Community Health ODH Implementation
- Julia Skapik (Deactivated)
- Andrea Price (Deactivated)
- Raymonde Uy
Resources
Community Health ODH Implementation Guide Outline
Introduction/Context:
Intro to occupational and environmental health
COVID-19 relationship based on essential worker status
Essential worker is defined as one who performs a duty or work during an emergency that cannot be performed remotely or is required to be completed at the work site; AND provides a service that the essential employer determines to be essential or critical to its operations.
CDC ODH Data Model
Purpose:
To support community health centers in identifying, screening and treating patients with occupational exposures
To support public health surveillance in occupational health
To provide a brief, feasible and EHR-enabled, standards-based approach to ODH
Use Cases and Proposed Workflows
Registration
Eligibility
Clinical
SDOH assessment
Personas
Full time essential worker (healthcare)
Full time essential worker (grocery)
Full time low risk worker
Retired
Unemployed with regular occupation
Multiple jobs (Uber driver and cleaning service)
Hazardous exposures (chemical solvent user)
* Migrant workers
ODH Data Element Components
Occupational Data for Health Template Requirements Section (V2) Contexts
History of Employment Status Observation (optional)
Date of Retirement Observation (optional)
Combat Zone Period Observation (optional)
Usual Occupation Observation (V2) (optional)
Past or Present Occupation Observation (V2) (optional)
Employment Status - Proposed Elements
Full time
Part-time
Retired
Unemployed
Underemployed
Freelance/Contractor/Self-employed
Not in Labor Force
Current Industry:
Category (2022 NAICS) with possible extensions
Employer*
Employer address
Employed site
Date of hire
Former Industries?
Multiple current job industries*?-- link each industry and role
*Asterisk = optional, not required
Current or Most Recent Occupation/Role
SOC codes
Title/Description
Exposures*
Exposure type-- hazardous? (chemical, radiation, infectious, physical, combat/deployment)
VSet for codes related to different exposures
Previous Occupations?
Possible exposures/length of time?
ODH Employment Status Elements and Definition
Employed | A person is considered employed if they worked for at least one hour during the past week, with or without pay. They could have worked for a business, the government, or them self in their own business, farm, or professional arrangement. A person who did not work in the past week is still considered employed if they were temporarily absent from their job but will return. |
Not in Labor Force | A person who has no job and is not looking for one. |
Unemployed | A person who does not work right now but has been trying to find work. |
Integration Approaches:
Access to and use of NAICS and SOC code systems
NIOSH extensions, use of terminology hierarchy to direct selection of most appropriate code
Existing EHR-based data element alignment
SDOH section on occupational status/role
SMART on FHIR vs Creating New/Realign Existing Data Elements natively
Testing Plan:
Identify metrics of use/data capture
Apply alpha test procedure with dev team
Identify 1-3 sample users from each user category to perform beta testing
Identify pilot site(s) for rollout after beta test
Extract and examine metrics for use/data capture
Plan/timeline to scale to entire organization
Sample Training Materials and Training Plan:
One pager or card for staff
Short video on ODH for CHCs
Training sessions for primary data capture users
Applications of ODH:
Identifying Patients who are Essential Workers for COVID-19 risk evaluation or prevention/treatment
Identifying Patients at Risk for a Specific Occupational Health-related Condition: to trigger screening or counseling
Administrative purposes like Worker’s Compensation or claims related to occupational exposure
Using ODH to support treatment or counseling for existing medical condition that could be affected by occupational exposure
Value Sets for Industry and Occupation
Rajamani S, Chen ES, Lindemann E, Aldekhyyel R, Wang Y, Melton GB. Representation of occupational information across resources and validation of the occupational data for health model. J Am Med Inform Assoc. 2017;25(2):197-205.
