Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Luensman GB[original query] |
---|
Clinical decision support for worker health: A five-site qualitative needs assessment in primary care settings
Ash JS , Chase D , Baron S , Filios MS , Shiffman RN , Marovich S , Wiesen J , Luensman GB . Appl Clin Inform 2020 11 (4) 635-643 BACKGROUND: Although patients who work and have related health issues are usually first seen in primary care, providers in these settings do not routinely ask questions about work. Guidelines to help manage such patients are rarely used in primary care. Electronic health record (EHR) systems with worker health clinical decision support (CDS) tools have potential for assisting these practices. OBJECTIVE: This study aimed to identify the need for, and barriers and facilitators related to, implementation of CDS tools for the clinical management of working patients in a variety of primary care settings. METHODS: We used a qualitative design that included analysis of interview transcripts and observational field notes from 10 clinics in five organizations. RESULTS: We interviewed 83 providers, staff members, managers, informatics and information technology experts, and leaders and spent 35 hours observing. We identified eight themes in four categories related to CDS for worker health (operational issues, usefulness of proposed CDS, effort and time-related issues, and topic-specific issues). These categories were classified as facilitators or barriers to the use of the CDS tools. Facilitators related to operational issues include current technical feasibility and new work patterns associated with the coordinated care model. Facilitators concerning usefulness include users' need for awareness and evidence-based tools, appropriateness of the proposed CDS for their patients, and the benefits of population health data. Barriers that are effort-related include additional time this proposed CDS might take, and other pressing organizational priorities. Barriers that are topic-specific include sensitive issues related to health and work and the complexities of information about work. CONCLUSION: We discovered several themes not previously described that can guide future CDS development: technical feasibility of the proposed CDS within commercial EHRs, the sensitive nature of some CDS content, and the need to assist the entire health care team in managing worker health. |
Opportunities at the intersection of work and health: Developing the occupational data for health information model
Marovich S , Luensman GB , Wallace B , Storey E . J Am Med Inform Assoc 2020 27 (7) 1072-1083 OBJECTIVE: The study sought to develop an information model of data describing a person's work for use by health information technology (IT) systems to support clinical care, population health, and public health. MATERIALS AND METHODS: Researchers from the National Institute for Occupational Safety and Health worked with stakeholders to define relationships and structure, vocabulary, and interoperability standards that would be useful and collectable in health IT systems. RESULTS: The Occupational Data for Health (ODH) information model illustrates relationships and attributes for a person's employment status, retirement dates, past and present jobs, usual work, and combat zone periods. Key data about the work of a household member that could be relevant to the health of a minor were also modeled. Existing occupation and industry classification systems were extended to create more detailed value sets that enable self-reporting and support patient care. An ODH code system, available in the Public Health Information Network Vocabulary Access and Distribution System, was established to identify the remaining value sets. ODH templates were prepared in all 3 Health Level 7 Internationalinteroperability standard formats. DISCUSSION: The ODH information model suggests data elements ready for use by health IT systems in the United States. As new data elements and values are better defined and refined by stakeholders and feedback is obtained through experience using ODH in clinical settings, the model will be updated. CONCLUSION: The ODH information model suggests standardized work information for trial use in health IT systems to support patient care, population health, and public health. |
Enhancing worker health through clinical decision support (CDS): An introduction to a compilation
Filios MS , Storey E , Baron S , Luensman GB , Shiffman RN . J Occup Environ Med 2017 59 (11) e227-e230 OBJECTIVE: This article outlines an approach to developing clinical decision support (CDS) for conditions related to work and health. When incorporated in electronic health records, such CDS will assist primary care providers (PCPs) care for working patients. METHODS: Three groups of Subject Matter Experts (SMEs) identified relevant clinical practice guidelines, best practices, and reviewed published literature concerning work-related asthma, return-to-work, and management of diabetes at work. RESULTS: SMEs developed one recommendation per topic that could be supported by electronic CDS. Reviews with PCPs, staff, and health information system implementers in five primary care settings confirmed that the approach was important and operationally sound. CONCLUSION: This compendium is intended to stimulate a dialogue between occupational health specialists and PCPs that will enhance the use of work information about patients in the primary care setting. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Apr 29, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure