A Combat Zone Period Observation is a clinical statement indicating the self-reported date range(s)when a person worked in what is considered a combat zone. Both civilian workers, such as Department of Defense contractors, and military service members could have worked in combat zones. Many people who have served in the military seek care first outside of the Veterans Health Administration system. Collecting this observation can facilitate important conversations about possible related health concerns, potentially prompting referral to the Department of Veterans’ Affairs (VA).

The self-reported current and/or historical status about a person’s economic relationship to work (e.g. having one or more jobs), including start and end dates. A person’s Employment Status could change over time, for example, a person could be employed following a period of choosing to not be in the labor force. Outside of ODH, the employment arrangement between an employer and a person (one job) has sometimes been referred to as a person’s ‘employment status.’ However, in ODH, Employment Status is used to characterize a person, Work Classification is used to characterize a job, and Retirement Date is used to characterize a person as retired.

covers information about a patient’s work, including some voluntary work, or a patient’s household members’ work. ODH is designed for the social history section of a medical record, to facilitate clinical care in multiple disciplines and delivery environments. ODH can be used for clinical decision support, population health activities and value-based care, and public health reporting.

A Past or Present Occupation Observation is a clinical statement about the type of work done by a person in a job, as reported by that person. It includes a set of self-reported, related observations that remain associated with one-another to characterize the job and provide clinically-relevant information. It also can be used in a minor’s record for the job(s) of people who share a home with the person (see optional related subject). A job is defined as a work situation, training position, or (potentially clinically-relevant) volunteer position held for a specified time period; for a given job, updates to Job Occupation, Past or Present Industry (Job Industry), Supervisory Level, or Employer would constitute a new job or volunteer position. A person can have more than one job at the same time and multiple jobs over time. Knowledge about a person’s job(s) informs diagnosis and management of illness and injury; it also informs management of health in the work environment, regardless of whether a condition is work-related. While knowing about a person’s current job(s) is likely to be most important, some work-related health conditions can manifest after a long latency so a history of jobs can also provide valuable information. This set of related Job observations also can provide information for public health to locate infectious disease outbreaks and intervene to prevent further illness. Public health can also use these data to analyze work-related conditions such as silicosis, pesticide poisoning, and some types of cancer to identify Occupations, Industry sectors and Employers for whom interventions are needed to mitigate risk.

A Date of Retirement Observation is a clinical statement about a self-reported date (at least year) that a person considers themselves to have ‘retired’. If present, the person has retired. A person can be both retired and employed; most often, a person would be retired from one job and employed in another job.

A Usual Occupation Observation is a clinical statement about the type of work (paid or unpaid) done by a person for the longest amount of time during his or her life, not including voluntary work. It includes a set of self-reported, related components about the work a person performed for the longest amount of time during his or her life, regardless of the person’s current job and regardless of whether or not the person performed this work for a continuous time. It also can be used in a minor’s record for the Usual Work of people who share a home with the person (see optional related subject). Usual Work supports recognition of new and known chronic conditions which evolve over many years and may become evident after the person is no longer performing that type of work, e.g., some respiratory conditions and cancers. These data also are used by public health entities and medical researchers to investigate the relationship between conditions and exposures at work and illnesses, causes of death, or cancer.

A person or organization that hires the services of another. This contains the address of the employer, which might not be the work location.

A flag indicating if this is the person’s current job (at the time the resource was last updated)

Concepts describing the kind of business that compensates the person for work (e.g., wages, training) or assigns work to a volunteer, as reported by the person. The kind of business is determined based on the primary business activity conducted by the company, organization, or individual (for those who are self-employed), or, for a military position, the self-reported branch of service. The value set was created by coding the NAICS index terms, which are relatable to the general public, to facilitate collection and validation by patients. A downloadable file available from the PHIN VADS ODH Hot Topics section is structured to support computer-assisted searching of this value set. The file also contains a crosswalk from the concepts in this value set to Occupation_CDC_Census value set concepts.

Concepts describing a person’s self-reported type of work, i.e., the set of activities or tasks that the person is paid to perform or, if unpaid, the person’s contribution to a household/family business/community. The value set was created by coding the O*NET-SOC alternate titles, which are relatable to the general public, to facilitate collection and validation by patients. A downloadable file available from the PHIN VADS ODH Hot Topics section is structured to support computer-assisted searching of this value set. The file also contains a crosswalk from the concepts in this value set to Occupation_CDC_Census value set concepts.

Concepts representing whether a person does or does not currently have a job or is not currently in the labor pool seeking employment.

2010 Occupation coding system used by CDC (NIOSH & NCHS) for coding occupation text. Occupation describes a set of activities or tasks that individuals are paid to perform or, if unpaid, define a person’s contribution to a household/family business/community. This code system includes 2010 U.S. Census Bureau occupation codes with modifications made by CDC for unpaid workers and military occupations. The 2010 Census occupation categories are based on the 2010 BLS Standard Occupational Classification (SOC) system. The PH_Industry_CDC_Census2010 code system should be used in conjunction with this occupation code system when coding both industry and occupation. For more information and instructions on using this coding system, see the instruction manual for CDC-Census I&O coding at: http://www.cdc.gov/niosh/topics/coding/

2010 Occupation coding system used by CDC (NIOSH & NCHS) for coding occupation text. Occupation describes a set of activities or tasks that individuals are paid to perform or, if unpaid, define a person’s contribution to a household/family business/community. This code system includes 2010 U.S. Census Bureau occupation codes with modifications made by CDC for unpaid workers and military occupations. The 2010 Census occupation categories are based on the 2010 BLS Standard Occupational Classification (SOC) system. The PH_Industry_CDC_Census2010 code system should be used in conjunction with this occupation code system when coding both industry and occupation. For more information and instructions on using this coding system, see the instruction manual for CDC-Census I&O coding at: http://www.cdc.gov/niosh/topics/coding/

Code system of concepts representing a person’s job type as defined by compensation and sector (e.g. paid vs. unpaid, self-employed vs. not self-employed, government vs. private, etc.).

Describes an individual’s typical arrangement of working hours for an occupation

Value set indicating yes or no (values drawn from Snomed CT), equivalent to LL361-7.

An indicator of responsibilities of a person’s job for directing work and personnel management, as reported by the person. Pay grade is used to represent supervisory or personnel management responsibilities for U.S. military service, because it conveys similar meaning across branches of service.

Occupational Data For Health Code System

This example includes a combat zone period of 1 year for patient Maya Gordon.

This example shows an employment status of ‘Employed’ for patient Maya Gordon.

This example shows a retirement date for test patient Maya Gordon.

This is an example of patient, Maya Gordon, that is associated with the work profile examples.

Example for the Usual Work profile

Complete composition example of work information for patient Maya Gordon.

US Core Organization - South Hospital Example

This is an example of a Past or Present Job for patient, Maya Gordon. This example includes coded Occupation, Industry, Work Classification (compensation sector and employment type), Work Schedule, Weekly Work Days, Daily Work Hours, Job Duties, and Occupational Hazard.