Health Centers Incorporate Patient Work Information into EHRs

Health centers are using EHRs to capture and use patient work information, an important determinant of health that enables clinical decision support functions to assist providers.


Ninety-six percent of federally-funded health centers had an electronic health record in use at some or all sites in 2013 and 84.5 percent reported that their providers are receiving meaningful use payments, according to data released last week by the Health Resources and Services Administration.

HRSA also reports that the health centers are using EHRs to capture and use patient work information to learn more about their patients’ work and health. To help the health centers, the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (NIOSH) EHR Working Group is working with them to improve the collection and use of work information in EHRs.

“While work is an important determinant of health, information about patients’ occupation(s) and the industries in which they work or have worked is not typically present and systematically organized in health records,” states an Aug. 15 blog from NIOSH. “Recording industry and occupation data in EHRs not only allows providers access to this important information on patients, but it can also enable clinical decision support functions to assist providers in caring for patients based on each individual’s work history.”

In an effort to incorporate patient industry and occupation fields into a commercial EHR, NIOSH awarded a contract with St. John’s Well Child and Family Center in Los Angeles. Launched in October 2013, the project will modify the GE Centricity EHR used by the center to include patient industry and occupation information. St. John’s will collect one year of data, allowing staff to incorporate patient work information into clinical and population health activities and evaluate impacts upon health center workflow. The data also will support wider efforts at St. John’s to identify and treat work-related health concerns and provide advocacy on behalf of low-wage worker populations in their service area.

Last year, community health centers--the largest providers of healthcare to underserved individuals in the U.S.--provided care to more than 21.7 million patients, more than 62 percent of which were racial/ethnic minorities and almost 35 percent of which were uninsured.

NIOSH also has started a project to develop occupationally-related clinical decision support for health issues such as work-related asthma, diabetes, and return-to-work guidelines. And, a NIOSH-developed “Occupational Data for Health” information model (soon to be published) will provide the structure for programming the work data elements that are most useful for patient care and population health and facilitate EHR modifications.

“Data capture would be the first step to allow health-care organizations to develop programs aimed at meeting the occupational health needs of their patients, harnessing the power of EHRs for capturing, storing, tracking, exchanging, and reporting data,” states the blog.

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