38634 Federal Register / Vol. 77, No. 125 / Thursday, June 28, 2012 / Notices 

authorized by Section 941 of the Public 

Health Service Act, 42 U.S.C. 299c. In 

accordance with its statutory mandate, 

the Council is to advise the Secretary of 

the Department of Health and Human 

Services and the Director, Agency for 

Healthcare Research and Quality 

(AHRQ), on matters related to AHRQ’s 

conduct of its mission including 

providing guidance on (A) Priorities for 

health care research, (B) the field of 

health care research including training 

needs and information dissemination on 

health care quality and (C) the role of 

the Agency in light of private sector 

activity and opportunities for public 

private partnerships. 

The Council is composed of members 

of the public, appointed by the 

Secretary, and Federal ex-officio 

members specified in the authorizing 

legislation. 

II. Agenda 

On Friday, July 13, 2012, the Council 

meeting will convene at 8:30 a.m., with 

the call to order by the Council Chair 

and approval of previous Council 

summary notes. The AHRQ Director 

will present her update on current 

research, programs, and initiatives. 

Following the morning session, the 

Council will hold an Executive Session 

between the hours of 12 p.m. and 1:30 

p.m. This Executive Session will be 

closed to the public in accordance with 

5 U.S.C. App. 2, section 10(d) and 5 

U.S.C. 552b(c)(9)(B). This portion of the 

meeting is likely to disclose information 

the premature disclosure of which 

would be likely to significantly frustrate 

implementation of a proposed agency 

action. The final agenda will be 

available on the AHRQ Web site at 

www.AHRQ.gov no later than Friday, 

June 29, 2012. 

Dated: June 21, 2012. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2012–15795 Filed 6–27–12; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[Docket Number CDC–2012–0008; NIOSH– 

251] 

Request for Information: Collection 

and Use of Patient Work Information in 

the Clinical Setting: Electronic Health 

Records 

AGENCY: The National Institute for 

Occupational Safety and Health 

(NIOSH) of the Centers for Disease 

Control and Prevention (CDC), 

Department of Health and Human 

Services (HHS). 

ACTION: Request for public comments. 

SUMMARY: The National Institute for 

Occupational Safety and Health 

(NIOSH) of the Centers for Disease 

Control and Prevention (CDC), 

Department of Health and Human 

Services (HHS) requests public 

comments to inform its approach in 

recommending the inclusion of work 

information in the electronic health 

record (EHR). NIOSH requests input on 

these issues (including answers to the 

three questions listed below). The 

instructions for submitting comments 

can be found at www.regulations.gov. 

Written comments submitted to the 

Docket will be used to inform NIOSH 

with its planning and activities in 

response to the 2011 letter report 

‘‘Incorporating Occupational 

Information in Electronic Health 

Records’’ written by the Institute of 

Medicine (IOM) Committee on 

Occupation and Electronic Health 

Records. 

DATES: Public Comment Period: 

Comments must be received by August 

27, 2012. Comments should reference 

docket number CDC–2012–0008. 

ADDRESSES: Written comments: You 

may submit comments by any of the 

following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• Mail: NIOSH Docket Office, Robert 

A. Taft Laboratories, MS–C34, 4676 

Columbia Parkway, Cincinnati, OH 

45226. 

Instructions: All submissions received 

must include the agency name and 

docket number. All relevant comments, 

including any personal information 

provided, will be posted without change 

to http://www.regulations.gov. 

• Email: nioshdocket@cdc.gov. 

All information received in response 

to this notice will be available for public 

examination and copying at the NIOSH 

Docket Office, 4676 Columbia Parkway, 

Cincinnati, Ohio 45226. 

NIOSH includes all comments 

received without change in the docket, 

including any personal information 

provided. All material submitted should 

reference docket number CDC–2012– 

0008 and must be submitted by August 

27, 2012 to be considered by the 

Agency. 

