A brief overview of a 2017 project to integrate EHRs and EDRS systems to improve vital event data collection, as well as transmission of the vital event data using HL7.

1. Federal and State Collaboration to
Improve Vital Events Reporting
Federal Health Architecture Learning Series
HIMSS FHA Technology Showcase Demos
April 1, 2016

2. 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

3. 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.

4. 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

6. Capturing Birth and Death Data
in Electronic Health
Record Systems
Improving the Timeliness, Accuracy and
Completeness of Vital Records Data
Electronic Exchange Using HL7
and IHE Based Standards

7. 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

9. IMAGINE
Integrating Medical InformAtion IN EDRS
A module within the UCDHS Epic EMR
Launched by the physician after a patient expires

11. Imagine

15. 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)

18. Decedent Affairs requests Remote Attestation and the physician either fax or voice attests
OR
The physician logs into EDRS and e-Attests

19. Decedent Affairs transfers the certificate to the Funeral Home

20. The Funeral Home completes the Personal Information and Authenticates PI
Then, submits to the Local Registrar for local registration

21. The Local Registrar registers the record

22. The State registers the record

23. 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

24. 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

26. 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