Characterizing employment of colorectal cancer survivors using electronic health records.

Abstract

ObjectiveAlthough the value of collecting occupational data is well-established, these data are not systematically collected in clinical practice. We assessed the availability of electronic health record (EHR)-based occupation data within a large integrated health care system to determine the feasibility of its use in research.Materials and MethodsWe used a mixed-methods approach to extract EHR data and define employment status, employer, and employment industry of 1107 colorectal cancer survivors. This was a secondary analysis of a subset of the Patient Outcomes Research to Advance Learning (PORTAL) colorectal cancer cohort.ResultsWe categorized the employment industry for 46% of the cohort. Employment status was available for 58% of the cohort. The employer was missing for over 95% of the cohort.ConclusionBy combining data from structured and free-text EHR fields, we identified employment status and industry for approximately half of our sample. Findings demonstrate limitations of EHR data and underscore the need for systematic collection of occupation data in clinical practice.LAY SUMMARYOur study assessed whether employment information taken from an electronic health record (EHR) could be used in research. We examined the health records of 1107 colorectal cancer survivors receiving care from an integrated health system. We combined data from different parts of the health record, including insurance sources and free-text notes from providers. For the vast majority of patients, (95%), no specific employer was documented. However, we identified employment status for 58% and type of industry for 46% of this group. Our findings suggest that information about occupation and employment in the EHR is limited. To improve data collection, hospitals could integrate questions about patients’ occupation and employment into existing procedures using national standards.