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Electronic Death Registration Systems Project
In January 1997, the report Toward an Electronic Death Registration System in the United States: Report of the Steering Committee to Reengineer the Death Registration Process was prepared by a task force representing federal agencies (the National Center for Health Statistics and the Social Security Administration) and professional organizations representing funeral directors, physicians, medical examiners, coroners, hospitals, medical records professionals, and vital records and statistics officials (NAPHSIS). The committee examined in detail the feasibility of developing electronic death registration in the United States. The conclusion of the report was that the introduction of automated registration processes in the States is a viable means to resolve several historical and continuing problems in the process of death registration.
Death certificates are used in the United States for administrative and public health purposes. For nearly a century the States have managed centralized vital records agencies to collect, process and archive death certificates. Death records are universally recognized as the primary source of death information, but registration processes remain labor intensive, employ disparate and limited automated procedures, and require several professionals at different locations to complete each of the more than 2.3 million death certificates registered each year.
Since the origination of civil vital records registration in the United States, death certificate completion has mostly remained the provenance of funeral directors, with physicians and frequently medical examiners and coroners providing cause and manner of death information. Manual certificate preparation, including the personal delivery of records to physicians for signature, extensive and costly travel by funeral director staff to file certificates, and labor-intensive processing of paper records locally and at state Vital Records offices, all contribute to slowing registration and delay the availability of death data.
Furthermore, even though each state has laws requiring the registration of death records within a specific time period, a significant number of certificates are not appropriately filed, may contain incorrect or inconsistent entries, or are not finalized until many weeks after the death occurred. In addition, incomplete death certificates and coroner cases may take weeks or even months to resolve. These late-filed, partially completed or inaccurate death certificates are not acceptable for use by family members, nor do they meet federal administrative needs or satisfy the information demands of local, state and federal agencies. In fact, they can adversely affect mortality statistics which are routinely produced by state and federal agencies. Automating death registration processes is the key to addressing these long-standing issues.
The States and federal agencies understand the shortcomings of death registration methods currently practiced in the United Sates. Now that recent advances in computer and network access technology allow for the practical and efficient development and implementation of automated systems to register death information, several registration areas have independently pioneered electronic death registration methods. These different approaches will serve as the basis for developing standardized EDR attributes, methods and processes in order that the States may successfully implement electronic death registration to satisfy administrative and statistical death information needs.