Resource | Resource Full Name | Description |
NAICS | North American Industry Classification System | The standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy. Updated every 5 years. |
O*Net | Occupational Information Network | A regularly updated database of occupations, their characteristics, and worker requirements; the occupations are classified by an extended modification of SOC. |
SOC | Standard Occupation Classification System | A periodically updated statistical standard used by federal agencies to classify workers into occupational categories for the purpose of collecting, calculating, or disseminating data. |
Census I/O Classification Systems | U.S. Census Bureau Industry and Occupation Classification Systems | Industry and occupation classification system used by the U.S. Census Bureau to collect data on several surveys. Adapted from NAICS and SOC. |
CDC Census I/O Classification Systems | CDC-modified Census Bureau Industry and Occupation Classification Systems | Modification of the Census Classification System to code narrative survey and death certificate responses; includes unpaid occupations (e.g., homemaker) and basic military classifications. Updated within 1 year after Census System update is released. |
ISCO | International Standard Classification of Occupations | A high-level occupation classification system for statistical evaluations of surveys and censuses. |
PHIN VADS ODH Data Element Codes and Value Set Identifiers
Data Element | LOINC* Code | Value Set Object Identifier (OID)** |
Employment Status | ||
Employment Status | 74165-2 | 2.16.840.1.114222.4.11.7129 |
Past or Present Job | ||
Occupation | 11341-5 | 2.16.840.1.114222.4.11.7901 |
Industry | 86188-0 | 2.16.840.1.114222.4.11.7900 |
Supervisory Level | 87707-6 | 2.16.840.1.114222.4.11.7613 |
Work Classification | 85104-8 | 2.16.840.1.114222.4.11.7597 |
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 |
Employer Name | 80427-8 | N/A |
Employer Location | 80429-4 | N/A |
Job Duties | 63761-1 | N/A |
Occupational Hazards | 10161-8 | N/A |
Usual Work | ||
Occupation | 21843-8 | 2.16.840.1.114222.4.11.7901 |
Industry | 21844-6 | 2.16.840.1.114222.4.11.7900 |
Duration in Years | 74163-7 | N/A |
Start Year | 63756-1 | N/A |
Combat Zone Period | ||
Combat Zone Period | 87511-2 | N/A |
Retirement Date | ||
Retirement Date | 87510-4 | N/A |
Household Member of a Minor | ||
Household Member Type | 63517-7 | 2.16.840.1.113883.1.11.19579 |
Concept | Description (User friendly - 8th grade reading level) |
Employment Status | |
Employed | A person is considered employed if they worked for at least one hour during the past week, with or without pay. They could have worked for a business, the government, or them self in their own business, farm, or professional arrangement. A person who did not work in the past week is still considered employed if they were temporarily absent from their job but will return. |
Not in Labor Force | A person who has no job and is not looking for one. |
Unemployed | A person who does not work right now but has been trying to find work. |
Work Classification | |
Paid work, not self-employed | When a person works for a business that they do not own, and they are paid a salary or wage. |
Paid work, self-employed | When a person earns a salary or wage working for himself or herself, rather than working for someone else. |
Paid work, armed forces | When a person serves in the armed forces and gets a paid salary or wage. |
Paid work, local government | When a person works for a local government and gets paid a salary or wage. |
Paid work, state or territorial government | When a person works for a state or territory government and gets paid a salary or wage. |
Paid work, national government | When a person works for the federal government and gets paid a salary or wage. |
Unpaid work, self-employed | When a person works for himself or herself but does not get paid a salary or wage. |
Unpaid work, not self-employed | When a person works for a business that they do not own and does not get paid a salary or wage. |
Voluntary work, disaster response or emergency services | When a person chooses to participate in disaster response or emergency services, willingly and without pay. |
Voluntary work, 20 or more hours/week (not disaster response or emergency services) | When a person chooses to do tasks willingly and without pay, especially for other people or for an organization. This includes formal work done through public, private and voluntary organizations. It also includes informal work in a community. |
Job Supervisory Level or Paygrade | |
