MaineStakeholders Meeting
Rose TrasattiProject Manager
National Association for Public Health Statistics and Information Systems
October 03, 2008
NAPHSIS
National Association for Public Health Statistics and Information SystemsRepresents all 57 vital registration jurisdictionsFunded by SSA to support development of EDR systems throughout the U.S.www.naphsis.org
What is EDR?
Electronic filing of death certificatesUser-friendly death record data entry screensOn-line help and built-in instructionsInternet accessibilityElectronic authenticationOn-line collaboration among multiple death registration system users
Who benefits from an EDRS?
FamiliesPhysicians, physician assistants, certified nurse practitionersMedical ExaminersFuneral directorsLocal and state registrarsFederal, state and local agenciesPublic health researchers
Benefits of an EDRS
Greater efficiency- participants interact electronicallyImproved timeliness of death registrationHigher quality data via real-time edits Reduces errors in and rejection of death
certificates Promotes uniformity in demographic and cause-of-
death statistics
Increased security and fraud preventionSupports partial electronic/paper death registration
Benefits of an EDRS
Electronic referrals to Medical Examiners by Physicians Funeral directors Health departments
Printing of the Disposition of Human Remains PermitElectronic trade calls between Funeral HomesElectronic Medical Examiner Release approvalsOrdering of certified copiesReport and file generation
Online Verification of SSN
SSN can be verified during the entry of death data prior to registrationOnline verification integrated into EDR systemSSN electronically verified after key decedent data items entered:
Name DOB Gender Social Security Number
Receive notification through the EDR system about the accuracy of the SSN
Online Verification of SSN
Reduces decedent’s SSN errors on death certificates prior to registrationImproves accuracy of SSN reported to SSASpeeds notification of fact of death to SSAEliminates the need for funeral director to submit an SSA 721 form to SSA
EDRS implementation – it isn’t easy
An EDRS is a complex system Numerous data items with extensive edit checks Detailed business rules and workflow Multiple users working on the same death
record Many users accessing the system from many
points Internet application with a need for high-levels
of security
EDRS implementation – it isn’t easy
Because an EDRS is a complex system it is important to have: Well defined requirements Realistic schedule Adequate funding Sufficient technical expertise in developing the
system Participation by stakeholders in the full project
lifecycle Satisfactory infrastructure and connectivity to
the Internet
EDRS experiences – what we learned
Important to market and garner EDRS support National level Local level
Commonality among jurisdictions related to EDRStandards and guidelines can provide assistance in EDRS developmentA national model can provide a starting point for EDRS developmentJurisdictions can learn from each other Focal point of contact needed to facilitate communication
NAPHSIS EDRS activities
Focus on education and marketing at the national level Death data providers State and local government Federal agencies Death data users
Developed marketing brochures and training packages
NAPHSIS EDRS activities
Exhibit EDR booth and speak at national level conferences National Funeral Director Association National Association of Medical Examiners Alliance for Continuing Medical Education Association for Hospital Medical Education American Medical Association Continuing
Medical Education Director’s Taskforce
NAPHSIS EDRS activities
Provide consulting services to jurisdictions for implementing EDR systems Meet with vital records agencies/vital records staff Meet with EDR participants Help review state statutes/regulations Facilitate communication with other jurisdictions Developed tools to assist jurisdictions:
EDRS Standards & Guidelines Help review EDRS materials developed either in-
house or by a vendorAssist jurisdictions with the tailoring of the EDRS National Model to meet their needs
EDRS National Model - goals
Model should meet 80-85% of any jurisdiction’s electronic death registration requirementsComponents should be modularDesign should allow customization without changing softwareAddress the needs of the death data providersInclude participation from multiple jurisdictions Include a procedure for other jurisdictions and EDRS vendors to review and submit comments
EDRS National Model - process
Established an EDRS National Model Team Representatives from six jurisdictions NAPHSIS Social Security Administration National Center for Health Statistics
Conducted validation sessions to identify EDRS requirements and develop re-engineering artifacts Use Cases – functionality/workflow System requirements/Business rules Reports, Files, and other EDRS outputs
Published the EDRS National Model for review NAPHSIS did an in-depth review of the model Received comments from jurisdictions Received comments from EDRS vendors
Configuration Control Board established Approved recommended changes
Re-engineering artifacts revisedJurisdictions can then tailor the EDRS National Model to meet their specific requirements
EDRS National Model - process
Examples of Jurisdiction Specific Requirements
User Authentication User ID and Password User ID and Password and PIN Biometrics
Fingerprint Check Attestation Process
Fax Attestation Phone Attestation
Secure ID Tokens
Alaska
California
Idaho
Oregon
Washington
Montana
Wyoming
Utah
Colorado
ArizonaNew Mexico
Texas
Oklahoma
Kansas
Nebraska
South Dakota
North Dakota Minnesota
Wisconsin
Iowa
Illinois
OhioIndiana
Kentucky
WV
Virginia
N. Carolina
Georgia
Florida
AlabamaMS
Missouri
Arkansas
LA
Nevada
Hawaii
Michigan
PennsylvaniaNJ
New York CT
MA
VT
NH
Maine
Tennessee
MD
DE
RI
DC
S. Carolina
Electronic Death Registration Systems, by Jurisdiction,With SSA Funding Indicator, September 2008
New York City
Up and Running Development Planning/Rqmts
Received SSA Funding
*
**
*
*
***
**
*
**
*
** *
**
**
*
*
*
**
*
*
*
*
*
*
Back Office only
Intelligence Reform and Terrorism Prevention Act of 2004
Establish minimum standards for birth certificates Certification and seal by issuing custodian Use of safety paper or an alternative, equally secure
medium Other features to prevent tampering, counterfeiting,
or duplication for fraudulent purposesEstablish requirements for proof and verification of identify of requestorEstablish standards for the processing of birth certificate applicationsAccommodate differences between jurisdictions in manner and form in which birth records are stored and birth certificates issued
Intelligence Reform and Terrorism Prevention Act of 2004
Matching birth and death records Jurisdictions will need to computerize their birth
and death records Jurisdictions will need to develop the capability
to match birth and death records within and among each jurisdiction
The fact of death will need to be noted on the birth certificate of the deceased
Matching must be done in a timely fashion Electronic birth registration systems Electronic death registration systems Interstate exchange of birth and death data
Maximizing the success of your Electronic Death Registration Project
Work with your Vital Records OfficeParticipate in the planning processParticipate on EDR stakeholders committeeInvite Vital Records Office staff to local meetingsInvite Vital Records Office staff to write articles for local publicationsSupport legislative changes
Maximizing the success of your Electronic Death Registration Project
Participate in validation sessionsDefine your requirementsReview edit rules and design logicVolunteer to be a pilot siteShare experiences with other system usersHelp market the system to garner maximum participation
NAPHSIS contact information
Rose TrasattiProject Manager
National Association for Public Health Statistics and Information Systems
(NAPHSIS)962 Wayne Avenue Suite 701Silver Spring, Maryland 20910
(301) 563-6001 (phone)(301) 563-6012 (fax)