ASTM E2473-05(2011)
(Practice)Standard Practice for the Occupational/Environmental Health View of the Electronic Health Record (Withdrawn 2020)
Standard Practice for the Occupational/Environmental Health View of the Electronic Health Record (Withdrawn 2020)
SIGNIFICANCE AND USE
This practice is directed at defining the application of existing conventions for the structure and content of EHR systems used to support healthcare practitioners in a workplace setting. In addition to supporting the capture of data on encounters and of periodic patient health assessments conducted during the time the employee is at work, this document also recognizes the interaction of care rendered over a lifetime and when not at work with that due to the work environment that is delivered on the work site, either for care events that have occupational significance or for surveillance of potential health conditions that may result from the work or living environment. This document recognizes not only the privacy and confidentiality of records that are kept in the work setting but also the need to be able to interchange data from the workplace record with health records in other settings in order to fully support employee and environmental health.
Occupational Health Programs:
Most occupational health programs are oriented, first, to any regular surveillance for observations associated with potentially adverse health conditions known to attend environmental stressors that may be present in either the workplace or the living environment and, second, to care and documentation of any illness or injury incurred during the workday at the work site or in other living environments. Each of these activities requires recording data for the care record that is a subset of that regularly required for care in other more extensive ambulatory and inpatient care settings. It also requires relating the events occurring in either the work place or the living environment to those observed healthcare data.
This practice is intended to identify the most frequently used of the general data elements which are more completely documented in Practice E1384 and Specification E1633. Thus, this description constitutes a “view” of the more comprehensive set of data that might be capt...
SCOPE
1.1 This Practice is intended to assemble a logical occupational/environmental health view of the already defined general structure and vocabulary for the Electronic Health Record (EHR) and to suggest the ways in which this view can be used to support employee health assessments and other healthcare delivered at the work site. This view is consistent with the ANSI/ADA Clinical Concept Data Model 2005, which identified the major data entities that will need to be involved. This view would complement other views addressed in other settings of care for the employee and could logically either request other EHR data or deliver to other practitioner requester’s record systems portions of occupational/environmental health data that have been recorded at the work site. This practice does not deal with the specific implementation of the content and it also does not either suggest or recommend implementation techniques. Likewise, it does not suggest standards of care. These functions are dealt with in other domains.
WITHDRAWN RATIONALE
This Practice is intended to assemble a logical occupational/environmental health view of the already defined general structure and vocabulary for the Electronic Health Record (EHR) and to suggest the ways in which this view can be used to support employee health assessments and other healthcare delivered at the work site.
Formerly under the jurisdiction of Committee E31 on Healthcare Informatics, this practice was withdrawn in January 2020 in accordance with section 10.6.3 of the Regulations Governing ASTM Technical Committees, which requires that standards shall be updated by the end of the eighth year since the last approval date.
General Information
Relations
Standards Content (Sample)
NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
Designation: E2473 − 05 (Reapproved 2011)
Standard Practice for the
Occupational/Environmental Health View of the Electronic
Health Record
This standard is issued under the fixed designation E2473; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (´) indicates an editorial change since the last revision or reapproval.
1. Scope Electronic Health Record (EHR) Systems (Withdrawn
2017)
1.1 This Practice is intended to assemble a logical
E1340 Guide for Rapid Prototyping of Information Systems
occupational/environmental health view of the already defined
(Withdrawn 2017)
general structure and vocabulary for the Electronic Health
E1384 Practice for Content and Structure of the Electronic
Record (EHR) and to suggest the ways in which this view can
Health Record (Withdrawn 2017)
be used to support employee health assessments and other
E1578 Guide for Laboratory Informatics
healthcare delivered at the work site. This view is consistent
E1633 SpecificationforCodedValuesUsedintheElectronic
withtheANSI/ADAClinicalConceptDataModel2005,which
Health Record (Withdrawn 2017)
identified the major data entities that will need to be involved.
E1714 Guide for Properties of a Universal Healthcare Iden-
This view would complement other views addressed in other
tifier (UHID)
settings of care for the employee and could logically either
E1715 Practice for An Object-Oriented Model for
request other EHR data or deliver to other practitioner request-
Registration,Admitting, Discharge, and Transfer (RADT)
er’s record systems portions of occupational/environmental
Functions in Computer-Based Patient Record Systems
health data that have been recorded at the work site. This
(Withdrawn 2017)
practice does not deal with the specific implementation of the
E1744 Practice for View of Emergency Medical Care in the
content and it also does not either suggest or recommend
Electronic Health Record (Withdrawn 2017)
implementation techniques. Likewise, it does not suggest
E1762 Guide for Electronic Authentication of Health Care
standards of care. These functions are dealt with in other
Information (Withdrawn 2017)
domains.
E1869 Guide for Confidentiality, Privacy, Access, and Data
1.2 This international standard was developed in accor-
SecurityPrinciplesforHealthInformationIncludingElec-
dance with internationally recognized principles on standard-
tronic Health Records (Withdrawn 2017)
ization established in the Decision on Principles for the
E1986 Guide for Information Access Privileges to Health
Development of International Standards, Guides and Recom-
Information (Withdrawn 2017)
mendations issued by the World Trade Organization Technical
E1987 Guide for Individual Rights Regarding Health Infor-
Barriers to Trade (TBT) Committee.
mation (Withdrawn 2007)
E1988 Guide for Training of Persons who have Access to
2. Referenced Documents
Health Information (Withdrawn 2007)
2.1 ASTM Standards:
E2017 Guide forAmendments to Health Information (With-
E1239 Practice for Description of Reservation/Registration-
drawn 2017)
Admission, Discharge, Transfer (R-ADT) Systems for
E2066 Guide forValidation of Laboratory Information Man-
agement Systems (Withdrawn 2015)
This practice is under the jurisdiction ofASTM Committee E31 on Healthcare E2084 Specification for Authentication of Healthcare Infor-
Informatics and is the direct responsibility of Subcommittee E31.25 on Healthcare
mation Using Digital Signatures (Withdrawn 2009)
Data Management, Security, Confidentiality, and Privacy.
E2085 Guide on Security Framework for Healthcare Infor-
Current edition approved May 1, 2011. Published May 2011. Originally
mation (Withdrawn 2009)
approved in 2005. Last previous edition approved in 2005 as E2473 05. DOI:
10.1520/E2473-05R11.
For referenced ASTM standards, visit the ASTM website, www.astm.org, or
contact ASTM Customer Service at service@astm.org. For Annual Book of ASTM
Standards volume information, refer to the standard’s Document Summary page on The last approved version of this historical standard is referenced on
the ASTM website. www.astm.org.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959. United States
E2473 − 05 (2011)
E2086 Guide for Internet and Intranet Healthcare Security Interchange—Information Model Methods
(Withdrawn 2009)
2.3 ANSI/HL7 Standards:
E2145 Practice for Information Modeling (Withdrawn
ANSI/HL7 Interface Standard v2.4
2017)
HL7 Message Development Framework v 3.0 Jan 1997
E2147 Specification for Audit and Disclosure Logs for Use
3 2.4 ISO Standards:
in Health Information Systems (Withdrawn 2017)
ISO/IEC TR 9789 Information Technology—Guidelines for
E2171 Practice for Rating-Scale Measures Relevant to the
3 the Organization and Representation of Data Elements for
Electronic Health Record (Withdrawn 2017)
Data Interchange—Coding Methods and Principles
2.2 ANSI/IEEE Standards:
ISO 12200 Computer Applications in Terminology—
ANSI/IEEE 610.2 Standard Glossary of Computer Applica-
Machine-Readable Terminology Interchange Format
tions Terminology
(MARTIF)—Negotiated Interchange
ANSI/IEEE 610.5 Standard Glossary of Information Man-
ISO 12620 Computer Applications in Terminology—Data
agement Terminology
Categories
ANSI/IEEE 610.12 Standard Glossary of Software Engi-
ISO IS 12207 Information Technology-Software Life Cycle
neering Terminology
Processes
ANSI/IEEE 729 Fundamental Terms in Software Engineer-
ISO IS 15188 Project Management Guidelines forTerminol-
ing
ogy Standardization
ANSI/IEEE 830 Software Requirements Specification
ISO WD 15288 System Life Cycle Processes
ANSI/IEEE 1058 Software Project Management Plans
ISO 15440 Guide for Life Cycle Processes
ANSI/IEEE 1062 Recommended Practice for Software Re-
2.5 Other Standards:
quirements
ANSI X3.172 American National Dictionary for Informa-
ANSI/IEEE 1063 Software User Documentation
tion Systems
ANSI/IEEE 1073 Framework and Overview
ANSI/ADA TR 1039 2005 Clinical Content Data Model
ANSI/IEEE 1073.2 Application Profile Framework and
ANSI/ADA 1000.0 Introduction, Model Architecture, and
Overview
Specification Framework
ANSI/IEEE 1073.3.1 Transport Profile
ANSI/ADA 1000.1 Individual Identification
ANSI/IEEE 1073.4.1 Physical Layer-Cable Connected
ANSI/ADA 1000.2 Codes and Nomenclature
