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| Block 3: Occupational Health Management - Section 3: Medical Surveillance Programme |
| OHM3.4: Case Management |
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| Block 3: Occupational Health Management - Section 3: Medical Surveillance Programme |
| OHM3.4: Case Management |
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This is the careful monitoring
of affected employees, to ensure they are not lost to follow-up, and that they
are ultimately managed in such a manner as to reduce or eliminate risks to their
health, or to the health and safety of others. Ideally, this process means a
return to optimal function. This may entail medical treatment and rehabilitation,
or even a transfer to a more suitable occupation.
WE NEED TO KNOW HOW TO HANDLE REFERENCES TO SYNERGEE
I SUSPECT THAT WE NEED TO CRAFT SOME GENERIC REFERENCE TO SYNERGEE AS THE NEXT
STEP FOR THOSE IN PRACTICE WHO WANT TO TAKE THINGS FURTHER BUT TO REMOVE THE
PARTICULAR REFERENCES
The Synergee System provides a tracking mechanism for tracking these employees, by means of codes that indicate the employee is still under evaluation. Furthermore, fields in the medical surveillance datasets are available for recording referrals to specialists, and their outcomes.
LINK SCREENING INDIVIDUALS VIA DATA MANAGEMENT TO GROUP SURVEILLANCE
PERHAPS GIVE A GENERIC EXAMPES
IS WHAT FOLLOWS PERHAPS AN EXAMPLE OR AN EXEMPLARY APPROACH?
GREG WILL PUT IN SOME TEXT ON DATA MANAGEMENT AND ITS CAPABILITIES
The Synergee Coding System: THIS IS AN EXAMPLE OF A REFERENCE TO SYNERGEE WE NEED TO KEEP
In order to enable this, outcomes of the evaluations are categorised according to groups, coded as follows:
| Synergee Coding System | |
|---|---|
| A | Findings within normal limits. |
| B (1-4) | Abnormal findings - Occupational: (1-4 = Borderline - Mild - Moderate - Severe) |
| BP (1-4) | Abnormal findings - Occupational, but pre-existing (from prior workplace): (1-4 = as above) |
| C (1-4) | Abnormal findings - Non-occupational: (1-4 = Borderline - Mild - Moderate - Severe) |
| D (1-4) | Unclear reasons for findings: (1-4 = Borderline - Mild - Moderate - Severe) |
| E | Employee is exempt from the test or examination. |
| X | This test was missed or skipped for some reason, and is outstanding. |
Further modifying codes ("modifiers") are used to indicate two other vital pieces of information:
| Progress Modifier | Compensation Indicators | ||
|---|---|---|---|
| +/-3 | Change by more than a full category | C | Indicates an occupational disease that meets the requirements for a submission to the Compensation Commissioner |
| +/-2 | Change by a category | NC | Indicates an occupational disease that meets the requirements for a submission to the Compensation Commissioner SHOULD THIS NOT BE DOES NOT MEET THE REQUIREMENTS? | +/-1 | Change, but still within the same severity category. |
| P0 | No test-to-test change | ||
| PX | No prior test available (a "Baseline") | ||
| - | Indicates a test to-test deterioration | SHOULD THESE BE A FOOTNOTE TO THE FIRST THREE CATEGORIES | |
| + | Indicates a test to-test - improvement | DITTO? | |
This coding system provides a useful tool by means of which to examine risk profile of the group under evaluation, and is also a ready reference by which to designate appropriate actions by categories. Given some flexibility for isolated individual cases, a generic follow-up plan for these categories is as follows:
IT WOULD BE GREAT TO BE ABLE TO CLICK AND GET A POTTED CASE HISTORY TYPE EXAMPLE
| Group | Suggested actions |
|---|---|
| CAT A,B1, C1 & D1 | Inform employee. Take special note of borderline cases. Routine follow-up. |
| CAT B2 (occupational) | Investigate & record as an incident. Inform employee, management and Department of Labour, as required by Occupational Health and Safety Act. Careful follow-up (6-monthly if necessary). Consider issuing more effective risk controls (See hierarchy of controls). |
| CAT B3 (occupational) | As for CATB2. Requires direct attention of the risk control team, with a view to immediate exposure reduction. |
| CAT B4 (occupational) | As for CATB3. This may require submission to the Compensation Commissioner for possible award. Provide maximum exposure protection - seriously consider a move to a non-exposed job. |
| CAT C2, C3 & 4 | Inform employee only (not management). Intensity of follow-up depends upon the severity of the disorder and on-going exposure. (6-monthly if necessary). Refer for ingoing medical management and follow-up as necessary (usually at own cost). |
| CAT D | The "D" code is the flag that indicates "Case Management in progress". Make every attempt to define the underlying cause and allocate a code from those above. In borderline or mild cases, careful follow-up may suffice. |
In this way, there is consistency in the way in which the medical programmes flow and are reported. Interpretations are more rapid and key performance indicators more transparent. The procedure, the documentation and the underlying IT data gathering process all knit tightly together to form an integrated system, minimising information loss and optimising efficiency.
SHOULD WE DROP THIS PARA? OR SHOULD WE INDICATE THE GENERIC WAY TO PROCEED WITH THIS TYPE OF DATA?The spreadsheets provided by Synergee allow normal numeric data entry too, (actual results of tests), not exclusively the coded outcomes. This is particularly useful for tracking data that is not easily and immediately attributed to work exposure, such as lung function tests, lab tests, etc. The actual values can be recorded, for subsequent analysis. The analytical tools built into the Synergee spreadsheets enable analysis of the data in many ways. This is by means of sophisticated filters, data sorts and proportionate analysis. The results are depicted numerically and graphically.
