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Oregon’s Electronic Death Registration System:
An UpdateOregon Mortuary and Cemetery Board
November 18, 2014
Jennifer A. Woodward, State Registrar Public Health Division
Center for Public Health PracticeCenter for Health Statistics
1
Overview of the Center for Health
Statistics
Changes in new law
Electronic Death Registration
Communication
Questions and Discussion
What are we talking about today?
Overview of the Center for Health Statistics
Analyze
What do we do?
Vital records
Collect
Register
Amend
Store
Sell
Analyze
4
CHS (Vital Records) is one of a few state programs (below the agency level) that is created in statute.
ORS 432.010 (1) There is established in the Oregon Health Authority the Center for Health Statistics, which shall maintain, operate and advance the system of vital statistics throughout this state . . .
General responsibilities according to law
5
National standards set by:
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Social SecurityAdministration
County Vital Records Funeral Directors Hospitals Medical Examiners State Medical Examiner Division of Child Support Department of Human Services Medicaid County Clerks Circuit Courts Secretary of State Department of Revenue
…..to name a few
Our external partners
1903 1915 1927 1939 1951 1963 1975 1987 1999
Registered domestic partnership records
2008
Divorce records1925
Fetal death records1919
Marriage records1906
Birth and death records1903
6 million vital records in Oregon
Overview of the Center for Health Statistics
8
1999
Number
Births 45,582
Deaths 33,888
Marriages 24,871
Divorces 14,198
ORDP 538
Diss. of Dom Part 109
Fetal Deaths 265
ITOPS 8,186
Total Records 127,637
Vital Events in Oregon: 2013Population = 3,919,020
Other work we did in 2013
Vital records issued 168,642
Amendments to records 36,771
Average # certificates issued/day 682
% orders processed as rush 69%
Highest number of certificates issued in a month (March 2013)
16,566
Changes in vital records law
House Bill 2093 – Vital Records Modernization- Jan. 1, 2014 Reorganized and updates vital records law.
◦ Last revision 1997 Based on a model state vital statistics law 80% of the law the same - just easier to
understand 20% new requirements
◦ Improve security and confidentiality of vital records and vital statistics
◦ Strengthen death registration ◦ Streamline the law
Major items of new law pertaining to death records
Who can certify the death?
Physicians, nurse practitioners and physician assistants licensed in Oregon, Washington, Idaho or California
Major items of new law pertaining to death records
Increase use of Electronic Death Registration
Law requires hospitals with more than ten deaths to have records certified in OVERS
Highlights of new law pertaining to death records
No public record Oregon is closed record state No public source of information
◦ Previous years death abstracts at the county were public
◦ No longer public record Report and abstract of death now 24-hour
Notice of Receipt of Body
Highlights of new law pertaining to death records
Order form required
New law requires written application for every order for certified copies of death certificates.
What did not change in law
Electronic Death Registration
Two ways to submit records…….
PaperElectronic
Secure web-based system
Real time
Comprehensive vital records system Electronic Death Records (EDR) (2006)
Electronic Birth Records (EBR) (2008)Electronic Fetal Death Records (2008)
Moves CHS from paper-based to electronic.
Electronic - Oregon Vital Events Registration System (OVERS)
Who using EDR?
All paper Split OVERS Total
Funeral directors 16 29 224 269
Funeral homes 10* 32 149 181
*5 of the 10 funeral homes not using OVERS are out of state.
Who is using EDR?
September 2014
Electronic Hybrid Paper
Doctors 20.9% 70.5% 8.7%
NP 39.5% 54.8% 5.7%
PA 21.6% 70.3% 8.1%
ME 88.9% 8.1% 3.0%
793 distinct medical certifiers have used EDRS to date during 2014. 4,393 medical certifiers signed death certificates.
Funeral service practitioners generally start records (except OHSU and State ME)
FSP provides to medical certifier or Medical Examiner in OVERS or on paper (hybrid)
After medical certification:◦ If paper or hybrid, goes to county to file and issue,
then forward to state for registration.◦ If electronic, state registers and available at state
and county to issue.
Who is involved in the EDR process?
Moving from paper to electronic death registration
2006 2007 2008 2009 2010 2011 2012 2013 2014 ytd0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
ElectronicHybrid Paper
New law
New resources◦ Communicating the importance of EDR◦ Improving partnership with State ME◦ Dedicating staff & resources to focus on
implementation in hospitals◦ Real time public health surveillance
What our we doing to increase the percentage of fully electronic records?
Why is EDR important?
Within 5 days 6 - 10 days 11 - 15 days 16 - 20 days More than 20 days0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%August 2014 deaths -
Timeliness of Registration by method filed
Electronic
Hybrid/Paper
To the family◦ Faster access for financial and legal needs
To the funeral home◦ Faster access for the family◦ Fewer amendments for missing information◦ Accurate social security numbers◦ Less expensive in staff time, delivery costs
Don’t have to track down doctors to get paper signed
Why is EDR important?
To the hospital◦ Reports of death never misplaced◦ More secure◦ Funeral directors don’t come to facility to find
doctors◦ Process is easy, quick, traceable◦ Fewer contacts with vital records for corrections
on missing items◦ Medical certifiers can do electronic amendment◦ Comply with law
Why is EDR important?
To CHS◦ Faster registration and faster amendments◦ Fewer amendments, particularly around
Blank/missing items Social Security numbers Insufficient cause or missing injury information
◦ Comply with law (required for deaths in hospitals)◦ Meet national expectations on timeliness◦ Meet CDC contract for expanded use
Why is EDR important?
To Public Health◦ Information on number of deaths in almost real-
time◦ Information on causes of death more timely◦ Information on rare causes or emerging causes of
death more timely
Why is EDR important?
80% fully electronic by August 2015
Do not anticipate 100% electronic◦ 2013 deaths 33,906 registered deaths◦ 4,928 medical certifiers
14 signed more than 100 records (mostly ME) 36 signed 50 – 100 records 899 signed 10 – 49 records 3,979 signed fewer than 10 records
1,743 signed one record
Goals for adoption
Method death record filed for facility deaths by month (non-Medical Examiner)
Facility where death occurredSeptember
Electronic %Harney District Hospital 3 100.0%Lake District Hospital 1 100.0%Tillamook Regional Medical Center 1 100.0%Doernbecher Children's Hospital 1 100.0%Blue Mountain Hospital 1 100.0%OHSU Hospitals and Clinics 54 98.2%
Sacred Heart Medical Center - RiverBend 39 81.3%
Legacy Emanuel Medical Center 10 71.4%
Legacy Good Samaritan Medical Center 8 66.7%
St Charles - Madras 2 66.7%
Kaiser Foundation Hospital - Westside 5 62.5%
Tuality Community Hospital 6 60.0%Adventist Medical Center 12 57.1%Sky Lakes Medical Center 5 55.6%Legacy Mount Hood Medical Center 6 54.5%
Getting hospitals on EDR
Signature pads – targeted at medical certifiers
Other functionality for funeral homes◦ Enter time of death in record if no medical owner◦ Change date of death in record if no medical
owner◦ Medical certifier to refer to funeral home
Ordering online 24 hour receipt of body notice (card)
Future plans
OVERS help desk One-one with CHS staff Newsletters Emailed notices and alerts Information on the web Training on the web Webinars Reports
Communication
34
Questions or comments?
35