What are the implications?
OSHA mandates keeping occupational health records, which are controlled by employers, independent and distinct from non-occupational health records controlled by patients (American Health Information Management Association (AHIMA), “The Privacy and Security of Occupational Health Records”). Additionally, according to OSHA’s “Access to Employee Exposure and Medical Records” regulation (29 CFR 1910.1020), occupational health records must be retained 30 years after termination of an employee, while minimum general medical record retention varies by state.
Navigating these record keeping obligations can become increasingly difficult in hospital employee health departments, where an employee may also be a hospital patient. Not storing information properly and poorly monitoring setting securities could lead to personal health information being inadvertently available to hospital staff who have access to patient medical records.
Because of these stipulations, American Health Information Management Association highlights the critical importance of “designing an electronic health record system that is able to manage and segregate different types of health record systems with differing rules of access, use, and disclosure as need” (AHIMA, “The Privacy and Security of Occupational Health Records”).
These scenarios bring to light practical examples that could be applicable to employee health or occupational medicine:
During an employee’s annual flu shot, she discloses she is pregnant. While that information may be documented in her general medical record, the employer should have no way to access that information but should only be informed that she has received her immunization.
An employee attends a fitness exam required by his employer and discloses on a medical history form that he has diabetes and is allergic to iodine. If his diabetes doesn’t affect his ability to perform his job functions, it shouldn’t be documented in his occupational health record (with the exception of it being required by law or if there is a threat to public safety). However, his allergy to iodine could be added to both records.
Incorporating Occupational Medicine Services into your current Employee Health organization workflow might help your business see better results, but before committing there are Three Questions You Need to Ask About Your Employee Health Workflow!
Distribution of nonfatal occupational injuries and illness by private industry sector, 2017
Injuries accounted for 95 percent of cases reported among all private industry workplaces combined in 2017, as well as the majority of cases reported among individual industry sectors. Illnesses accounted for only a small fraction of cases reported in each industry sector. Source: https://www.bls.gov/iif/osch0062.pdf
How to Keep Occupational Health Records Separate from General Medical Records
Documenting in separate systems that never interface, which forces duplicate documentation in cases where information could rightfully be documented into both records, such as immunizations, medications, or allergies.
Paper or Spreadsheets
Documenting with paper or generic spreadsheets, leading to extra manual work especially when providing reports for employers or managers. An additional challenge is to audit access of the records.
Documenting in a single software. Note that this solution will only work with complete segregation of the general medical record from the occupational health record—if this is not the case this method may be a breach of law.
The ideal solution is a software solution built specifically to separate the information seamlessly but also interface the appropriate information into the general medical record like medications, allergies, and immunizations when applicable, in a single patient-centric record. Additionally, role-based access, individual permission settings, enforcing unique user login with strong passwords, and user access audit reports are crucial tactics to effectively manage records based on mandated policies.
A compliant solution should also maintain workers’ compensation cases separately and independently of any other record and be able to provide Work Status Reports for employers that only include relevant work restrictions and no other confidential information.
Consult your health information management department and/or compliance departments to ensure you are in compliance with federal and state privacy and security regulations to mitigate potential legal risk.
Our Occupational Medicine and Employee Health offerings can serve your distinct program areas or a blended OM/EH initiative. Services are designed for both new clients, preparing to integrate their business processes with Agility® for the first time, and existing clients who want a professional analysis on the overall effectiveness and efficiency of their programs. Click here to see some of today's challenges in Occupational Medicine & Employee Health.
STATES WITH THE HIGHEST NON-FATAL OCCUPATIONAL INJURY AND ILLNESS INCIDENCE RATES (per 100 full-time workers)
Four Key Concerns of Occ Med Management
The COO of a 30-year old Corporate Health program, touching 90,000 lives annually, shares the reasons she was compelled to integrate a specialized Occupational Medicine EHR into their Epic-based system.
With 12 centers, 18 onsite medical programs, and 3,800 employer clients in their network, this institution faced a host of relatable operations, compliance, and growth roadblocks:
- The need to ensure individuals' privacy (PHI) across records and reports
- A mandate to streamline and efficiently manage a high volume of employer protocols
- An obligation to maximize revenue and reimbursement via an integrated billing system
The Top 4 Strategies for Reducing Employee Health Spend
RWJBarnabas Health's approach to Employee Health and Workers' Comp reduced total claim frequency by more than 50%.
Hear executives from this 40,000 employee explain their transformation strategy and share results that included managed care savings of $11.2M, over two years.
System-wide impact (earning them the 2015 Teddy award for an "exceptional workers' compensation program" ) -
- Lost-time claim frequency rate decreased 72% (2012-2014)
- Total claim frequency rate decreased 54% (2012-2014)
- 94% of medical-only claims since 2012 have total incurred cost <$1,000
- Managed Care savings of over $11.2 million (2012-2014)
Our Occupational Medicine and Employee Health offerings can serve your distinct program areas or a blended OM/EH initiative. Services are designed for both new clients, preparing to integrate their business processes with Agility® for the first time, and existing clients who want a professional analysis on the overall effectiveness and efficiency of their programs.
Consider these possible results:
Your results will depend on the particular components of your Occupational Medicine or Employee Health program.
- Develop KPIs and learn to understand your programs’ effectiveness at-a-glance
- Continue driving down costs by eliminating paper charts and storage, once and for all
- Optimize processes around scheduling and visits to reduce wait times and cancellations
- Create a healthy Occupational Medicine revenue cycle with Agility RCM
- Boost staff productivity and stakeholder satisfaction by maximizing secure data and documentation sharing tools
There are three ways to bring Net Health 360 professional services to your facility. All programs are designed to pinpoint gaps in compliance or effectiveness, boost productivity, and retool your Employee Health and Occupational Medicine programs.
- Workflow Analysis & Optimization
- Annual Health Check
- Customized package around critical needs
For more information on how the Net Health 360 professional services can help to optimize your facility’s clinical and operational practices and procedures, contact Net Health today.