Examinetics

Examinetics, Inc. is the largest provider of mobile and on-site occupational health screening and data management services in the United States. The company was established in 2004 following the consolidation of a number of small businesses providing occupational health screening and compliance services with over thirty years experience.

Examinetics, is headquartered in Overland Park, Kansas, operates over 70 mobile screening units to provide medical surveillance testing and reporting services to US industrial and governmental companies and organizations in over 8,000 locations across the US.

Operations

Examinetics is a US-based provider of occupational health screening, surveillance and compliance services. Since its inception in 2004, the company has undertaken a number of strategic acquisitions including that of Industrial Health in 2006.

Key management personnel include Simon Barker (Chairman), Jeff Kerns (Chief Executive Officer), Troy Heppner (Chief Finance Officer) and James Wickes (non-executive director). These individuals have led the organization through its development; Jeff Kerns and Troy Heppner are Certified Public Accountants. Other key individuals within the management team include Mike and Tim Sterrett who have over 60 years combined experience in the occupational health industry. Kent Peterson, MD., renowned worldwide for his work in occupational health, is a consultant to many professional societies, healthcare providers, government agencies, and Fortune 500 companies. Kent is the Medical Director of Examinetics.

Examinetics employs over 200 staff from various technical and professional disciplines including nurses, medical assistants, certified X-ray technologists and audiologists, the majority of whom operate from the Examinetics fleet of mobile screening stations. They are responsible for carrying out nearly one million screening tests each year for some 1,700 corporate customers, nationally.

Staff training is taken very seriously at the company due to the nature of the services that the organization provides. Initial and on-going training is conducted in the field with supplemental courses from US organizations Council for Accreditation in Occupational Hearing Conservation (CAOHC) and the National Institute for Occupational Safety and Health (NIOSH). Workers are trained with detailed, written procedures and standardized protocols and proof of their training is documented via a series of written tests and proficiency evaluations. Their performance is monitored via continuous improvement evaluations documented by mobile unit managers and each employee is normally evaluated at least every six weeks. Every twelve weeks, corporate office supervisory staff visit each mobile unit to observe and provide feedback to all the staff working from them including the unit manager, field maintenance technician/driver and crew.

Services

In the United States, health and safety issues at work are covered under a law called the Occupational Safety and Health Act 1970 (in the UK, under the Health and Safety at Work etc. Act 1974). Regulations that are governed under the health and safety laws and those that are enforced by federal, industry and local authorities (including the Departments of Employment and Transport) fall under the responsibilities and duties of employers, employees and health and safety professionals. In 2000, it was estimated that the US annual cost for occupational health compliance more than $30 billion and a year later the costs of Workers' Compensation was estimated by the National Safety Council to be $130 billion. In order to facilitate compliance with certain regulations and laws under this act, Examinetics developed occupational health screening, compliance and wellness programs that are delivered from their fleet of mobile occupational health screening units and their online occupational health data management and reporting system known as the Examination Management Network (XM Network).

Mobile screening units

Monitoring employees in accordance with statutory guidelines is usually undertaken 'offsite' at local hospitals or clinics or 'onsite' by occupational health professionals within the organization or by external subcontractors. Examinetics operates mobile occupational health screening units to provide screening and medical testing at the workplace.

Four person mobile occupational health screening unit.

The vehicles are occupational health screening units (Mobile Multi-Phase; MMP) for wellness and medical surveillance testing and four-man and eight-man audio units for audiometry (testing hearing function). Medical surveillance is an important aspect of occupational health monitoring as it examines and evaluates employees over time to detect early signs of medical conditions or ailments that may come about as a result of the tasks they perform at work or hazardous situations or substances encountered in their occupational setting. Employers use results of the testing to implement protective measures and health plans for their employees so that early signs of medical conditions do not progress further.

Mobile occupational health screening unit (mobile multi-phase unit).

The MMP units are all completely equipped, self-contained and compartmentalized to facilitate full testing capabilities at the clients' worksites which can be remote and difficult-to-access locations across North America, including businesses operating in the agricultural, construction and transportation sectors. Mobile occupational health testing is seen as particularly advantageous for such businesses as it is often difficult for workers to leave their place of work during working hours. Onsite testing also allows employers to maintain productivity levels as workers do not have to leave the workplace or travel to an occupational health clinic.

