Advancing Workforce Health at the Department of Homeland Security Protecting Those Who Protect Us (2014) / Chapter Skim
Currently Skimming:
8 Information Management and Integration
8 Information Management and Integration
Pages 217-238
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 217... ...
This chapter presents the committee's recommendations for steps DHS can take to establish a systems approach to information management, supported by a robust health information technology and informatics infrastructure, that enables evidence-based decision making, surveillance, accountability, and continuous quality improvement. INFORMATION AND KNOWLEDGE MANAGEMENT Obtaining reliable and consistent information is essential to the implementation and sustainment of an integrated workforce health protection program.
|
From page 218... ...
In the most striking example, Customs and Border Protection (CBP) reported that its occupational safety and health office had conducted a cost-benefit analysis of placing medical clinics or practitioners at some of its high-volume stations along the southwest border to help manage employee injuries and illnesses.
|
From page 219... ...
In fact, the only source of data currently received by OHA of which the committee is aware is the centralized electronic patient care record. In a presentation to the IOM Committee on Department of Homeland Security Workforce Resilience, representatives of the Office of the Chief Human Capital Officer outlined a number of currently available DHSwide data sources related to workforce health, readiness, and resilience (see Box 8-1)
|
From page 220... ...
Health and safety program quality and implementation (on-site assessments) The Office of the Chief Human Capital Officer relies on data calls to DHS com ponent agencies for • employee assistance program (EAP)
|
From page 221... ...
In the absence of a comprehensive, standardized system with which to measure the performance of DHS's occupational safety and health, occupational medicine, operational medicine, health promotion, and workers' compensation programs, it is not possible to determine whether each component agency is managing its safety risk in an acceptable manner and whether occupational health programs are meeting objectives for improving workforce health and readiness. Thus, there is no means of ensuring FIGURE 8-1 A systems approach to data management.
|
From page 222... ...
The Chief Medical Officer, in collaboration with the proposed Com ponent Lead Medical Officers, should develop a common core set of performance and outcome metrics to allow analysis of activities, outcomes, and trends in the areas of workplace safety and health, workforce medical readiness, and quality of medical services. Ongoing monitoring and analysis of these metrics as part of a measurement and evaluation framework are essential to drive continuous improvement and accountability.
|
From page 223... ...
• Operational medicine metrics should include process and quality measures, and they also should demonstrate the value of having medical support available to those engaged in DHS operations, highlighting the impact of operational medicine programs on mis sion capability. • Health promotion metrics should include aggregated, deidentified population health data and utilization rates, and they should be used to inform the creation and continuance of health promotion programs (see Box 8-2 for unique opportunities to collect such data at DHS)
|
From page 224... ...
for its mandatory medical exams, provides FOH with queries for extracting population health information; FOH then generates reports with deidentified aggregated data based on those queries. FAMS is planning to use these data to guide its new employee health and wellness program.
|
From page 225... ...
INFORMATION MANAGEMENT AND INTEGRATION 225 TABLE 8-1 Suggested Core Metrics for Tracking Departmental and Component Health, Safety, and Readiness Function Metric Purpose Occupational • Occupational Safety and • To assist in identifying safety and health Health Administration workplace hazards and assessing (OSHA) recordable incident the effectiveness of safety rate per year interventions • Lost Time Case Rate • To assist in identifying workplace hazards and assessing the effectiveness of safety interventions • Safety climatea index scores • To gauge workforce perception by site of workplace safety and health as a leading indicator of injury risk • Number of seriousb hazards • To serve as a leading indicator of identified and corrected occupational safety and health program effectiveness • Percentage of job series with • To serve as an indicator of current job safety analysisc supervisory commitment to job safety and health Workers' • Temporary/total disability • To assist in evaluating mission compensation daysd per 1,000 workers per readiness year • Medical and indemnity costd • To provide incentives to per $100 payroll prevent and respond quickly to workplace hazards Operational • Number of employee • To assist in determining trends medicine treatment encounters in medical readiness and mission outside of the conventional safety workspace per 1,000 operational person days and per 1,000 training days • Percent of deployed personnel • To gauge fitness for duty of receiving predeployment deployed personnel assessments • Number of employees who • To assess the effectiveness of return to duty during the on-location medical intervention same shift per 100 injured and to demonstrate the value of employees operational medicine programs to line leadership • Percentage of operations that • To serve as a leading indicator have an effective after-action for assessing operational plan readiness continued
|
From page 226... ...
