Management

Lucinda England - Medical Officer

Genny Luesman - project lead

Barbara Wallace - Healthcare IT consultant

Michele Kowalski-Mcgraw - Physician, UC San Diego and board certified in Occupatioal Medicine

Review of Action Items from Previous Meeting

OT18-1802 Cooperative Agreement project Identifying Essential and Frontline Workers Using Structured Work Information

• Introductions

• Project Discussion

  • CSLSTS CoAg and NACHC

Best to discuss content with the content team the deliverables, etc.

• Goals/objectives

• Resources

The NIOSH staff already put together the data lists this is a change since the RFP went out.

• Timeline

• Communication plan

• Potential challenges/concerns

Mondays are best for Michele.

Monday 10/18 @2pm looks free.

Lauren asked if NIOSH should contact CHCs?  

We said that we can provide that contact, but if they had a list of CHCs, we could include those.

Lauren said AllianceChicago/HCN. 

Kathy suggested OCHIN as well.  Could work with HCCNs, CHCs and or both.

Conclusion: Once NACHC has seen the TR and responded, we can dig into the details, and we will set up a meeting right away with Julia and her team. Looking at Monday 10/18 2pm.