Electronic Death Registration System EDRS: New York Citys Implementation of the National Model

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Electronic Death Registration System (EDRS)
New York Citys Implementation of the National
Model

• Flor Betancourt, Director
• NYC Vital Records Registration

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EDRS National Team

• New York City
• Alabama
• California
• Florida
• New York State
• Washington State
• NAPHSIS
• NCHS
• SSA

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Designing NYC EDRS

• Basis for our new system
• National model-NAPHSIS NCHS standards
• Use-case modeling
• NYC system requirements developed prior to
  national model
• Vendor modified existing application to comply
  with national model
• Vendor supported and promoted national model
• Joint Application Design (JAD) sessions

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Designing NYC EDRS - 2

• Fitting into the big picture
• Identify our common functions
• Model addresses 80-85 of our needs
• Understanding concept of developing system
• Becoming familiar with national model
  requirements
• Importance of creating system requirements
• Use case modeling
• Alternative workflows
• Terminology
• Identify and document software and hardware
  requirements

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Designing EDRS - 3

• Our business needs
• Incorporate business rules and workflows
• Registration, nosology, manual and electronic
  filing, electronic corrections and amendments,
  statistical analyses, SSA verification
• User (stakeholders) groups
• Funeral homes, hospitals, Medical Examiner,Vital
  Records registration staff
• JAD and Steering Committees
• User-friendly system
• Intuitive and easy to navigate
• Timely filing
• Improved customer service

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Designing EDRS - 4

• Establishing hardware and technical requirements
• Host environment
• Servers-Web, application, database
• Integration with NYCs health portal NYCMED
• Integration with Office of Chief Medical Examiner
• Security patches
• Creating disaster recovery plan
• Duplicate and identical set of hardware/software
• Supports ongoing maintenance (data replication)
• Maintain manual systems as backups

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Designing NYC EDRS - 5

• Identify NYC extensions from national model
• Relinquishment of cases
• Trade calls
• Printing disposition permits
• Submission of manual and part-manual/part-electron
  ic certificates
• Corrections and amendments
• Biometric authentication
• Medical Examiner
• Creating interface
• Case referrals
• Cremation clearance

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Reengineering NYC Business Processes

• National model helped evaluate current business
  processes
• Benefits to changing certain business processes
• Model served as point reference for making
  decisions
• Antiquated business processes not consistent with
  other jurisdictions
• Consistent with the national model

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Reengineering NYC Business Processes - 2

• Health Code changes enacted in October 2004
• Repealed requirement of filing amputation
  certificates and cremation affidavits

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Reengineering NYC Business Processes - 3

• Legislation passed to amend NYC administrative
  code for electronic submission of certificates
• Creation and implementation of EDR
• National model provided foundation for NYC
  compliance to Local Law 2
• NYCs EDR compliant with Local Law 2
• Internet-based system, electronic data entry,
  electronic transmission, electronic corrections
  and amendments, electronic authentication,
  electronic printing of disposition permits
• Create Advisory Panel-consist of funeral
  directors, MDs, and medical examiner, DOHMH staff

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EDR System Features Phase I

• Setting user profiles
• Electronic validation and submission by MDs and
  funeral directors
• Electronic numbering of death certificates
• Will replace current numbering system
• Supports fully electronic and hybrid submissions
• Electronic review and approval by Vital Records
  staff
• Electronic ordering and payment of death
  certificates
• Biometric authentication

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Prototype Review

• Review of screen shots
• Ensure system is consistent with national model
  guidelines
• Ensure system requirements incorporated into EDR
• Ensure validation rules fire in appropriate
  fields
• Opportunity to enhance system requirements
• Review ease of navigation
• Clear, logical screens
• Field labels

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Evaluation Phase Testing the System

• Test scripts
• System functionalities including validation
• Integrated functionalities (hospitals, funeral
  directors, registration staff)
• Electronic ordering and payment
• Response time between screens
• System connections
• Technical support

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Evaluation Phase - 2

• Application demonstration to pilot hospital and
  funeral directors (12/04)
• Testing and training for pilot hospital and
  funeral directors (3/05)
• Biometric authentication functionalities

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Evaluating EDR - 3

• Biometric authentication
• Fingerprint recognition device
• Recommended by national reengineering committees
• Assess compatibility with EDR
• Electronic signatures-medical certifiers and
  funeral directors
• Electronic signature combination of username of
  PIN (identity verification) with biometric device
  (user authentication)

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Progress

• Sample EDRS screens

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Future Plans

• Marketing
• Roll-plan
• Literature
• Developing EDR website
• Going live with first participants
• SSA Validations
• Corrections and amendments
• Medical examiner certificates and interface
• Complex transactions funeral home trade calls,
  funeral home relinquishment of cases
• Defining requirements for OCME EDRS interface
• Conducting gap analysis-identifying additional
  needs

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Lessons Learned

• National model serves as groundwork for
• Base set of requirements
• Standard for rules and workflows
• Contact other jurisdictions with experience
• Know current business processes
• Involve all staff
• Consider changes to current business processes
• Establish key staff to test system thoroughly
• Use NAPHSIS resources
• Do not make assumptions