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

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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)

www.naphsis.orgrtrasatti@naphsis.org