Electronic Death Registration

1. Electronic Death Registration “Never Sign a Death Certificate Again” Presented by Texas Department of State Health Services Texas Vital Statistics www.texasvsu.org

2. New Legislation Requiring Electronic Death Registration House Bill 1739, which mandates electronic death registration for funeral homes and medical certifiers, was signed by the Governor on June 15, 2007, and became effective on September 1, 2008. Section 193.002 of the Texas Health & Safety Code will now require the person in charge of interment or in charge of removal of a body from a registration district for disposition to file death certificates electronically as specified by the State Registrar. Likewise, Section 193.005 requires that medical certifiers on a death certificate submit the medical certification and attest to its validity using an electronic process (currently Texas Electronic Registrar) approved by the State Registrar.

3. Fast Facts As of 3/15/09: • There are 1,228 funeral homes registered to use TER (1,354) • There are 5,168 physicians registered to use TER (15,000) • There are 305 local registrars registered to use TER (400) • There are 13 medical examiner offices registered to use TER (13) • 27% of all death certificates are fully electronic. • 92% of all Social Security numbers are successfully validated using TER

4. Texas Electronic Registrar • Internet Application • Accommodates all levels of participation • Initiates social security verification process • Edits, cross-checks, SSN verification – all reduce potential errors • Result – a faster, more efficient, more accurate process

5. Scenarios of Participation Funeral Director Participating Medical Certifier NOT Participating, AND/OR Local Registrar Participating Funeral Director • Initiates D/C in TER (demo tabs 1-5) • Validates social security info with SSA • Designates medical certifier (if participating in TER) • OR • Prints the death certificate from TER - drop-to-paper (DTP) (if medical certifier not participating in TER) • Delivers DTP death certificate to medical certifier for cause of death completion • Files DTP death certificate with Local Registrar

6. Scenarios of Participation Funeral Director NOT Participating Medical Certifier Participating Local Registrar Participating(or NOT) • If coordinated between Medical Certifier and Funeral Director – Medical Certifier may initiate record in TER • Medical Certifier prints the death certificate from TER (drop-to-paper) • Funeral Director completes appropriate death certificate information manually • Funeral Director delivers death certificate to Local Registrar • Process continues as it does currently…

7. Scenarios of Participation Funeral Director Participating Medical Certifier Participating Local Registrar Participating 100% TER Death Registration!

8. What about my Signature? • When Funeral Directors and Medical Certifiers (Physicians, JP’s, ME’s) are entered as users in TER, they are assigned a temporary PIN (Personal Identification Number). • The first time each Funeral Director or Medical Certifier verifies/certifies a record, they will be required to change the PIN to a number only they will know. • This PIN must be kept confidential; therefore, each Funeral Director and each Medical Certifier MUST verify/certify their own records (in other words, the signature process cannot be delegated to office staff). • The PIN holds the same legal standing on the electronic death certificate as a signature has traditionally held on the paper certificate.

9. Record Types Medical certifiers using TER will usually only be involved in Electronicregistration. In some cases, a medical certifier may initiate a record in TER and drop-to-paper for a non-participating funeral home. Manual Drop-to-Paper (DTP) Electronic Local Registrar Not using TER (8.5” x 14” only) Using TER (8.5” x 11” only)

10. Computer Specifications • 1.0 gigabyte processor speed or faster with 512MB of RAM or more • Adobe Acrobat Reader • Pentium 4 or equivalent • Windows XP Operating System • Web browser with Flash Player (7.0 or greater) • Internet access at 56K or better • 1024 x 768 resolution color monitor

11. How can I Participate? • Fax Request for TER – Death • Receive Updates • Visit VSU E-Death Website www.tedr.texasvsu.org

12. Click here

14. Start-up email from help-ter@dshs.state.tx.us • Welcome to Texas Electronic Registrar Death Registration • Computer specifications • Resources and website information • Service Level Agreement • Confidential and Non-disclosure Agreement • User ID, Password and PIN number • help-ter@dshs.state.tx.us or help-ter@texasvsu.org • Password Guidance document • Remote Access Security Policies document

15. Start up email from help-ter@dshs.state.tx.us

16. User Setup *see back of TER brochure

17. Let’s get started.

18. Help-TER John Smith The notification prompt will be in the form of an email, or can be sent to any other electronic device that uses an email address (pager, PDA, etc). The email contains the name of the funeral home The basic information about the deceased And the unique EDR #

19. Accessing The Record • Access the Internet by clicking on the icon. • Copyhttps://ter2.dshs.state.tx.us/edeathto the address bar. • Select ‘Enter’ or icon. https://ter2.dshs.state.tx.us/edeath

20. Click on ‘ Thin Client Application ’ This is called the . Portal Page

21. Logging into TER Enter User Name Password Click Login Dr. Kilgore Select Location Click OK

22. Under ‘Functions’, click Medical Data Entry or click on icon This screen is called the Main Menu

23. From the Medical Data Entry screen, click the ‘Search Record’ icon This is the Medical Data Entry screen Let’s retrieve the record.

24. or, select ‘Search’ from the registration menu

25. This is the Search Recordscreen You can search with any combination of items

26. Enter your search information or EDR # Click ‘Find’

27. The system will retrieve all records matching the search criteria

28. Click on the desired record or records – the row(s) will become highlighted Click ‘Select Records’

29. The selected record will be displayed

30. or, click to choose Filter Option

31. Choose desired filter option

32. Click to access records in queue

33. Select record to complete

34. The selected record will be displayed

35. Start entering data on Medical 1 tab

36. Enter First Name and press ‘TAB’ to advance to the next item

37. If there is no middle name, press ‘TAB’ to skip to the next field.

38. If an item is skipped, you will be asked if you mean ‘NONE’ or if you need to complete the item later – if you say NO, the item will resolve

39. Enter the rest of the information, TABBING from field to field

40. Select Date of Death Type

41. Select Type of Place of Death

42. Type the first letter of the name of the Place of Death

43. Select Place of Death

45. The certifier section will already be completed based upon the funeral director’s designation

46. Complete the rest of the items. Clicking ‘TAB’ from the AM/PM field will move you to the next page of information

47. We are now on the Medical 2 Tab

48. Complete each item by selecting the appropriate response from the pull-down lists

49. Quick tip – TER Death will not allow a physician to certify a manner of death other than ‘Natural’. A message will be displayed notifying the physician, who should then ‘DECLINE’ the record. The funeral home can re-designate the record to the appropriate JP or ME for certification.

50. Responding ‘NO’ to the Injury question will “disable” the rest of the injury questions and not allow entry