Electronic Death Registration System (EDRS): New York City’s Implementation of the National Model

1. Electronic Death Registration System (EDRS):New York City’s Implementation of the National Model Flor Betancourt, Director NYC Vital Records Registration NAPHSIS Conference - June 2005

2. EDRS National Team • New York City • Alabama • California • Florida • New York State • Washington State • NAPHSIS • NCHS • SSA NAPHSIS Conference - June 2005

3. 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 NAPHSIS Conference - June 2005

4. 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 NAPHSIS Conference - June 2005

5. 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 NAPHSIS Conference - June 2005

6. Designing EDRS - 4 • Establishing hardware and technical requirements • Host environment • Servers-Web, application, database • Integration with NYC’s 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 NAPHSIS Conference - June 2005

7. 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-electronic certificates • Corrections and amendments • Biometric authentication • Medical Examiner • Creating interface • Case referrals • Cremation clearance NAPHSIS Conference - June 2005

8. 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 NAPHSIS Conference - June 2005

9. Reengineering NYC Business Processes - 2 • Health Code changes enacted in October 2004 • Repealed requirement of filing amputation certificates and cremation affidavits NAPHSIS Conference - June 2005

10. 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 • NYC’s 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 NAPHSIS Conference - June 2005

11. 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 NAPHSIS Conference - June 2005

12. 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 NAPHSIS Conference - June 2005

13. 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 NAPHSIS Conference - June 2005

14. 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 NAPHSIS Conference - June 2005

15. 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) NAPHSIS Conference - June 2005

16. Progress • Sample EDRS screens NAPHSIS Conference - June 2005

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24. 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 NAPHSIS Conference - June 2005

25. 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 NAPHSIS Conference - June 2005