Table 1.

Example user stories for data elements to be included in the Occupational Data for Health information model

Topic	User story
Patient care	A 42-year-old man presents with asthma. Symptoms of wheezing and cough began 6 months ago. For the past year, he has worked in an autobody shop painting cars. This occupation is identified by a clinical decision support tool as one associated with work-related asthma. An occupational medicine consultant identifies isocyanates in the paints he uses as a likely cause for his asthma. Change to a job without exposure to these paints results in resolution of symptoms over a period of 3 months.
Population health	A practice that routinely collects information on occupation during registration uses the population health tool to analyze the occupations of the patients in its care population. Notable are the numbers of patients who are housepainters. In follow-up discussions with some of these patients, it is revealed that much of their work involves removing lead paint from older houses. Screening for lead poisoning is instituted based on occupation, and educational materials are provided to these patients through the health IT systems, so they are aware of important preventive measures to take while working.
Public health	A 19-year-old man presents to an emergency department with flu-like symptoms. His occupation is a farm worker and the industry in which he works is peach farming. Based on this information, the physician asks about his activities during the time right before symptom onset. He was at work, picking peaches. Laboratory testing confirms a diagnosis of pesticide poisoning. As required by state law, a report is sent by the healthcare organization through their health IT systems to the state health department. A health department epidemiologist analyzes reported cases from all nearby healthcare facilities and sees that several such cases within the month were persons working for the same employer. The state health department works with the employer to assess and reduce exposure to pesticides.

IT: information technology.