Federal and State Collaboration to Improve Vital Events Reporting

Federal Health Architecture Learning SeriesHIMSS FHA Technology Showcase Demos

April 1, 2016

Presenters

• Michelle Williamson, MS, RN, CPHIT

Senior Health Informatics Scientist

CDC/National Center for Health Statistics

• Glenna M Gobar, DVM, MPVM, MS

Sr. Project Manager/Health Informatician

UC Davis Health System

• Vira Danak, MSHI, MSBI

Jr. Project Manager/Health Informatician

UC Davis Health System

Demo Overview

• Demonstration will provide an overview of a project that involves Federal and State collaboration to improve the timeliness, quality and accuracy for vital events death reporting.

• Project is supported by the CDC/National Center for Health Statistics through Patient-Centered Outcomes Research Trust Funding allocated for “Improving Mortality Data.”

• Demo depicts death reporting pilot implementation activities in progress by the California Electronic Death Registration System (CA-EDRS) supported by the University of California Davis Health System (UCDHS) in collaboration with CDC/NCHS.

National Center for Health Statistics

• NCHS is one of the Centers within CDC• Division of Vital Statistics (DVS) within NCHS

• DVS component of the National Vital Statistics System (NVSS)

• NVSS oldest and most successful example of inter-governmental data sharing in Public Health • Data are provided through contracts between

NCHS and jurisdictional vital registration systems that are legally responsible for the registration of vital events (births, fetal deaths and deaths)

• NCHS collects vital events data and disseminates the Nation's official vital statistics

Capturing Birth and Death Data in Electronic Health

Record SystemsImproving the Timeliness, Accuracy and

Completeness of Vital Records Data

Electronic Exchange Using HL7 and IHE Based Standards

Death Reporting Pilot Project

• NCHS has been working with the California Department of Public Health (CDPH) and University of California Davis Health System (UCDHS) to support pilot implementation activities using the HL7 and IHE vital records standards

• Goal is to enable interoperable electronic data exchanges among electronic health record systems, the California Electronic Death Registration System (CA-EDRS) and the NCHS to improve mortality data

IMAGINE

Integrating Medical InformAtion IN EDRS

A module within the UCDHS Epic EMR

Launched by the physician after a patient expires

Imagine

Death Reporting from an EHR to EDRS

After completing the Cause of Death information in IMAGINE, the physician submits the information.

This information is pre-populated in the California Electronic Death Registration System (CA-EDRS)

Decedent Affairs requests Remote Attestation and the physician either fax or voice attestsORThe physician logs into EDRS and e-Attests

Decedent Affairs transfers the certificate to the Funeral Home

The Funeral Home completes the Personal Information and Authenticates PIThen, submits to the Local Registrar for local registration

The Local Registrar registers the record

The State registers the record

Now the record is state registered

Upon State registration, a record is automatically populated in the VRBIS Reporting System

Next, a trigger automatically creates a Cause of Death HL7 message and sends it to NCHS via CDC’s Public Health Information Network (PHIN MS)

Death Reporting from an EDRS to NCHS

Now the record is state registered

NCHS receives the HL7 death file from California’s Department of Public Health through the PHIN-MS

NCHS will send back an ACK message to CDPH by PHIN MS

NCHS parses the HL7 messages to create two output files including the textual description of the cause of death (COD) and some of the patient’s demographic information

NCHS will take the cause of death file and run it through our automated COD coding system to generate an International Classification of Disease (ICD-10) coded COD that will be sent back to the state

Death Reporting from EDRS to NCHS

Next Steps for eVital Standards Initiative

• Plans for CDPH/UCD Implementation – Add proposed pilot implementation date

• NCHS exploring ways to fund future demos and pilots using the birth/fetal death and death standards

• Utah Department of Health has implemented the HL7 V2.5.1 Vital Records Death Reporting standard

• Birth Quality Assessment with UT and DC in progress to assess the quality of data reported using birth/fetal death standards with reporting through Epic EHR system