Industry and Occupation in the Electronic Health Record: An Investigation of the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System

Details

• Personal Author:
  Forst L ; Schmitz, Michael
• Description:
  Inclusion of information about a patient's work, industry, and occupation, in the electronic health record (EHR) could facilitate occupational health surveillance, better health outcomes, prevention activities, and identification of workers' compensation cases. The US National Institute for Occupational Safety and Health (NIOSH) has developed an autocoding system for "industry" and "occupation" based on 1990 Bureau of Census codes; its effectiveness requires evaluation in conjunction with promoting the mandatory addition of these variables to the EHR. Objective: The objective of the study was to evaluate the intercoder reliability of NIOSH's Industry and Occupation Computerized Coding System (NIOCCS) when applied to data collected in a community survey conducted under the Affordable Care Act; to determine the proportion of records that are autocoded using NIOCCS. Methods: Standard Occupational Classification (SOC) codes are used by several federal agencies in databases that capture demographic, employment, and health information to harmonize variables related to work activities among these data sources. There are 359 industry and occupation responses that were hand coded by 2 investigators, who came to a consensus on every code. The same variables were autocoded using NIOCCS at the high and moderate criteria level. Results: Kappa was .84 for agreement between hand coders and between the hand coder consensus code versus NIOCCS high confidence level codes for the first 2 digits of the SOC code. For 4 digits, NIOCCS coding versus investigator coding ranged from kappa=.56 to .70. In this study, NIOCCS was able to achieve production rates (ie, to autocode) 31%-36% of entered variables at the "high confidence" level and 49%-58% at the "medium confidence" level. Autocoding (production) rates are somewhat lower than those reported by NIOSH. Agreement between manually coded and autocoded data are "substantial" at the 2-digit level, but only "fair" to "good" at the 4-digit level. Conclusions: This work serves as a baseline for performance of NIOCCS by investigators in the field. Further field testing will clarify NIOCCS effectiveness in terms of ability to assign codes and coding accuracy and will clarify its value as inclusion of these occupational variables in the EHR is promoted. [Description provided by NIOSH]
• Subjects:
  Database Occupational Health Safety
• Keywords:
  Author Keywords: Medical Informatics Databases Electronic Health Record Electronic Health Records Industry Code Information Retrieval Systems Medical Records NIOCCS Occupation Occupational Health Occupation Code Occupations Surveillance

  More +
• ISSN:
  2291-9694
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Grant
• Genre:
  Journal Article
• Place as Subject:
  Illinois ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  4
• Issue:
  1
• NIOSHTIC Number:
  nn:20051977
• Citation:
  JMIR Med Inform 2016 Feb; 4(1):e5
• Contact Point Address:
  Linda Forst, MD, MPH, Environmental and Occupational Health Sciences, School of Public Health, University of Illinois at Chicago, 2121 W. Taylor, MC 922, Chicago, IL, 60612 United States
• Email:
  Forst-L@uic.edu
• Federal Fiscal Year:
  2016
• Performing Organization:
  University of Illinois at Chicago
• Peer Reviewed:
  False
• Start Date:
  20100701
• Source Full Name:
  JMIR Medical Informatics
• End Date:
  20150630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8490722a7ea3cb764e8766e4d75926e40da40367934323dcbca6011859b314e1c9c4b605197787261e7b195d2ac5fd9eceb6ef384aebd62a0e636d017a42314a
• Download URL:
  https://stacks.cdc.gov/view/cdc/211617/cdc_211617_DS1.pdf
• File Type:
  [PDF - 659.34 KB ]