ANSI/IEEE 1074 Standard for Developing Life Cycle Pro-
ANSI/ADA 1000.3 Individual Characteristics
cesses
ANSI/ADA 1000.4 Population Characteristics
ANSI/IEEE 1074.1 Guide for Developing Life Cycle Pro-
ANSI/ADA 1000.5 Organization
cesses
ANSI/ADA 1000.6 Location
ANSI/IEEE1220 StandardforApplicationandManagement
ANSI/ADA 1000.7 Communication
of the System Engineering Process
ANSI/ADA 1000.8 Healthcare Event
ANSI/IEEE 1233 Guide to Preparing System Requirements
ANSI/ADA 1000.9 Health Materiel
Specifications
ANSI/ADA 1000.10 Health Services
ANSI/IEEE 1320.1 Standard for Conceptual Modeling
ANSI/ADA 1000.11 Health Service Resources
Language—Syntax and Semantics for IDEF0
ANSI/ADA 1000.12 Population Health Facts
ANSI/IEEE 1320.2 Standard for Conceptual Modeling
ANSI/ADA 1000.13 Patient Health Facts
Language—Syntax and Semantics for IDEF1X97 (IDEF
ANSI/ADA 1000.14 Health Condition Diagnosis
Object)
ANSI/ADA 1000.15 Health Service Plan
ANSI/IEEE 1362 Guide for Information Technology—
ANSI/ADA 1000.16 Patient Health Service
System Definition—Concept of Operations Document
ANSI/ADA 1000.17 Clinical Investigation
ANSI/IEEE 1490 Guide to Project Management Body of
ANSI/ADA 1000.18 Comments Subject Area
Knowledge
DICOM Supplement 15 Visible Light Image, Anatomic
ANSI/IEEE 1498 Trial Use Standard for Information
Frame of Reference, Accession and Specimen for
Technology—Software LifeCycle Processes—Software
Endoscopy, Microscopy, and Photography
Development: Acquirer—Supplier Agreement
CEN ENV 1613 Medical Informatics—Messages for the
ANSI/IEEE 12207.0 Standard for Information
Exchange of Laboratory Information
Technology—Software Life Cycle Processes
CEN ENV 1614 Healthcare Informatics—Structure for
ANSI/IEEE 12207.1 Guide for Information Technology—
Nomenclature, Classification and Coding of Properties in
Software Life Cycle Processes—Life Cycle Data
Clinical Laboratory Sciences
ANSI/IEEE 12207.2 Guide for Information Technology—
CEN EN 12017 Medical Informatics Vocabulary (MIVoc)
Software Life Cycle Processes—Implementation Consid-
CEN EN 12264 Categorical Structures of Systems of
erations
Concepts—Model for Representation of Semantics
IEEE P1157.1 Trial Use Standard for Healthcare Data
(MOSE)
Internet RFC 1521 N. Borenstein, N Freed MIME [Multi-
purpose Internet Mail Extensions] Purpose: Mechanisms
Available fromAmerican National Standards Institute (ANSI), 25 W. 43rd St.,
4th Floor, New York, NY 10036, http://www.ansi.org. for Specifying and Designating the Format of Internet
E2473 − 05 (2011)
Message Bodies Bellcore Innosoft Sep 1993 3.2.2 CDC—Centers for Disease Control and Prevention,
ANSI X12 Dept. of Health and Human Services
CLSI AUTO1-A Laboratory Automation: Specimen
3.2.3 CDSS—Clinical Decision Support Systems
Container/Specimen Carrier
3.2.4 CLIMS—Clinical Laboratory Information Manage-
CLSI AUTO2-A Laboratory Automation: Bar codes for
ment System
Specimen Container Identification
3.2.5 CLSI—Clinical and Laboratory Standards Institute
CLSI AUTO3-A Laboratory Automation: Communications
with Automated Clinical Laboratory Systems, 3.2.6 CPR—Computer-based Patient Record
Instruments, Devices and Information Systems
3.2.7 DHHS—Department of Health and Human Services
CLSI AUTO4-A Laboratory Automation: Systems Opera-
3.2.8 EC—Electronic Commerce
tional Requirements, Characteristics and Information El-
3.2.9 EDI—Electronic Data Interchange
ements
CLSIAUTO5-A LaboratoryAutomation:Electromechanical
3.2.10 EHR—Electronic Health Record
Interfaces
3.2.11 EPA—Environmental Protection Agency
ANSI/ CLSI ASTP2 Point of Care In-vitro Diagnostic Test-
3.2.12 HIN—Health Information Network
ing
3.2.13 IDS—Integrated Delivery Systems
ANSI/CLSI GP19 Laboratory Instruments and Data Man-
agement Systems: Design of Software User Interfaces and
3.2.14 ISA—Information Systems Architecture
Software Systems Validation, Operations and Mainte-
3.2.15 LAS—Laboratory Automation System
nance
3.2.16 LIMS—Laboratory Information Management System
CLSI LIS-3A(priorASTM E792) Guide for Procurement of
3.2.17 MDSS—Management Decision Support System
a Clinical Laboratory Information Management System
