Enhancing Worker Health Through Clinical Decision Support (CDS)

Filios, Margaret S.; Storey, Eileen; Baron, Sherry; Luensman, Genevieve B.; Shiffman, Richard N.

doi:10.1097/jom.0000000000001179

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…Regrettably, the current pandemic follows a long tradition of incomplete occupational illness surveillance in most countries, including the US Data sources commonly used for occupational illness surveillance (e.g., national surveys, workers' compensation data) are deficient in multiple ways, 99‐101 the most important of which, for COVID‐19, are timeliness and both socioeconomic and geographic granularity. The extent to which electronic health record (EHR) data collection 102 has improved the situation remains suboptimal despite improvements in recent years 103 . A variety of systems, tools, big data platforms and apps 104,105 present opportunities to enhance occupational data collection, characterize, and address relationships between COVID‐19 and work, and inform the response to the current and future pandemics, yet require substantial privacy controls and voluntary buy‐in 106,107…”

Section: Introductionmentioning

confidence: 99%

COVID‐19 as an occupational disease

Carlsten

Gulati

Hines

et al. 2021

American J Industrial Med

116

155

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The impact of coronavirus disease 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 permeates all aspects of society worldwide. Initial medical reports and media coverage have increased awareness of the risk imposed on healthcare workers in particular, during this pandemic. However, the health implications of COVID‐19 for the global workforce are multifaceted and complex, warranting careful reflection and consideration to mitigate the adverse effects on workers worldwide. Accordingly, our review offers a framework for considering this topic, highlighting key issues, with the aim to prompt and inform action, including research, to minimize the occupational hazards imposed by this ongoing challenge. We address respiratory disease as a primary concern, while recognizing the multisystem spectrum of COVID‐19‐related disease and how clinical aspects are interwoven with broader socioeconomic forces.

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Section: Introductionmentioning

confidence: 99%

COVID‐19 as an occupational disease

Carlsten

Gulati

Hines

et al. 2021

American J Industrial Med

116

155

View full text Add to dashboard Cite

show abstract

“…In addition to providing simple tools to clinicians like standardized questionnaires, electronic health records have the potential to enhance care through more advanced functions such as clinical decision support. 30 In the case of respiratory disease, clinical decision support algorithms could be triggered by specific clinical presentations. For example, if the patient were to present with adult onset or worsening of asthma, the electronic health record could prompt the clinician to ask three questions 31 :…”

Section: Obtaining An Occupational Respiratory Hazard Exposure Historymentioning

confidence: 99%

Importance of and Approach to Taking a History of Exposures to Occupational Respiratory Hazards

Weissman

Radonovich

2023

Semin Respir Crit Care Med

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Occupational respiratory diseases are caused by exposure to respiratory hazards at work. It is important to document those exposures and whether they are causing or exacerbating disease because these determinations can have important impacts on diagnosis, treatment, job restrictions, and eligibility for benefits. Without investigation, it is easy to miss clinically relevant exposures, especially in those with chronic diseases that can have work and nonwork causes. The first and most important step in identifying exposures to respiratory hazards at work is to take an appropriate history. For efficiency, this is a two-step process. An initial quick screening history is done by asking only a few questions. Follow-up questions are asked if there are positive responses to the screening questions or if an occupational etiology is suspected based on the clinical presentation. Electronic health records have promise for facilitating this process. Follow-up to the screening history may include additional questions, evaluating additional sources of information about workplace exposures, and medical testing. Radiographic findings or tests conducted on noninvasive samples or lung tissue can be used as biomarkers. Online resources can be used to learn more about exposures associated with occupations and industries and to see if investigations evaluating exposures were performed in the patient's own workplace. It is important to adhere to the patient's wishes about contacting the employer. With patient consent, the employer can be an important source of information about exposures and, if a problem exists, has an important role in taking corrective action. Consultation for challenging cases is available from a variety of professional and governmental entities. If a clinician identifies a significant public health issue, such as an occupational disease outbreak, it is important to notify relevant public health authorities so that steps can be taken to prevent additional exposures and appropriately care for those already exposed.

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“…Electronic health record (EHR) systems can facilitate the collection of information and support and encourage clinical decision making that includes occupational health concerns [ 69 , 70 ]. Some key limitations to healthcare provider acceptance of this integration in the US arethe lack of time to address occupational aspects of health in the brief clinical encounters that increasingly typify the practice of medicine and clinicians’ perception that impacting working conditions is beyond their control [ 71 ].…”

Section: Current Challenges To Application Of Ldct Among Aepmentioning

confidence: 99%

Lung Cancer Screening in Asbestos-Exposed Populations

Markowitz

2022

IJERPH

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Asbestos exposure is the most important cause of occupational lung cancer mortality. Two large randomized clinical trials in the U.S. and Europe conclusively demonstrate that annual low-dose chest CT (LDCT) scan screening reduces lung cancer mortality. Age and smoking are the chief risk factors tested in LDCT studies, but numerous risk prediction models that incorporate additional lung cancer risk factors have shown excellent performance. The studies of LDCT in asbestos-exposed populations shows favorable results but are variable in design and limited in size and generalizability. Outstanding questions include how to: (1) identify workers appropriate for screening, (2) organize screening programs, (3) inform and motivate people to screen, and (4) incorporate asbestos exposure into LDCT decision-making in clinical practice. Conclusion: Screening workers aged ≥50 years with a history of ≥5 years asbestos exposure (or fewer years given intense exposure) in combination with either (a) a history of smoking at least 10 pack-years with no limit on time since quitting, or (b) a history of asbestos-related fibrosis, chronic lung disease, family history of lung cancer, personal history of cancer, or exposure to multiple workplace lung carcinogens is a reasonable approach to LDCT eligibility, given current knowledge. The promotion of LDCT-based screening among asbestos-exposed workers is an urgent priority.

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Enhancing Worker Health Through Clinical Decision Support (CDS)

Cited by 7 publications

References 13 publications

COVID‐19 as an occupational disease

COVID‐19 as an occupational disease

Importance of and Approach to Taking a History of Exposures to Occupational Respiratory Hazards

Lung Cancer Screening in Asbestos-Exposed Populations

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