| A diabetic patient's working conditions, such as working more or different hours or working in hot environments, can contribute to hyper- or hypoglycemic episodes. Also, for some “safety-sensitive” jobs, a worker with impairment of cognition due to low blood sugar could be at risk for injury to himself or to others. Triggered by an A1C level greater than 8 or a hypoglycemia diagnosis, the clinical decision support (CDS) would prompt providers to ask specific work-related questions and would generate educational information for the provider and patient based on the responses. |
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Return to work activity prescriptions for low–back pain
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| Some patients with low back pain (CDS trigger) and functional limitations may request their provider write a letter to their employer describing their limitations. The provider, based on both the patients’ reported function limitations (e.g., in a questionnaire) and the clinical assessment, chooses from four levels of recommended activity (sedentary, light, light-medium, medium). The system would guide the provider through generating a letter that specifies permitted activities based on which activity level was chosen and provides a date for elimination of activity restrictions. |
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Work-related asthma
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| Many cases of work-related asthma first present in a primary care setting and recognizing this connection is important to the success of the patient's management. The proposed CDS system would be triggered for adult patients with new onset or worsening asthma symptoms of less than 2 years of duration. The system would suggest the provider ask three questions about the relationship of the asthma symptoms to the patient's work. If the patient responds positively to any of these screening questions and the diagnosis of asthma is supported by spirometry results, the system would provide both clinician and patient information about work-related asthma. This information would help identify specific potential high-risk work exposures and referral resources. It would also prompt scheduling an extended visit to obtain work and exposure history and documentation in the EHR of the discussion. |
