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Should What You Do for a Living Be Part of Your Electronic Health Record?

Handwritten patient medical records, fixtures in American health care, are set to go by the wayside in 2014. That’s the deadline set by the Patient Protection and Affordable Care Act (PPACA) for every person in the United States to have a certified electronic health record (EHR) as opposed to the current norm: scribbled files scattered amongst every health care provider and medical facility visited over the course of a lifetime.

Job-Related Illnesses More Costly than Cancer, Diabetes

A new NIOSH-funded study from the University of California Davis shows that the cost of job-related injuries and illness is $250 billion a year. That’s $31 billion more than the cost of all cancers and $76 billion more than the cost of diabetes.

Proponents of EHRs say they offer the potential for improved patient care and a more efficient health care system. Whether it is a routine examination or an emergency room situation, health care providers will have immediate access to a patient’s medical history. Problems will be diagnosed faster. Errors will be reduced. Care will be better coordinated, therefore safer and less costly. Tests will not be needlessly duplicated. Treatments already found to be unsuccessful will not be prescribed again due to lack of awareness. Patients and their families will have the information necessary to be more involved in decisions.

However, EHRs will only be as good as they are complete. For this reason, a growing number of occupational health professionals, including those at the LHSFNA, recommend that occupational health records (OHRs) be part of these materials. Despite the fact that most people between the ages of 21 and 65 spend 40 percent of their waking hours at work, what they do for a living is not typically noted when health care providers see them.

This omission is a major oversight because the workplace is the source of many costly health problems.

The Institute of Medicine of the National Academies (IOM) finds that more than 4,000 occupational fatalities, more than three million occupational injuries and more than 160,000 cases of occupational illnesses occur in the U.S. every year. Many of these involve construction workers. The most recent data released by the Bureau of Labor Statistics (BLS) finds that more than 88,000 injuries and illnesses that required time away from work were in the construction and extraction occupations. Incorporating OHRs into EHRs could lead to more informed diagnosis and treatment, as doctors and other medical personnel will have more information to accurately diagnose. Knowing that someone is a construction Laborer at a highway site rather than at a nuclear site gives new insight to the provider and the likelihood of improved implementation of safety measures through which the entire work force could benefit. In addition, this information could facilitate more effective determination of whether the costs of a health problem should be assigned to the patient’s health insurer or the employer’s workers’ compensation policy.

However, if OHRs are to be part of EHRs, the issue of patient privacy must be addressed. Regulatory measures must be established in regard to storage and sharing of this data.

At the request of the National Institute of Occupational Safety and Health (NIOSH), the IOM conducted a study of these issues. Its findings will help determine whether OHRs will be included in EHRs and be a part of the evolving health care landscape.

[Janet Lubman Rathner]

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