. cThe Occupational Safety and Health Administration (OSHA)
|
From page 227... ...
ENABLING HEALTH SYSTEM INTEGRATION AND CONTINUOUS IMPROVEMENT THROUGH INFORMATION MANAGEMENT SYSTEMS The ability to transform data into actionable information is a critical capability. A number of achievements in informatics and health information technology (HIT)
|
From page 228... ...
A working group comprising representatives from OHA, the Office of the Chief Human Capital Officer, and other DHS components identified the following mission and capability needs for the eHIS3: • ensure that staff are medically suitable for their assigned or volun teered duties (e.g., job and environment) ; • provide for the execution of an efficient DHS-wide fitness-for-duty and limited-duty program; • enable efficient dispensing, tracking, and follow-up for medical countermeasures; • lower occupational health costs across the department; and 3 E-mailcommunication, I
|
From page 229... ...
will be integrated with the eHIS should that system be implemented in the future. At the individual component level, the Coast Guard, working with the VA and the Office of the National Coordinator for Health Information Technology, is building an integrated health information system (IHiS)
|
From page 230... ...
However, this informatics capability does not appear to be represented at the component level, with the exception of the Coast Guard, which has a Chief Medical Information Officer. The lack of health informatics expertise across DHS may help to explain the lack of success of the Medical Quality Management (MQM)
|
From page 231... ...
An informatics and information technology capability is essential for implementation of the measurement and evaluation framework described in Recommendation 10, and Recommendation 11 is meant to complement efforts currently under way at DHS. Building on the work already accomplished by a DHS eHIS working group, the proposed strategic plan should provide the blueprint for a robust health and safety informatics and information technology infrastructure incorporating medical, public health, and consumer informatics capabilities, and it should be consistent with the overarching DHS information technology strategy.
|
From page 232... ...
Consequently, its information management needs center on occupational safety and health data sources. Commercial occupational health management software, in contrast to more traditional electronic health records, is designed to facilitate the integration of occupational safety, health, industrial hygiene, environmental, and ergonomics
|
From page 233... ...
It is important to note that some component agencies, including TSA and the Coast Guard, have already invested heavily in systems for health information management. In addition to integrating data sources internally, the proposed strategic plan should address mechanisms for integrating data collected by vendors providing outsourced health services (e.g., preplacement and fitness-for-duty evaluations; clinical services, including vaccinations; medical surveillance; and nurse case management)
|
From page 234... ...
In light of current staffing, external consultants will be needed initially to augment the currently insufficient informatics expertise within the department. However, DHS should initiate an education and training program as part of a workforce strategy designed to ensure that sufficient expertise will be available internally to meet general workforce requirements for clinical and public health informatics, as well as to build expertise in informatics areas specific to DHS missions (e.g., telemedicine for care of detainees at border areas, fitness-for-duty health programs monitored via electronic health records throughout the world)
|
From page 235... ...
Given the up-front investment costs and implementation challenges, the decision on the best approach going forward will require a series of business cases for each component, followed by a business case addressing whether common systems would be most effective across the department. The benefits of an electronic health record may be obvious for the Coast Guard and the detainee health services unit within ICE, both of which have longitudinal health services missions such that the loss of paper records as a consequence of patients moving within the system could result in missed diagnoses or other inappropriate care.
|
From page 236... ...
Because informatics and HIT continue to evolve, the committee believes DHS should create a Health Information and Informatics Advisory Group consisting of experts from across government that would work iteratively with leaders of both the governance board and the steering committee. The goal of these interrelated groups would be to meet the operational and management information and communication needs of individual components while exploiting opportunities for collective benefit where appropriate.
|
From page 237... ...
2012. Coast Guard awards $17 million contract for health information sys tem.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.