Eight person mobile occupational health screening unit.

The MMP units enable Examinetics nurses and technicians to carry out medical tests including physical examinations, vision screening and tonometry and operate bio-instrumentation for spirometry (measuring lung function), electrocardiography (measuring the electrical activity of the heart), chest X-ray and blood tests. The units also have multiple audio booths for audiometric testing. Due to the nature of the equipment being used and the tests being undertaken and handled, the technicians and nurses are required to be fully trained, licensed and certified in accordance with safety and health regulatory agency (e.g. Occupational Safety and Health Administration; OSHA) criteria and requirements.

The audio units each hold two back-up audiometers and sound level meters which are operated by qualified occupational health specialists. The facilities enable complete hearing conservation programs to be created for businesses with work environments that have high noise levels. These businesses are required by law to protect and conserve their employees' ability to hear. In the US, employers must provide preventative measures and protection for employees who experience 85 dB or more, over an 8-hour time weighted average.^[1] The audio units also contain fit test equipment so that employees who wear respirators (such as dust masks and supplied air masks) are tested to see whether they are physiologically capable of using the equipment without injury and that the equipment properly fits. There are strict health and safety standards and regulations surrounding the occupational use of Personal Protective Equipment at work including respirators.^[2]

The Examination Management Network (XM Network)

Examinetics developed the XM Network, a secure online data management and reporting system, for occupational health professionals and employers. With XM Network, the company achieved its objective to establish a "data interchange standard for the occupational health industry". With data derived from occupational health screening tests, XM Network allows various reporting options enabling employers to manage, import, interpret and export data in order to produce occupational health reports for their organizations. The system is used in conjunction with the screening undertaken in the mobile units and was developed, in accordance with security and privacy of health data, to be fully compliant with the US Health Insurance Portability and Accountability Act (HIPAA).

XM Network allows reports to be generated at an 'individual' level expressing data for specific employees such as their test history and reviews from occupational health professionals. This is particularly important for individual employees working in challenging environments (e.g. temperature extremes, working with toxic or harmful chemicals) that need regular testing and evaluation compared to other employees working in less risky situations (e.g. an office). Summary reports can also be generated for whole organizations allowing analysis of test data at organizational and departmental levels.

For specific tests, such as audiological data, trend reports (e.g. 10 dB Annual Trending and 25 dB Annual Trending) can be created to analyze and monitor shifting patterns in hearing thresholds of employees. According to the OSHA standard (29 CFR 1910.95) for Occupational Noise Exposure, effective Hearing Conservation Programs must be in place in certain industries to protect workers exposed to noise thresholds. To support these programs, database and web-linked resources including XM Network handle the administrative requirements as set out in the occupational noise standard.^[3] Any changes observed can be evaluated rapidly allowing employers to intervene and take preventative measures to protect their employees from further shifts.

OccHealth Search

A Scientific American article^[4] by Tim Berners-Lee and Professor Nigel Shadbolt argued that the emerging discipline of web science will allow for the development of more powerful search techniques. One example comes from research around data networks on the web known as the Semantic Web. In 2008, Examinetics developed a semantic web tool called "OccHealth Search" - a sophisticated search facility for occupational health professionals (OccHealth Search tool) which coincided with a re-launch of their main website. The company's strategy was for the website and OccHealth search tool to become the leading search portal for the global occupational health industry whilst providing educational support and quality search results for students and general searchers interested in occupational health issues.

The facility uses four Google custom search engines to identify occupational health information in the areas of Research, Regulation, Suppliers and Current Practice and hence 'contextualizes' search results. The tool allows occupational health researchers, human resource managers, occupational health professionals, and company managers to find relevant information on occupational health matters and is freely available from the Examinetics website to benefit the occupational health community.

Once a user of OccHealth search has set up a profile, their search criteria can be saved on their personal clipboard. By typing in keywords related to occupational health, the search tool scans a pre-sorted industry relevant database developed by occupational health researchers. The database contains thousands of links to topical articles, research abstracts, news items, occupational health societies, regulatory bodies and charities. Once keywords are entered, the OccHealth Search tool prioritizes links according to the search terms and further classifies them according to the four search areas.

