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New York State

New York State. REVISED CERTIFICATE OF LIVE BIRTH. Peter Carucci Vital Records, NYS DOH Terry Sowinski Bureau of Biometrics, NYS DOH. PRESENTERS. NYS BIRTH REGISTRATION SYSTEM. 131,000 Births Registered Each Year 110 Birthing Hospitals 90 Registration Districts.

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New York State

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  1. New York State REVISED CERTIFICATE OF LIVE BIRTH

  2. Peter Carucci Vital Records, NYS DOH Terry Sowinski Bureau of Biometrics, NYS DOH PRESENTERS

  3. NYS BIRTH REGISTRATION SYSTEM • 131,000 Births Registered Each Year • 110 Birthing Hospitals • 90 Registration Districts

  4. REENGINEERING NYS BIRTH REGISTRATION SYSTEM • Started In Late 1990’s • Part Of Statewide Perinatal Data System (SPDS) • Web Based Birth Registration Is The Core Of The SPDS • SPDS Was Mandated By NYS Commissioner Of Health

  5. SPDS OBJECTIVES INCLUDE • Vital Records Registration • Perinatal Regionalization • Public Health Surveillance & Reporting • Hospital Quality Improvement (QI) • Medicaid Infant Enrollment • Immunization Registry

  6. TO REENGINEER, OR NOT? • PC Based Software For A Decade • Data Is Not Timely • Technology Not Current • Dot Matrix Printers • File Downloads Of Encrypted Data

  7. TO REENGINEER, OR NOT? • NCHS • Implementation Date For The New U.S. Standard Certificate • January 1, 2003 • Possibly Allow States To Implement As Late As 2004 or 2005

  8. DECISION TIME! DO WE DESIGN THE WEB SYSTEM AROUND THE OLD U.S. STANDARD REVISION?

  9. PROS: Less Design Less Testing CONS: Will Have To Revise As Soon As Web System Is Completed Hospitals Would Have 2 Major Changes Switch From PC To Web System Adapt To New U.S. Standard Items

  10. CONSIDERATIONS • Would State Have Fiscal Resources For 2nd Major Revision? • Unlikely And Funding Uncertain • Delay Implementation For One Year? • Hospitals And Registrars Would Face Only One Major Change • Can Current Staff Accomplish Reengineering And U.S. Standard Revision?

  11. AND THE ANSWER IS… • Planned To Implement Web Birth Certificate On January 1, 2003 • Decision Made To Reengineer And Revise To Comply With New U.S. Standard Certificate • January 1, 2003 Implementation Date Is Unrealistic • Mid-Year Implementation Considered • January 1, 2004 Feasible

  12. FORGING AHEAD

  13. Compare Current NYS Data Dictionary To Vital Statistics Birth Edit Specs Item By Item Review • Determine If NCHS Proposed Changes Will Meet Needs Of NYS DOH • Internal DOH Program Areas • Determine If NYS Law Requires Certain Items Be Collected Or Not Be Collected • NYS Law Prohibits Asking About the Marital Status Of The Parents • NYS Law Mandates Serological Testing And Date Questions Be Asked

  14. STILL FORGING AHEAD • Determine What Items We Want To Accept Completely or Modify • Apgar Scores 1-5-10 Minute • Left 1 Minute Score • Added 10 Minute Score • Eliminate Special Interest Items • Another Tool Should Be Used • Removed Poorly Reported Items

  15. REVISIONS • NYS Accepted U.S. Standard Revisions Completely For: • Race • Ethnicity • Education • Smoking Questions • Breast Feeding • Date Of Last Prenatal Visit

  16. REVISION EXAMPLES

  17. REVISION EXAMPLES - EDUCATION • Change From Number Of Years Of Education To Specific Levels And Degrees • Changes Are Driven By: • Decreased Importance Of Exact Measure Of Elementary Years • Increased Importance Of Post-secondary Education

  18. Selections Available In Drop-down List: • 8th Grade Or Less • 9-12th Grade: No Diploma • High School Grad Or GED • Some College Credit, But No Degree • Associate Degree • Bachelor’s Degree • Master’s Degree • Doctorate Degree • Unknown

  19. REVISION EXAMPLES - OTHER

  20. WORK BOOKLETS

  21. Completely Revised • Includes NCHS Changes • Includes QI Questions • Matches Screen Flow • Collect Information From Best Source • Mother And Medical Staff • Available In English And Spanish

  22. WORK BOOKLETS • Hospitals Should Not Modify • Modifications Lead To Data Quality Issues • Hospitals Should Use The Workbooks Provided To Ensure The Data Collection Process Is Accurate And Consistent Statewide

  23. COMMUNICATION, AND LOTS OF IT • Choose Beta Test Sites • Large, Small, Urban and Rural • Requires Double Entry • Requires Feedback From Beta Testers

  24. COMMUNICATION, AND LOTS OF IT • Letters to All Birthing Hospitals • New System Will Be Put In Place • Old Certificates Will Not Be Accepted • Hardware Requirements • Minimum Computer Configuration • Software Requirements

  25. COMMUNICATION, AND LOTS OF IT • Letters To Local Registrars • Newspaper Announcement No Longer Offered In SPDS • HIPAA • New System Put In Place • Old Certificates Will Not be Accepted • Sent A Supply Of New Work Books • Sent FAQ’s • Training Details Given

  26. COMMUNICATION, AND LOTS OF IT • Letters To County Health Departments • Old System Will Become Obsolete • How New System Will Affect Them • Training Details Given • Meetings With DOH Data Users • Explain And Help Prepare Them For Changes

  27. TRAINING SESSIONS FOR HOSPITALS AND LOCAL REGISTRARS

  28. Statewide Training Via Videotaped Satellite Teleconference • Approximately 20 Sites • Live Panel Discussion • Phone Calls And Faxed Questions From Audience Members Accepted • Mailed Video Tapes To All Hospitals For Training Of Future Employees

  29. TRAINING SESSIONS – COUNTY DOH • Three, One Hour Live Video-Conference Training Sessions Held To Accommodate All 57 Counties

  30. RECOMMENDATIONS FOR HOSPITALS TO PREPARE FOR IMPLEMENTATION • Get Up To Date With Filing Records • Review New Workbooks And Guidelines • Make Arrangements To Ensure New Data Items Will Be Available For Entry Into New System

  31. USER HELP • Hyperlink For Each Item Leads To Expanded Text • On Screen Documentation • Help Desk To Support Hospitals With A Variety of SPDS Related Problems

  32. ON-SCREEN HELP

  33. USER DOCUMENTATION • Available Online In PDF Format • Hospital Instruction Manual • County Instruction Manual • FAQ’s • Medical Guidelines And Glossary • Work Books, English And Spanish • Contact Listing

  34. Support Desk • Toll Free Number • Support Desk E-mail Address • Two Person, Full Time For First Three Months • One Person, Half Time For Next Nine Months • Plus Additional Help After Major Revision Is Released • Tracking System For Every Call • From Initiation To Resolution

  35. RECOMMENDATIONS TO OTHER STATES • If Possible, Implement U.S. Standard Certificate Changes Prior To Developing Web Based System • Consider: • Time • Money • Human Resources • With the Right Skill Sets

  36. MISSED OPPORTUNITIES (MISTAKES MADE) • Develop ‘Demo’ System That Hospitals Can Practice On Prior To Going Live. • Adequate Staff with Right Skill Sets • Or YOU Will Become The Expert! • Elaborate Testing Plan

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