IHE FHIR Profile: Occupational Data for Health (ODH), published by IHE Patient Care Coordination Committee. This guide is not an authorized publication; it is the continuous build for version 1.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/PCC.ODH/ and changes regularly. See the Directory of published versions

4:XX National Extensions

The following sections define the technical differences between this IHE Occupational Data for Health (ODH) profile, which is international in scope, and each National Extension that is intended to derive from it for implementation. Only the elements that differ are listed. The IHE ODH column states the cardinality and constraints in this profile. The National Extension column states the cardinality and constraints of the national implementation guide. Each entry in the Notes column begins with the nature of the change:

• Constrained: the national extension is stricter than IHE ODH.
• De-constrained: the national extension is less strict than IHE ODH.
• Replaces: the national extension uses its own profile, extension or value set in place of the IHE ODH one.

National Extensions for IHE United States

Comment Submission

This national extension document was authored under the sponsorship and supervision of IHE PCC with collaboration from the CDC/National Center for Health Statistics, who welcome comments on this document and the IHE USA initiative. Comments should be directed to PCC Public Comments.

Occupational Data for Health (ODH) USA Constraints

The ODH constraints for the USA are defined in the HL7 FHIR Profile: Occupational Data for Health (ODH), Release 1, STU 1.3 (1.3.0) implementation guide (HL7 US ODH). HL7 US ODH depends on US Core 5.0.1 and on the CDC PHIN VADS value sets. This IHE profile was derived from HL7 US ODH: the profiles have the same structure, codes and slice names, and the tables below list where they differ.

The ISCO-08 to SOC 2010 Concept Map (Appendix A.1) maps the ISCO-08 occupation codes used by this profile to the US SOC 2010 occupation codes, as an example of how the international codes can be translated into a national code system. The SOC 2010 to ISCO-08 Concept Map (Appendix A.2) maps the US SOC 2010 occupation codes to ISCO-08 codes, as an example of how a national code system can be translated into the international codes.

ODH Composition Constraints

This table lists the differences between the IHE ODH Occupational Data for Health Composition and the HL7 US ODH Occupational Data For Health Composition.

Table 4:XX-1: IHE ODH and HL7 US ODH Composition Differences

Element	IHE ODH	HL7 US ODH 1.3.0	Notes
subject	0..1 Reference(Any)	1..1 Reference(Any)	Constrained
category	0..*	0..1	Constrained
author	1..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	1..* Reference(Practitioner | PractitionerRole | Device | US Core Patient | RelatedPerson | Organization)	Constrained A Patient author must conform to US Core Patient.
attester.party	0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	0..1 Reference(US Core Patient | Practitioner | RelatedPerson | Organization | PractitionerRole)	Constrained A Patient attester must conform to US Core Patient.
section.author	0..* Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	0..* Reference(Practitioner | PractitionerRole | Device | US Core Patient | RelatedPerson | Organization)	Constrained A Patient section author must conform to US Core Patient.
section.entry	1..*	0..*	De-constrained IHE ODH requires at least one entry in the Occupational Data section.
section.entry slices	Reference the IHE ODH Observation profiles: Employment Status Retirement Date Combat Zone Period Usual Work Past or Present Job	Reference the HL7 US ODH Observation profiles: Employment Status Retirement Date Combat Zone Period Usual Work Past Or Present Job	Replaces The slice names and cardinalities are the same. See Table 4:XX-2 for the Observation differences.

ODH Observation Constraints

This table lists the differences between the IHE ODH Observation profiles and the corresponding HL7 US ODH Observation profiles. Rows for "All ODH Observations" apply to the Employment Status, Retirement Date, Combat Zone Period, Usual Work and Past or Present Job profiles. IHE ODH leaves open the elements that HL7 US ODH prohibits, and marks them as not recommended; see Open issue ODH_004.

Table 4:XX-2: IHE ODH and HL7 US ODH Observation Differences

Profile	Element	IHE ODH	HL7 US ODH 1.3.0	Notes
All ODH Observations	subject	0..1 Reference(Patient | Group | Device | Location)	1..1 Reference(US Core Patient)	Constrained
All ODH Observations	category	1..* Slice social-history 1..1, fixed social-history Open slicing	0..1 coding fixed to social-history	De-constrained HL7 US ODH allows category to be absent. Constrained HL7 US ODH allows only one category, which must be social-history.
All ODH Observations	performer	0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	0..* Reference(Practitioner | Organization | US Core Patient | RelatedPerson)	Constrained HL7 US ODH does not allow PractitionerRole or CareTeam performers.
All ODH Observations	value[x]	0..1 Restricted to the one data type of the profile	0..1 Constrains the profile's data type but does not restrict value[x] to it	De-constrained A value of another data type is not prohibited by the HL7 US ODH profiles.
All ODH Observations	bodySite method specimen device referenceRange hasMember	Base cardinality bodySite, method, specimen, device and referenceRange are marked not recommended	0..0	Constrained
Employment Status Retirement Date Combat Zone Period Usual Work	derivedFrom	0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	0..* Reference(DocumentReference | Media | QuestionnaireResponse | Observation)	Constrained IHE ODH Past or Present Job has the same restriction as HL7 US ODH.
Employment Status Retirement Date Combat Zone Period	focus	0..* Not recommended	0..0	Constrained For household member work, see Open issue ODH_005.
Employment Status Retirement Date Combat Zone Period	dataAbsentReason	0..1	0..0	Constrained
Employment Status Retirement Date Combat Zone Period	interpretation	0..*	0..1	Constrained
Employment Status Retirement Date Combat Zone Period	component	0..*	0..0	Constrained
Employment Status	effective[x]	0..1 Period only	0..1 dateTime | Period | Timing | instant	De-constrained
Retirement Date Combat Zone Period	effective[x]	0..1	0..0	Constrained
Usual Work	focus	0..* Reference(Any)	0..* Reference(RelatedPerson)	Constrained IHE ODH Past or Present Job has the same restriction as HL7 US ODH. See Open issue ODH_005.
Usual Work Past or Present Job	interpretation	0..* Not recommended	0..0	Constrained
Usual Work Past or Present Job	component.interpretation component.referenceRange	0..* Not recommended	0..0	Constrained
Past or Present Job	effective[x]	0..1 Period only	1..1 Period only	Constrained
Past or Present Job	extension:employer extension:isCurrentJob	0..1 IHE ODH Employer 0..1 IHE ODH Is Current Job	0..1 Employer (slice employer) 0..1 ODHIsCurrentJob-extension (slice ODHIsCurrentJobExtension)	Replaces See Table 4:XX-4.

