Office of the National Coordinator for Health Information ...
Proposal for Work Information in the ISARepresenting Work Information (Vocabulary)TypeStandard / Implementation SpecificationStandards Process MaturityImplementation MaturityAdoption LevelFederally requiredCostTest Tool AvailabilityStandard for observationsLOINCFinal ProductionLow adoptionNo FreeNoStandard for observation valuesOccupational Data for Health (ODH) Code SystemBalloted DraftPilotFeedback RequestedNoFreeNoStandard for observation valuesCDC Census 2010 Industry and Occupation SystemBalloted DraftPilotLow adoptionNoFreeYesLimitations, Dependencies, and Preconditions for ConsiderationApplicable Value Set(s) and Starter Set(s)Self-reported, structured and standardized work history has broad applicability to healthcare as part of the medical record and is suitable for many use cases supporting patient care, population health, and public health.An Information Model, Occupational Data for Health (ODH), supports the collection and classification of Work Information in health IT systems and has been published in JAMIA.The ODH industry value set includes the search-friendly terms from the North American Industry Classification System (NAICS) index with the respective category. The terms in this value set are relatable to the general public.The ODH occupation value set includes the search-friendly terms from the Occupational Information Network-Standard Occupational Classification (O*NET-SOC) system alternate titles with the respective category. The terms in this value set are relatable to the general public.The ODH industry and occupation value sets were created to facilitate collection and validation of these concepts by patients. Downloadable Occupation and Industry files from the PHIN VADS ODH Hot Topics section are structured to support computer-assisted searching. These files also contain crosswalks from ODH industry and occupation value set concepts to CDC_Census industry and occupation value set concepts.A downloadable file for the ODH value sets other than Occupation and Industry is available under the PHIN VADS ODH Hot Topics section. It contains additional metadata such as user-friendly 8th grade reading-level descriptions. Historically, the CDC_Census 2010 system has been used by public health programs?to classify industry and occupation when only a text description has been collected. This system was referenced in earlier versions of the ISA and in Standards for Trial Use for interoperability and so is still referenced here.Representing IndustryPast or Present Industry Question (LOINC code 86188-0)Usual Industry Question (LOINC code 21844-6)PHVS_Industry_NAICS_Detail_ODH? (urn:oid: 2.16.840.1.114222.4.11.7900)PHVS_Industry_CDC_Census2010 codes (urn:oid:2.16.840.1.114222.4.11.7187)Representing OccupationPast or Present Occupation Question (LOINC 11341-5)Usual Occupation Question (LOINC 21843-8)PHVS_Occupation_CDC_ONETSOC_Detail_ODH (urn: oid: 2.16.840.1.114222.4.11.7901)PHVS_Occupation_CDC_Census2010 codes (urn:oid:2.16.840.1.114222.4.11.7186)Representing Employment StatusEmployment Status Question (LOINC 74165-2)PHVS_EmploymentStatus_ODH (urn:oid: 2.16.840.1.114222.4.11.7129)Representing Work ScheduleWork Schedule Question (LOINC 74159-5)PHVS_WorkSchedule_ODH (urn:oid: 2.16.840.1.114222.4.11.7130)Representing Work ClassificationWork Classification Question (LOINC 85104-8)PHVS_WorkClassification_ODH (urn:oid: 2.16.840.1.114222.4.11.7597)Representing Job Supervisory Level or Pay GradeJob Supervisory Level or Pay Grade Question (LOINC: 87707-6)PHVS_JobSupervisoryLevelorPayGrade_ODH (unr:oid: 2.16.840.1.114222.4.11.7613)Interoperability Need: Work Information (Content/Structure)TypeStandard / Implementation SpecificationStandards Process MaturityImplementation MaturityAdoption LevelFederally requiredCostTest Tool AvailabilityImplementation SpecificationHL7 CDA? R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes; Occupational Data for Health, Release 1 – US Realm (STU)Balloted DraftPilotLow adoptionNoFreeYes Usual Work)Implementation SpecificationIHE Patient Care Coordination (PCC) Technical Framework Supplement: CDA Content Modules, Revision 2.6 – Trial ImplementationBalloted DraftPilotLow adoptionNoFreeNoneImplementation SpecificationHL7 FHIR Release 4.0.1 Profile: Occupational Data for Health (ODH), Release 1.0 (STU)Balloted DraftPilotLow adoptionNoFreeYes (Usual Work)Implementation SpecificationHL7 Version 2.9 Messaging Standard – An Application Protocol for Electronic Data Exchange in Healthcare Environments, Normative. Chapter 3, Patient Administration.FinalFinalUnknownNoFreeNoneImplementation SpecificationHL7? EHRS-FM Release 2 Functional Profile: Work and Health, Release 1 - U.S. Realm (Informative)Balloted DraftFeedback requestedUnknownNoFreeNoneLimitations, Dependencies, and Preconditions for ConsiderationApplicable Security Patterns for ConsiderationAn information model of Work Information, called Occupational Data for Health (ODH), has been published in JAMIA.The Occupational Data for Health (ODH) section can be incorporated as a non-breaking addition to the social history section of interoperability specifications.The ODH section for all Work Information Data Elements is an option in these implementation specifications:IHE Patient Care Coordination (PCC) Technical Framework Supplement to Volume 1, CDA Occupational Data Options (XDS-MS, XHPR, EDR), Revision 1.1 – Trial ImplementationIHE Patient Care Coordination (PCC) Technical Framework Supplement: Query for Existing Data for Mobile (QEDm), Revision 2.2 – Trial ImplementationIHE Quality, Research and Public Health Technical Framework Supplement: Healthy Weight (HW), Revision 2.3 – Trial ImplementationThe ODH Usual Work section is required in these implementation specifications:HL7 CDA R2 Implementation Guide: Reporting to Public Health Cancer Registries from Ambulatory Healthcare Providers, Release 1 – US Realm; HL7 DSTUHL7 CDA R2 Implementation Guide: Vital Records Death Reporting (EDRS to National Agency), Release 1, STU 2.1 – US Realm; HL7 STUThe ODH Job and Usual Work sections are options in these implementation specifications:HL7 CDA R2 Implementation Guide: Public Health Case Report – the Electronic Initial Case Report (eICR), Release 1.0 – US Realm; STU 2.0HL7 FHIR? Release 4.0.1 Implementation Guide: Electronic Case Reporting (eCR) – US Realm. Version 1.0.0 (STU)The interoperability specifications currently suggest or require the CDC_Census2010 category value sets for Occupation and Industry. However, the more detailed ODH value sets for Occupation and Industry facilitate self-selection. The interoperability specifications are being updated with a non-breaking “translation” in CDA and “slice” in FHIR to transmit either or both ODH and CDC_Census values.These standards are intended to transmit data that are part of the medical record and must be protected accordingly. ................
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