JMIR Publications

ABSTRACT

Background:

The cost of workplace injuries and illnesses impacts significantly on overall healthcare costs and is a significant annual economic burden in the United States. Within the dangerous occupational sector of Agricultural, Fishing, and Forestry, injury surveillance is limited and the annual economic burden of injuries not well known. Many farm owners in the Upper Midwest have expanded operations and taken on the role of manager and employer; yet they receive little training in injury prevention, farm safety, or workers’ compensation programs and processes. Clinicians play a key role in return to work of injured and ill farmers and farm workers, though little to no formal training is offered in medical school.

Objective:

This project aimed to develop a prototype application designed to assist clinicians in returning to injured workers to light-duty job assignments with their current employer.

Methods:

Semi-structured interviews with farmers and farm workers from the Upper Midwest, coupled with English- and Spanish-speaking farm worker focus groups advised the development team from conception through an iterative design and development project.

Results:

A total of 35 farm workers participated in five focus groups comprising three Spanish-speaking and two English-speaking groups. The initial interviews and worker focus groups guided an iterative design and development cycle. Guidance impacted everything from workflows and button placement to output sheets that offer specific light-duty farm work recommendations for the injured worker to discuss with his/her employer. Additionally, eight farmers were interviewed in the final year of the 5-year project to further explore barriers of adoption regarding the use of mHealth (mobile health).

Conclusions:

Development of a complex prototype intended to impact patient care is a significant undertaking. Reinventing a paper-based process to eventually integrate with an electronic health record or a private company’s human resource system requires substantial stakeholder input from each facet including patients, employers, and clinical care teams. The prototype is available for testing, and further research is needed in the form of clinical trials to assess effectiveness of the process and the software’s impact in return-to-work of injured and ill workers. Farmers are increasingly adopting new technology from smartphone apps to autonomous, self-driving equipment capable of capturing enormous amounts of operational data. There is significant financial incentive to return injured workers to a light duty job, limiting work time loss. It is unlikely that clinicians would face barriers amongst farmers in adopting return-to-work technology. However, there is little incentive for clinicians to adopt the technology. Without seamless integration into the clinical electronic health record workflow, it is unlikely that individual physicians would consistently leverage such a system at the point-of-care. Clinical Trial: Not a clinical trial; not applicable.