Non-Supervisor | A person who does not oversee the work of anyone else. |
First Line Supervisor | A person who oversees work and gives direction but cannot hire or fire workers or manage a budget. This would include a foreman. |
Manager | A person who makes forecasts, does planning, and sets strategic course. This person also can hire or fire workers and controls the budget. |
US Military paygrade E-1 | US Military Enlisted paygrade E-1 |
US Military paygrade E-2 | US Military Enlisted paygrade E-2 |
US Military paygrade E-3 | US Military Enlisted paygrade E-3 |
US Military paygrade E-4 | US Military Enlisted paygrade E-4 |
US Military paygrade E-5 | US Military Enlisted paygrade E-5 |
US Military paygrade E-6 | US Military Enlisted paygrade E-6 |
US Military paygrade E-7 | US Military Enlisted paygrade E-7 |
US Military paygrade E-8 | US Military Enlisted paygrade E-8 |
US Military paygrade E-9 | US Military Enlisted paygrade E-9 |
US Military paygrade W-1 | US Military Warrant Officer paygrade W-1 |
US Military paygrade W-2 | US Military Warrant Officer paygrade W-2 |
US Military paygrade W-3 | US Military Warrant Officer paygrade W-3 |
US Military paygrade W-4 | US Military Warrant Officer paygrade W-4 |
US Military paygrade W-5 | US Military Warrant Officer paygrade W-5 |
US Military paygrade O-1 | US Military Commissioned Officer paygrade O-1 |
US Military paygrade O-2 | US Military Commissioned Officer paygrade O-2 |
US Military paygrade O-3 | US Military Commissioned Officer paygrade O-3 |
US Military paygrade O-4 | US Military Commissioned Officer paygrade O-4 |
US Military paygrade O-5 | US Military Commissioned Officer paygrade O-5 |
US Military paygrade O-6 | US Military Commissioned Officer paygrade O-6 |
US Military paygrade O-7 | US Military Commissioned Officer paygrade O-7 |
US Military paygrade O-8 | US Military Commissioned Officer paygrade O-8 |
US Military paygrade O-9 | US Military Commissioned Officer paygrade O-9 |
US Military paygrade O-10 | US Military Commissioned Officer paygrade O-10 |
Work Schedule | |
Daytime Schedule | A regular work schedule during daytime hours (for example, between 6 a.m. and 6 p.m.) |
Evening Schedule | A regular work schedule during evening hours (for example, between 2 p.m. and 12 a.m.) |
Night Schedule | A regular work schedule during nighttime hours (for example, between 9 p.m. and 8 a.m.) |
Early Morning Schedule | A regular work schedule during early morning hours (for example, between 2 a.m. and 2 p.m.) |
Very Long Shift | A work schedule with shifts of 17 or more hours. |
Rotating Schedule with Night Shift | A work schedule that regularly changes between days and/or evenings, including some night shifts. |
Rotating Schedule without Night Shift | A work schedule that regularly changes between days and/or evenings and does not include night shifts. |
Split Shift | A work schedule with shifts of two distinct periods each day that are separated by a break of a few hours (such as 2 to 4 hours). |
Variable Shift | An unpredictable work schedule, with hours that vary and are scheduled on a short notice (such as, less than 2 days’ notice). The schedule is inconsistent and may be on-call, as needed, or as available. |
Household Member Role Type | |
Mother | A female who conceived or gave birth to the person. This may also be a female who did not conceive or give birth to the person but is raising and nurturing them. |
Father | A male who sired the person. This may also be a male who did not sire the person but is raising and nurturing them. |
Sibling | Someone who shares one or both parents in common with the person. |
Family member | Someone with whom the person is closely related, i.e., has a "familial" relationship. |
Roommate | Someone who shares living quarters with the person. |
Data Element | Description | AllianceChicago | HCN | OCHIN |
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Employment Status
| A person's self-reported relationship to working for pay, family earnings, or training (e.g. having one or more jobs, searching for work, etc.) |
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Retirement Date | Date a person self-defines as being retired, usually from a job or occupation |
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Combat Zone Period
| person self-reports as having military service or employment in a combat zone. |
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Past or Present Job
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Usual Work / Longest Held Work
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