I. Background 

Health care in the United States is 

undergoing a significant change as 

providers of health care transition from 

paper-based records to electronic health 

records (EHRs). EHRs represent the 

potential for cost savings and other 

efficiencies and improvements in the 

way that information is used to inform 

health care. The Office of the National 

Coordinator (ONC) for Health 

Information Technology promotes a 

nationwide health information 

technology (HIT) infrastructure that 

allows for the electronic use and 

exchange of health information. More 

information on the ONC and on 

electronic health records can be found 

at http://healthint.hhs.gov. 

NIOSH, along with other centers of 

CDC, works to promote and protect 

population health. Public health 

researchers and practitioners, including 

those promoting occupational public 

health, are working to ensure that public 

health goals are met through the use of 

EHRs. NIOSH is working to ensure that 

EHRs will contribute to improvements 

in individual and population health by 

meeting the need to support 

occupational considerations during 

clinical care and by enhancing public 

health professionals’ understanding of 

work-related conditions so they can 

identify effective treatment and 

prevention strategies. Currently, 

systematic collection and recording of 

patient work information in the clinical 

setting is not widespread. Where work 

information is collected and recorded in 

the EHR, that information may not be 

standardized or converted to structured 

data (i.e., coded), thus limiting its utility 

for clinical decision making and public 

health surveillance. For example, 

standardized patient occupation and/or 

industry information could be linked to 

resources that provide clinical decision 

support, such as job-specific 

information about exposures and 

associated potential health problems, as 

well as information that would facilitate 

appropriate determination of return-towork recommendations. 

In 2011, at the request of NIOSH, the 

Institute of Medicine (IOM) of the 

National Academies of Science 

appointed a committee to examine the 

rationale and feasibility of incorporating 

occupational information in the EHR. 

The committee concluded that inclusion 

of occupational information in the EHR 

‘‘could contribute to fully realizing the 

meaningful use of EHRs in improving 

individual and population health care’’. 

The Committee provided NIOSH with a 

set of ten recommendations, including 

‘‘Recommendation 1: Conduct 

Demonstration Projects to Assess the 

Collection and Incorporation of 

Information on Occupation, Industry 

and Work-Relatedness in the EHR.’’ The 

purpose of this Request for Information 


srobinson on DSK4SPTVN1PROD with NOTICES
Federal Register / Vol. 77, No. 125 / Thursday, June 28, 2012 / Notices 38635 

(RFI) is to gather information from 

providers of primary care and 

occupational medicine, vendors and 

creators of EHR software, and the public 

to inform NIOSH’s response to this and 

other IOM recommendations. Gathering 

information through this RFI will enable 

NIOSH to understand opportunities and 

challenges in collecting occupational 

information and how and why health 

care providers collect and use this 

information. The IOM report with the 10 

recommendations can be downloaded 

at: http://iom.edu/Reports/2011/ 

Incorporating-Occupational-Information

-in-Electronic-Health-Records-LetterReport.aspx. 

NIOSH has released this RFI to learn 

about how the following types of patient 

work information are collected and 

used: 

Employment status (e.g., employed, 

unemployed, disabled, retired, part 

time/full time, shift) 

Patient’s current occupation(s) 

Patient’s current industry(s) 

Patient’s usual (longest held) 

occupation(s) 

Patient’s usual (longest held) industry(s) 

Employer(s) name 

Employer Address(es) 

Work-relatedness of patient’s health 

condition(s) 

Other information about patient’s work, 

such as information about exposures 

at work. 

II. Questions of Interest 

Input from primary care providers, 

occupational and public health 

specialists, EHR vendors and others 

with interest in the topic is sought on 

the questions listed below pertaining to 

the collection and use of work 

information in the clinical setting. 

NIOSH is interested in input both from 

those who are currently using EHRs as 

well as those who are not. 

(1) For providers of primary health 

care: When do the clinicians in your 

practice setting currently ask patients 

about their work? 

Specifically, what information on 

patients’ work is collected? 

If you currently use an EHR: 

Where in the health record (either 

paper or electronic) is patient work 

information stored and/or viewed? For 

example, is the work information 

entered in the ‘social history’ section of 

an EMR? Where would you prefer 

patient work information to be stored 

and/or viewed in the EHR? 