(CLIMS)
3.2.18 MCO—Managed Care Organization
CLSI LIS-5A (prior ASTM E1238) Specification for Trans-
3.2.19 MPI—Master Person/Patient Index
ferring Clinical Observations Between Independent Com-
3.2.20 NCVHS—National Committee on Vital and Health
puter Systems
Statistics
CLSI LIS-1A (prior ASTM E1381) Specification for Low
Level Protocol to Transfer Messages Between Clinical 3.2.21 NIOSH—National Institute for Occupational Safety
and Health
Laboratory Instruments and Computer Systems
CLSI LIS-2A (prior ASTM E1394) Specification for Trans-
3.2.22 NPF—National Provider File
ferring Information Between Clinical Instruments and
3.2.23 NPI—National Provider Identifier
Computer Systems
3.2.24 NPS—National Provider System
CLSI LIS-7A (prior ASTM E1466) Specification for Use of
Bar Codes on Specimen Tubes in the Clinical Laboratory 3.2.25 OSHA—Occupational Safety and HealthAdministra-
CLSI LIS-8A (prior ASTM E1639) Guide for Functional tion
Requirements of Clinical Laboratory Information Man-
3.2.26 POC—Point-of-Care
agement Systems
3.2.27 POCT—Point-of-Care Testing
CLSI LIS-9A (prior ASTM E2118) Guide for Coordination
3.2.28 PPO—Preferred Provider Organization
of Clinical Laboratory Services Within the Electronic
Health record Environment and Networked Architectures 3.2.29 SSAN—Social Security Account Number (also SSN)
IUPAC/IFCC Silver Book: Compendium of Terminology
3.2.30 UMLS—Unified Medical Language System
and Nomenclature of Properties in Clinical Laboratory
3.2.31 VHA—Veteran’s Health Administration
Sciences
3.2.32 VistA—VHA Information Systems Technology Ar-
IUPAC/IFCC Properties and Units in Clinical Laboratory
chitecture
Sciences X Properties and Units in General Clinical
Chemistry
4. Significance and Use
IUPAC/IFCC Properties and Units in Clinical Laboratory
4.1 This practice is directed at defining the application of
Sciences XII Properties and Units in Clinical Pharmacol-
existing conventions for the structure and content of EHR
ogy and Toxicology
systems used to support healthcare practitioners in a workplace
setting. In addition to supporting the capture of data on
3. Terminology
encounters and of periodic patient health assessments con-
3.1 Definitions:
ducted during the time the employee is at work, this document
3.1.1 case—an Occupational/Environmental Health event in
also recognizes the interaction of care rendered over a lifetime
which one or more individuals and locations are found to
and when not at work with that due to the work environment
exhibit measurements of environmental stressors that are at
that is delivered on the work site, either for care events that
variance with criteria that define normative states.
have occupational significance or for surveillance of potential
3.2 Acronyms:
health conditions that may result from the work or living
3.2.1 CAP—College of American Pathologists environment. This document recognizes not only the privacy
E2473 − 05 (2011)
and confidentiality of records that are kept in the work setting 4.2.2 This practice is intended to identify the most fre-
but also the need to be able to interchange data from the quently used of the general data elements which are more
workplace record with health records in other settings in order
completely documented in Practice E1384 and Specification
to fully support employee and environmental health.
E1633. Thus, this description constitutes a “view” of the more
comprehensive set of data that might be captured in a general
4.2 Occupational Health Programs:
ambulatory care encounter. If the conventions given in this
4.2.1 Most occupational health programs are oriented, first,
document are adhered to, the data will ensure a record that is
to any regular surveillance for observations associated with
portable to any other setting and the record will be interoper-
potentially adverse health conditions known to attend environ-
able with other standards conformant systems, regardless of
mental stressors that may be present in either the workplace or
their implementation techniques. Fig. 1 shows the inte
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