Kelly Baker, MPH

State Registrar of Vital Records

Oklahoma State Department of Health

Partnering to Enhance Electronic Death Registration for Disaster Related Deaths

Sixth Annual National Disaster Epidemiology Workshop May 13-14, 2015 Atlanta, GA

Electronic Death Registration System (EDRS)

• It takes a village… to file a death certificate

– Family, Funeral home, Physician, Medical Examiner/Coroner, State

• Fact of Death (part 1)

– Decedent’s legal name, age, address, SSN

• Cause of Death (part 2)

– Cause, manner, location, contributing factors

Jurisdictions with EDRS NAPHSIS - March 2015

EDRS is here to stay

• Accessibility for data providers

• More complete

• More accurate

• More timely

• More secure

• Fewer duplications

• Less costly

May 2013 Moore, Oklahoma

Direct and Indirect Tornado Deaths Oklahoma, May 2013

0

2

4

6

8

10

Less

th

an 1

1-4

5-1

4

15

-24

25

-34

35

-44

45

-54

55

-64

65

-74

75

-84

85

+

Fre

qu

en

cy

Age

Direct Indirect

0

5

10

15

20

25

30

May 19 May 20 May 31

Fre

qu

en

cy

Event Date

Direct Indirect

BY EVENT DATE BY AGE

N=49 34 Direct; 15 Indirect

Impact During A Crisis Response

• Medical Examiner filing Death Certificates within 4 hrs

– Immediately ready for transmission to Funeral Homes

• Automatic Birth-Death Linkage

– Deaths to those born/reside outside OK immediately sent to appropriate state

• Records were flagged for future analyses and tracking

• Unduplicated casualty counts

• Deployment for on-site issuance of BCs to victims

– Assist with re-establishing identities

Many Sources of Disaster Data

• Vital Records

• Medical Examiners/Coroners

• Emergency Operation Centers

• Public Health and Mass Fatality

• FEMA

• National Weather Service

• American Red Cross

• Media

Issues to Consider

• Type of event

• Out of state medical facilities

• Delayed deaths

• Cause of Death related to disaster

• Preliminary vs final

• Do you have the right bells & whistles?

• State Size

• Development: In-house vs vendor

• Existing equipment/licensing needs e.g. upgrades

• Can it be integrated into existing systems

• Will data conversion be required

• How soon do you need it?

• Cost

EDRS Vary – A Lot!

Planning Partners

• Vital Records

• Doctors/Medical Examiners/Coroners

• Funeral Directors

• Epidemiologists

• Emergency Preparedness

Who’s Going to Pay for It?

• Lack of Available Resources is a Barrier

– Financial and human capital

• $20 million*

– Complete implementation for all jurisdictions

– Increase use among death data providers

– Modernize existing systems

– Training to data providers

*National Association of Public Health US Senate Testimony 3/16/15

CSTE/NAPHSIS Project Disaster Related Mortality Surveillance

• Timeline Aug 2014 – June 2015

• Engage subject matter experts

– to establish a mutual understanding for identifying and tracking disaster-related deaths using state-based EDRS.

• Facilitate the publication of the consensus agreements

• Gather and disseminate resources

– literature review, EDRS reports or surveys, web portal development, editorial support, and conference calls.

• April: Summit scheduled in Silver Spring, MD

• May: Finalize deliverables and communication plan

• Oklahoma Vital Records

• Derek Pate, DrPH OSDH Health Care Information

• Sheryll Brown, MPH and Tracy Wendling, DrPH OSDH Injury Div

• Cathy Molchan Donald Alabama Center for Health Statistics

• National Association of Health Statistics and Information Systems (NAPHSIS)

• Rebecca Noe, MN, MPH FNP-BC National Center for Environmental Health Public Health Service, CDC

• Margaret Warner PhD NCHS

Contact: KellyB@health.ok.gov www.NAPHSIS.org