Each state has tailored the workflow to meet their specific goals and mesh with their environment. This document shows several workflows that are in use by different states. There are also different options for what the forms themselves look like. Some states include a cover page with instructions, others send just the single page that needs to be reviewed and signed. The following diagrams show several workflow options.

Data Entry Highlights

Funeral home Medical data is handwritten by the physician, transcribed by the Funeral Director, and then faxed to the physician who certifies the data and signs the attestation form. Sample documents with fictitious content for this workflow process are included.

State staff Medical data is handwritten by the physician and faxed to the state, where the data is entered and approved as accurate and complete. The entered data is faxed to the physician who certifies the data and signs the attestation form. Sample documents with fictitious content for this workflow process are included.

Physician’s office Medical data is entered by staff at the physician’s office and faxed to the physician who certifies the data and signs the attestation form.

Manual All data is gathered manually, typically by the Funeral Director, and faxed to the state (or optionally brought to a local office) where the data is entered and approved as accurate and complete. The entered data is faxed to the physician who certifies the data and signs the attestation form.

Please contact Acordex for further information: Acordex Imaging Systems 37 Walker Rd., 1st Floor http://acordex.com 978-975-8000 North Andover, MA 01845

EDRS Remote Attestation Sample Workflows

Electronic Death Registration Systems (EDRS) use computer generated faxes to request physicians’ certification of medical data. Signed attestations from the physicians are automatically

computer processed to notify the EDRS of the certification.

EDRS Acordex Server Users

Funeral Director enters all

non-medical dataPrepare the Working Copy

data, which is missing the

medical section

Physician writes the cause

and manner of death, and

faxes the form back

Working Copy form and

instructions are faxed to the

physician

Funeral Director views the

Working Copy on-screen and

enters medical data

Recognize document;

notify the database of the

Working Copy’s return

Prepare the Attestation

Form, which includes the

medical sectionPhysician signs Attestation if

medical section is correct,

and faxes the form back

Tre

at

an

un

sign

ed

Att

est

ati

on

lik

e a

no

ther

Wo

rkin

g C

op

y

Attestation Form

Work Copy

Fax Attestation Workflow — Funeral Director Option

Capture medical data

(cause and manner of death)

Display Working Copy next

to data entry screen

Attestation Form is faxed to

the physician

Determine whether the

Attestation is signed or not

signed; notify the database

Death Certificate is issuedNo change request received

Issue Certificate

Is the Attestation signed?

No: repeat data entry.

Yes: issue death certificate

EDRS Database Acordex Server Users

Funeral Director enters all

non-medical dataPrepare the Attestation form,

which is missing the medical

information

Physician writes the cause

of death and signs form,

optionally requests Courtesy

Copy, faxes it back

Attestation form and

instructions are faxed to the

physician

State Nosologist views the

fax on-screen, enters and

approves cause of death

Optional audit

(local or state)

Recognize document,

determine whether it is

signed; notify VRS

Physician optionally reviews

typed cause of death, may

ask for changes

Death Certificate is issued

Courtesy Copy

Attestation Copy

Fax Attestation Workflow — State Nosologist Option

Capture medical data

(cause and manner of death)

Display form next to data

entry screen

Display Attestation in a web

page, if authorized

Courtesy Copy may be faxed

to the physician

Optionally type Courtesy

Copy of all data,

including cause of death

No change request received,

issuance process continues

Issue Certificate

Change requst may be

received; if so, notify VRS

EDRS Acordex Server Users

Funeral Director enters all non-medical data

Physician Office Staff enters medical information

Prepare the Attestation Form, which includes the

medical sectionPhysician signs Attestation if

medical section is correct, and faxes the form back

Attestation Form

Data Capture

Fax Attestation Workflow — Physician Office Option

Attestation Form is faxed to the physician

Determine whether the Attestation is signed;

notify EDRS

Death Certificate is issuedAttestation form signed without changes

Issue Certificate

Data Entry screen

Data Entry screen

Netsmart VRS Acordex Server Users

Local Office (e.g. county)

receives paper document

and faxes it to the state

Recognize document;

notify the database of the

Worksheet arrival

Prepare the Attestation

Form, which includes the

medical section

Physician signs Attestation if

medical section is correct,

and faxes the form back

Death Certificate is issued

Attestation Form

Worksheet

Fax Attestation Workflow — Manual Paper Option

Capture data

(medical &/or non-medical)

Display Worksheet

Is the Attestation signed?

No: repeat data entry.

Yes: issue death certificate

Attestation Form and

instructions are faxed to the

physician

Determine whether the

Attestation is signed or not

signed; notify the database

Is the everything complete?

Incomplete: Manually

contact the Funeral Director

Not signed: initiate Remote

Attestation

Complete: issue certificate

State staff views the Work-

sheet, determines what

death record it pertains to

and enters data

Funeral Director manually

collects medical and

non-medical information

Acordex Imaging Systems http://acordex.com 978-975-8000