Those that appear under current 'Research' are linked to published articles and abstracts in the literature featuring academic research undertaken in all fields of occupational health and medicine - from molecular interactions of occupationally derived toxic chemicals in the body thru to the science behind ergonomically correct workstations for employees. OccHealth search features abstracts and papers listed under Life Sciences and medical databases such as PubMed and Medline that are published in international occupational health and medicine journals such as the Journal of Occupational Medicine and Toxicology and the Journal of Occupational and Environmental Medicine.

Links filtered under 'Regulation' are directly related to the rules and regulations governing the occupational health area of interest that the user searched for. Results are generally featured from the US regulatory agency OSHA although information pages are also included from other international regulatory organizations such as the UK's Health and Safety Executive. Typing 'hearing' into the search tool generates a link to the 'Noise and Hearing Conservation' pages of the OSHA website. Results are also filtered under the search category 'Providers'. These are links to organizations that offer occupational health services. For example, private organizations offering training courses to enhance safety and health programs or assist in compliance to regulations. Search terms are also categorized under current 'Practice' where results direct the user websites such as NIOSH and other organizations that offer guidance about the practical issues surrounding specific occupational health topics or disease.

Once the user has generated a search, selected links can be saved to a clipboard so that they can be viewed at a later date. The clipboard utility also allows the user to write additional notes against each link selected or label the clipboard itself. Multiple clipboards can be generated so that a number of searches can be performed. Clipboards can also be printed or emailed to the user's account or emailed to other occupational health practitioners.

By semantic web principles, the web page results that users most frequently paste onto their clipboards (user favorites) are further prioritized for future users. The OccHealth Search tool also introduces 'related results' to make suggestions that might be of interest to users who make particular searches. This is a similar principle that is utilized by Amazon to provide their users with book title suggestions for the next time they visit the Amazon website.

Pathfinders

In 2008, in combination with the development of the OccHealth Search tool, Examinetics developed Pathfinder documents, freely-available resource pages, on the most frequently searched occupational health topics. Selected subject areas range from 'asbestos' through to 'working with solvents'. The Pathfinders were designed to keep occupational health professionals informed about the key issues regarding compliance with the specific Health and Safety regulations and legislation surrounding the subject area. This free service directs researchers to an 'Essential Links' section to find further information about the topic from health and safety and government agency websites such as the US Environmental Protection Agency and NIOSH. Each Pathfinder (Asbestos Pathfinder) also features a 'Business Owner Briefing (links to guides or brochures) for the owner of a small business and a 'Medical Director Review' (usually research articles from learned international journals) for occupational health professionals within larger organizations. Pathfinders are suggested in the 'Recommended results' section of the OccHealth Search tool so that when a user clicks on the professional resources tab after entering their keywords, the filter presents them with any relevant document on the subject.

Future services

The management team is leading the company to broaden its offering by introducing Clinic Management services. The company has national reach through its network of mobile units. Thus the organization is looking to advise businesses of the most appropriate and effective delivery options for their occupational health screening requirements. The company has determined that it is more cost-effective for businesses with 15 or more workers who require occupational health screening, for these to be carried out onsite through mobile screening facilities rather than offsite at clinics or hospitals. The addition of clinic management services enables Examinetics to optimize corporate health screening programs by combining the provision of mobile screening services with the scheduling and administration of individual employee tests through 'offsite' clinics.

References

1. ↑ OSHA. Technical Manual Section III Chapter 5: Noise and hearing conservation - what standards limit and control noise exposure? (https://www.osha.gov/dts/osta/otm/noise/standards.html)
2. ↑ OSHA. Technical Manual Section VIII Chapter 2: Respiratory protection. (https://www.osha.gov/dts/osta/otm/otm_viii/otm_viii_2.html)
3. ↑ Robert R. de Jonge and J. Mark Goffinet (2008) Chapter 18: Computer principles and applications, In: Audiology (2nd Edition). Holly Hosford-Dunn, Ross J. Roeser, Michael Valente (eds), pp355-377. Thieme Publishers. ISBN 3-13-116412-3, ISBN 978-3-13-116412-4.
4. ↑ Nigel Shadbolt and Tim Berners-Lee (2008) Web Science Emerges. Scientific American Volume 299(4) pp60-65.