Strategies for Improving Civil Registration and Vital Statistics Systems: The Canadian Experience

1
Strategies for Improving Civil Registrationand
Vital Statistics Systems The Canadian Experience

• Presentation to the United Nations Expert Group
  Meeting on International Standards for Civil
  Registration and Vital Statistics Systems
• June 27-30, 2011
• Jeff Latimer, Ph.D.
• Director, Health Statistics Division, Statistics
  Canada
• Co-Chair, Vital Statistics Council for Canada
•  
• Josée Dubé
• Director and Registrar General, Vital Statistics
  Branch, Service New Brunswick
• Co-Chair, Vital Statistics Council for Canada

2
The Canadian Model

• The cornerstone of Canadas national system of
  vital statistics is the cooperation and
  collaboration between the thirteen provincial and
  territorial vital statistics registrars and the
  federal government of Canada represented by
  Statistics Canada
• The registration of births, deaths, still-births,
  and marriages is a provincial responsibility
  (divorce registration is a federal
  responsibility)
• The collection and dissemination of vital
  statistics is a federal responsibility fulfilled
  by Statistics Canada under the federal Statistics
  Act

3
The Vital Statistics Council of Canada

• The VSCC is comprised of all thirteen
  provincial/territorial registrars and the federal
  government represented by Statistics Canada
• The mission of the VSCC is to
• Further the evolution of the vital statistics
  system and public health surveillance
• Support the exchange of vital statistics between
  the federal and provincial / territorial
  governments, pursuant to the federal Statistics
  Act
• Assist jurisdictions to fulfill their legislated
  mandates effectively and with excellence by
  sharing ideas and innovations
• The current priorities of the VSCC are focused on
  accuracy, confidentiality and privacy, and
  relevance

4
Registry Training Best Practices

• Full cross training of registry staff allows for
  the segregation of duties when dealing with the
  issuance of identity documents
• The segregation of application acceptance and
  issuance responsibilities is recommended
• Typically, training is guided by documented
  procedural manuals by transaction type
• Timely and accurate training information is
  readily available to all staff

5
Medical Coding Training

• Trainees complete NCHS computer-based modules on
  anatomy, physiology and medical terminology and
  an introduction to ICD-10 as a pre-classroom
  component to both underlying and multiple causes
  training
• All coders take the Basic ICD-10 Underlying Cause
  of Death Classification and the Basic ICD-10
  Multiple Causes of Death Classification courses
• For new coders, the process is generally to
  double code 100 of cases in the beginning and
  then follow a progressively reduced monitoring
  process until discrepancies are at an acceptable
  level

6
Outreach Passport Canada

• Passport Canadas proposed changes to acceptable
  ID documents for passport issuance would
  significantly impact vital statistics registries
  
• Collaborative effort between Passport Canada and
  the VSCC council
• Passport presentation to VSCC highlighted the
  changes under consideration
• Discussion paper including feedback from meeting
  was sent to VSCC members for formal input
• Additional discussions held with individual
  jurisdictions to allow for differences in
  provincial/territorial legislation
• Negotiations ensued on the appropriate timing for
  implementation of the proposed changes
• A communications strategy and accompanying
  outreach materials (press release, posters, etc.)
  were developed collaboratively

7
New Information Technologies

• The National Routing System is a distribution
  system for vital event data
• The traditional bulk file transfer of accumulated
  records is replaced by a messaging system that
  transmits record level data
• As soon as the registration of a birth or death
  is official, information related to that
  registration is distributed in almost real-time
• All data providers and data consumers use the
  same data format and technology
• Creates opportunities for timely data analysis
• Electronic Death Registration and Electronic
  Birth Registration
• Drop-down menus and mandatory fields improve data
  accuracy
• Creates a reduction in paper consumption and
  storage
• Reduces staff time in processing applications

8
Medical Coding Performance Monitoring

• There are a number of best practices currently
  being used within Canada to ensure that the
  medical cause of death coding is of high quality
• Querying death certifiers in order to clarify
  coding issues
• Pre-release review of selected causes of death
• Correlating age with cause of death and sex with
  cause of death for anomalies
• Monitoring the quality of the automated coding
  tools

9
Service Bundling

• Birth bundling is popular with parents as
  registration includes the automatic application
  for
• Social insurance number
• Medical insurance
• Child tax benefits
• Birth certificate
• For Federal departments it has provided cost
  savings, greater data integrity and timely death
  notifications
• Proposed bereavement bundle will allow funeral
  directors to electronically submit death
  registrations to Vital Statistics registrars
• Bundling allows for common communication to
  citizens on services provided by the Government

10
Future Priorities

• Increased access to vital statistics data
• Pilot project to include vital data in Research
  Data Centers
• Provide historical birth and death data free on
  website
• Improve Statistics Canada website to provide
  easier access
• Improved timeliness of vital statistics data
• release preliminary data 6 to 9 months after the
  end of the reference period and develop a
  revision policy for final data
• Work towards 100 of vital events transmitted to
  Statistics Canada through NRS
• Improved quality of vital statistics data
• review existing data standards and develop an
  annual review process
• develop mechanism to audit the quality of the
  cause of death coding
• develop service standards to improve the quality
  and timeliness of data