At a glance
Incorporating work information in EHRs or other information systems helps healthcare providers consider work conditions and job tasks in clinical decisions. It also allows access to resources that help guide diagnosis and care. This includes information on work-related hazards and related health problems.
Case Studies
The following case studies are examples for how structured work information supports patient care, population health, and public health.
Farmer
A physician sees a patient with a sudden illness. The patient's record shows the patient works on a farm. Seeing the patient is a farmer, the physician asks if the patient uses pesticides. She responds that she does use pesticides and that she was spraying crops before getting sick.
Based on the patient's symptoms, work information, and laboratory results, the physician diagnosis the patient with acute pesticide poisoning. By referring to work information in an EHR, the physician was able to make this diagnosis. The EHR also indicates that pesticide poisonings are a reportable condition in the state and automatically sends a case report to the health department.
The health department uses case reports for public health surveillance. When analyzing data from all recent case reports, the health department identifies an increase in pesticide poisoning cases among workers from a single farm. They perform outreach to prevent future pesticide poisonings.
Home Renovator
A nurse practitioner interviews a patient about reported symptoms. In the EHR, he notes the patient is a home renovator who strips paint for a construction company. The practitioner recalls an increasing number of reports from the health department on lead poisoning cases linked to a local construction company.
He asks the patient about blood lead testing since beginning work as a renovator and the patient reports no. The nurse practitioner orders a blood lead test, and the result shows elevated levels. The patient is referred to an occupational health physician who provides care and education to reduce lead exposure and prevent long-term complications.
The information was a reportable condition within the state and a case report was sent. After receiving reports from other patients who work at the same construction company, the health department notices that the patients all speak a language other than English. The health department works to develop informational materials in various languages to prevent future exposures.
Clinical Decision Support
When standardized work information is collected in EHRs it can be used to connect to tailored informational resources. NIOSH collaborated to develop and evaluate clinical decision support for diagnosis and management of work-related asthma, workplace factors that affect diabetes, and decisions about return-to-work after acute low-back pain.
For more information on clinical decision support, go to the American College of Occupational and Environmental Medicine's web page Clinical Decision Support Knowledge Resource Reports.