Does your EHR maintain a history of 

the information so that you can identify 

how long and when a patient was in a 

given occupation? 

If you currently do not use an EHR, 

where do you record this information in 

the paper record? Is it available to the 

care provider during the patient 

encounter? Is there a history of the 

patient’s work information available to 

the care provider? 

In your clinical practice, who (which 

personnel) besides the clinicians collect 

patients’ work information (e.g., 

registration personnel or nursing 

assistants)? 

Have those personnel been trained 

specifically in how to collect 

information about patient’s work i.e., 

how to gain an accurate job title etc.? 

Do you collect work information from 

teenagers? 

Do you collect work information from 

retirees? 

Are questions about work routine 

question or triggered based on specific 

complaints? 

How is work information used to 

inform patient care? 

Please provide an example/ 

description of the usefulness of patient 

work information in providing care to a 

patient. 

Please provide any additional 

comments you have about collection or 

use of patient work information in the 

clinical setting. 

(2) For providers of occupational 

(specialty) health care: At your clinical 

facility, how is the patient’s work 

information collected? 

Specifically, what information on 

patients’ work is collected? 

Is the work information entered in the 

administrative record used for billing 

purposes? 

Is patient work information collected 

on paper or in an EHR? Is it available 

to the care provider during the patient 

encounter? 

Is there a history of the patient’s work 

information available to the care 

provider? 

If you use a standardized form to 

collection information about patients’ 

work, please briefly describe its main 

elements. 

In your clinical practice, who (which 

personnel) besides the clinicians collect 

(e.g., registration personnel or nursing 

assistants)? 

Have those personnel been trained 

specifically in how to collect 

information about patient’s work i.e., 

how to gain an accurate job title, etc.? 

Where in the health record (either 

paper or electronic) is the information 

stored? For example, is the work 

information entered in the ‘social 

history’ section? 

What are the most important ways 

that clinicians can use to inform clinical 

care of patients? 

Please provide an example of the 

usefulness of work information in 

providing care to a patient. 

Do you have any other comments 

about collection or use of patient work 

information in the clinical setting? 

(3) For developers and vendors of 

EHR/software: Does your base/basic 

EHR product contain pre-ordained 

fields for Industry, Occupation, 

Employer or other information about 

patients’ work? If not, have you been 

asked to provide these fields? 

Regardless of whether they are in the 

base system or added on request, how 

are the values in the fields for Industry, 

Occupation, or other work information 

formatted (e.g., narrative text, dropdown menus, other)? 

Are these values coded and if so, what 

coding schema are used (e.g., NAICS, 

SOC, Census codes, user defined)? 

To the best of your knowledge, how 

are the data captured in these fields 

used by end users of your EHR/product? 

Please share challenges you anticipate 

in managing a history of employer, 

industry and occupation (current and 

usual) for multiple employment 

situations as both text and coded fields 

in your system, if your system does not 

already perform these functions? 

Could your system access and retrieve 

information from another web-based 

system via web services (such as an 

automated coding system for coding 

industry and occupation)? 

Your comments are appreciated. They 

will be used to improve NIOSH’s 

electronic health records efforts. 

FOR FURTHER INFORMATION CONTACT: 

Kerry Souza, NIOSH, 395 E Street SW., 

Suite 9257, Washington, DC 20002, 

telephone (202) 245–0639, Email 

hkv4@cdc.gov. 

Dated: June 20, 2012. 

John Howard, 

Director, National Institute for Occupational 

Safety and Health, Centers for Disease Control 

and Prevention. 

[FR Doc. 2012–15896 Filed 6–27–12; 8:45 am] 

BILLING CODE 4163–19–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Supplemental Submission for OMB 

Review; Comment Request 

Title: Mother and Infant Home 

Visiting Program Evaluation: Baseline 

collection of saliva for measuring 

cotinine. 

OMB No.: 0970–0402. 

Description: In 2011, the 

Administration for Children and 

Families (ACF) and Health Resources 

and Services Administration (HRSA) 


srobinson on DSK4SPTVN1PROD with NOTICES