million occupational injuries occur along with more than 160,000 cases of occupational illnesses (BLS, 2010b, 2011b). Advances in incorporating occupational information in EHRs could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population.

After gathering and reviewing the available evidence, the committee concluded that occupational information could contribute to fully realizing the meaningful use of EHRs in improving individual and population health care. The report examines the challenges that are inherent in this important advance and makes recommendations (Box 1) focused on moving forward the efforts to incorporate occupational information into EHRs including feasibility studies, demonstration projects, and other actions.


Initial Focus on Occupation, Industry, and Work-Relatedness Data Elements

Recommendation 1: Conduct Demonstration Projects to Assess the Collection and Incorporation of Information on Occupation, Industry, and Work-Relatedness in the EHR

NIOSH, in conjunction with other relevant organizations and initiatives, such as the Public Health Data Standards Consortium and Integrating the Healthcare Enterprise (IHE) International, should conduct demonstration projects involving EHR vendors and health care provider organizations (diverse in the services they provide, populations they serve, and geographic locations) to assess the collection and incorporation of occupation, industry, and work-relatedness data in the EHR at different points in the workflow (including at registration, with the medical assistant, and with the clinician). Further, to examine the bidirectional exchange of occupational data between administrative databases and clinical components in the EHR, NIOSH in conjunction with IHE should conduct an interoperability-testing event (e.g., Connectathon) to demonstrate this bidirectional exchange of occupational information to establish proof of concept and, as appropriate, examine challenges related to variable sources of data and reconciliation of conflicting data.

Recommendation 2: Define the Requirements and Develop Information Models for Storing and Communicating Occupational Information

NIOSH, in conjunction with appropriate domain and informatics experts, should develop new or enhance existing information models for storing occupational information, beginning with occupation, industry, and work-relatedness data and later focusing on employer and exposure data. The information models should consider the various use cases in which the information could be used and use the recommended coding standards. For example, NIOSH should

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