Occupation and Industry Coding

HL7 US ODH codes occupation and industry with the US Census and O*NET-SOC/NAICS based value sets published in CDC PHIN VADS. IHE ODH uses the international ISCO-08 and ISIC Rev.4 classifications. Each HL7 US ODH coding slice is optional (0..1), so a US coded value can include an ISCO-08 or ISIC Rev.4 coding alongside the US codings.

Table 4:XX-3: IHE ODH and HL7 US ODH Occupation and Industry Coding Differences

Profile	Element	IHE ODH	HL7 US ODH 1.3.0	Notes
Past or Present Job Usual Work	valueCodeableConcept (occupation)	Binding: ODH Occupations (ISCO-08) (preferred)	coding slices, each 0..1, required binding: occupationCDCCensus2010: Occupation CDC Census 2010 (2.16.840.1.114222.4.11.7186) occupationONETSOCDetailODH: Occupation ONETSOC Detail (ODH) (2.16.840.1.114222.4.11.7901) occupationCDCCensus2018: Occupation CDC Census 2018 (2.16.840.1.114222.4.11.8065)	Replaces See the ISCO-08 to SOC 2010 (Appendix A.1) and SOC 2010 to ISCO-08 (Appendix A.2) concept maps.
Past or Present Job	component:odh-PastOrPresentIndustry.valueCodeableConcept	Binding: ODH Industries (ISIC Rev.4) (preferred)	coding slices, each 0..1, required binding: industryCDCCensus2010: Industry CDC Census 2010 (2.16.840.1.114222.4.11.7187) industryONETSOCDetailODH: Industry NAICS Detail (ODH) (2.16.840.1.114222.4.11.7900) industryCDCCensus2018: Industry CDC Census 2018 (2.16.840.1.114222.4.11.8066)	Replaces
Usual Work	component:odh-UsualIndustry.valueCodeableConcept	Binding: ODH Industries (ISIC Rev.4) (preferred)	Same coding slices as the Past or Present Job industry	Replaces

Value Set and Extension Differences

The Employment Status, Work Classification and Work Schedule value sets are the same HL7 Terminology (THO) value sets, with the same required bindings, in both guides, so they are not listed.

Table 4:XX-4: IHE ODH and HL7 US ODH Value Set and Extension Differences

Profile	Element	IHE ODH	HL7 US ODH 1.3.0	Notes
Past or Present Job	component:odh-SupervisoryLevel.valueCodeableConcept	Binding: ODH Supervisory Level (SNOMED CT) (extensible)	Binding: Job Supervisory Level or Pay Grade (ODH) (2.16.840.1.114222.4.11.7613) (required)	Replaces
Past or Present Job	extension:employer	IHE ODH Employer https://profiles.ihe.net/PCC/ODH/StructureDefinition/IHE.ODH.Employer.Extension	Employer http://hl7.org/fhir/us/odh/StructureDefinition/odh-Employer-extension	Replaces Same structure: valueReference 1..1, Reference(RelatedPerson | Organization). Different canonical URL. See Open issue ODH_003.
Past or Present Job	extension:isCurrentJob	IHE ODH Is Current Job https://profiles.ihe.net/PCC/ODH/StructureDefinition/IHE.ODH.isCurrentJob.Extension Slice name isCurrentJob	ODHIsCurrentJob-extension http://hl7.org/fhir/us/odh/StructureDefinition/odh-isCurrentJob-extension Slice name ODHIsCurrentJobExtension	Replaces Same structure: valueBoolean 1..1. Different canonical URL and slice name. See Open issue ODH_003.

US National Extension Example

The US Maya Gordon example Bundle is an instance that conforms to both HL7 US ODH 1.3.0 and this profile. Its occupation and industry values carry both the ISCO-08 and ISIC Rev.4 codes and their US SOC and NAICS based translations, and its jobs use the HL7 US ODH Employer and isCurrentJob extensions, which fulfill the IHE ODH extensions (see Open issue ODH_003). Its Composition meets the HL7 US ODH Composition constraints but declares only the IHE ODH Composition profile, because the HL7 US ODH Composition entry slicing cannot be validated; see Open issue ODH_007.