Adding employment status in the medical record demonstrates its importance as a social determinant of health.

Abstract

Objective: To share findings of a quality improvement initiative to capture employment status in the electronic medical record (EMR) to mitigate the potential impact of work loss on the health of patients by utilizing the results to identify eligible individuals for resources to assist return-to-work efforts.

Materials and methods: Patients self-identified employment status through a structured new social determinants of health (SDOH) question within the EMR. An electronic outreach campaign was developed to provide information via the patient portal detailing services within healthcare and the community that could benefit the patients.

Results: Over the course of 12 months, 2059 patients were identified from the employment SDOH question. Resources to support stay at work and return to work efforts were provided to patients through an automated electronic portal campaign with 87% of patients reading the message and 7% engaging with a healthcare return to work case manager.

Discussion: Loss of employment has detrimental impacts on individual and population health. Most EMRs do not capture information on employment status. Adding this simple question identified individuals with potential gaps in SDOH, and in this case allowed specific resources to be shared with patients with an illness or injury that was acutely impacting work.

Conclusion: Medical center decision makers and EMR programmers should consider adding employment status as a social determinant of health.